Abstract: Objective: Farm to school (FTS) programs provide many established benefits to students and the community; however, fish to school programs are a less studied subset of FTS. The objective was to identify how fish to school programs are implemented, their impacts, and the enabling factors to support these programs. Methods: We conducted formative research and interviewed stakeholders from 2 school districts in Oregon in 2019. Results: Interviewees reported benefits of connecting students and the larger school community with local food and creating excitement from new lunch offerings. Factors that facilitated fish to school programs included strong program leaders and partnerships, FTS grant funding, and the creative use of resources. Challenges in maintaining the program included sustainable program funding, seafood distribution networks, recipe development, and higher cost per serving of seafood compared to other proteins. Conclusions: Resources exist for school professionals interested in starting or sustaining fish to school programs. These programs are difficult to launch and sustain, and thus, require many forms of support (institutional, financial, industry, culinary, etc) and benefit from innovations like fish to school aggregators and product development such as pre-prepared fish options.

Abstract: Objective To test whether a previously tested, small-changes weight loss program could be translated for use in African American churches. Methods The program consisted of 12 group sessions held weekly at a partner church. Key intervention messages were disseminated via Facebook. A single-arm pretest-posttest evaluation included assessments at baseline, program completion (3-month), and after three months with no contact (6-month). Results Participants (N = 17; 16 women, age 57.5±12.1 years, body mass index 36.5 kg/m2±5.4, hemoglobin A1c 6.3±0.5, blood pressure 132±14/82±7) attended an average of 77% (mdn=9) of treatment sessions and 94% and 100% completed the 3- and 6-month assessment visits. All participants reported they were "somewhat" or "very satisfied" with the program. There was minimal interaction with Facebook with an average of 0.5 comments and 3.9 reactions per post. Three- and six-month reductions (all p's≤.01) were observed for weight (mdn=-2.7 kg; mdn=-2.6 kg), waist circumference (mdn=-3.8cm; mdn=-5.1cm), and hemoglobin A1c (mdn=-0.5; mdn=-0.3). At 3-months, there were significant reductions in systolic (mdn=-10.7 mmHg) and diastolic blood pressure (mdn=-8.0) but not at 6 months. Conclusions This study suggests that a faith-based, faith-placed intervention utilizing a small-changes approach in African American churches may achieve sustained weight loss in parishioners with obesity.

Abstract: 79 Food availability, accessibility, and affordability have central roles in shaping an individual’s diet and subsequent health outcomes.1 In turn, a consumer’s knowledge and attitudes toward food affects purchasing, and consumer demand influences what is sold in neighboring stores.2 Multiple socio-ecological influences mediate food choice behaviors and nutrition across populations.3 Individuals purchase foods based on a complex system of taste preferences, sensory appeal, convenience, economic value, social norms, observation of shopping behaviors of others, and community or policy structure.3,4 Whereas many nutrition studies focus on increasing knowledge of the specific attributes of foods, such as fiber, protein content, or chronic disease health benefits, other food characteristics and socio-ecological factors may be more important influencers for purchases.5 To serve immigrant and multicultural populations, there is an increasing need for available, accessible, and affordable culturally diverse food resources in the communities where they live. Low income and rural areas are disproportionally affected by a paucity of stores.6 These geographic areas may be characterized as “food deserts” due to a lack of mainstream grocery outlets.7 Poor nutrition environments have limited healthy, quality, and affordable foods accessible to buyers.1 If healthy foods are not obtainable from local grocery stores, shoppers already motivated to purchase such items are restricted from buying them, and potentially interested shoppers are more likely to continue making less beneficial choices. Research supports that higher fruit and vegetable availability in stores increases the likelihood of consumer purchase.8 Indirectly, improving food access can foster increased

Abstract: For nearly 60 years, public health authorities have labeled the linkage of heart disease and several cancers with cigarette smoking as a public health “crisis.”1 Noted authorities also have cited obesity as “epidemic,” and a “crisis” for the public health community resulting from some 3 decades of decline in both physical activity and wise nutritional choices.2 Furthermore, numerous scientists, physicians, and organizations call the emergence of opioid use and addiction during the past decade as America’s new “public health emergency”3 and a “public health crisis.”4-7 Even in the past year the phenomenon of vaping and the skyrocketing sales of e-cigarettes have contributed to the widespread use of the term “crisis” in the public health lexicon.8-10 It is possible that COVID-19’s emergence requires that public health officials, social scientists, elected officials, and others of influence in decision-making and policymaking reassess the definition of what constitutes a “public health crisis.” Moreover, the scourge of COVID-19 has revealed the foolhardiness of years of neglecting or underfunding health education and services in schools, the fragility of America’s education system, and the vulnerability of America’s older adult population. In this commentary, we review the consequences of inaction by policymakers for citizens of the United States (US), despite there being a rich history of evidence-based studies, recommendations, and appeals.

Abstract: Objective: We investigated racial differences in overweight and obesity among 4 subgroups: (1) Whites at historically black colleges and universities (HBCUs); (2) Whites at non-HBCUs; (3) Blacks at HBCUs; and (4) Blacks at non-HBCUs. Methods: We conducted multivariable logistic regression using cross-sectional data to examine correlates of overweight or obesity by race and school type among white and black students (N = 260,719) who completed the American College Health Association-National College Health Assessment IIb from fall 2011 to spring 2015. Results: Among men, more Whites at HBCUs than Whites at non-HBCUs (22.22% vs 9.67%; p < .001) and more Blacks at HBCUs than Blacks at non-HBCUs (27.84% vs 16.64%; p < .001) had obesity. Among women, more Whites at HBCUs than Whites at non-HBCUs (25.82% vs 8.80%; p < .001) and more Blacks at HBCUs than Blacks at non-HBCUs (27.62% vs 20.58%; p < .001) had obesity. Overall, highest adjusted odds ratios for overweight and obesity were observed for Blacks at HBCUs (p < .001). Conclusions: Findings suggest the need for implementation of aggressive overweight and obesity prevention strategies for students at HBCUs. Additional research is needed to understand determinants of overweight and obesity among students at HBCUs.

Abstract: Objective:The United States COVID-19 outbreak shuttered public and private schools, confining more than 55 1 million students to their homes In this paper, we discuss the unique vulnerabilities faced by families affected by pediatric diabetes as well as structural issues exposed by the COVID-19 pandemic Methods: Drawing on clinical and anthropological expertise, we review the unintended consequences of remote schooling for management of pediatric diabetes and other chronic health conditions Results: We identify multiple barriers to pediatric diabetes care imposed by conditions during the COVID-19 pandemic We propose a 4-tiered policy solution that aims to improve crisis response and to protect the health of children with chronic conditions, like diabetes, long-term Conclusions: The COVID-19 pandemic has precipitated wide disruptions to schooling, employment, finances, and transportation, placing enormous burdens on families that care for a child with diabetes Comprehensive policies supporting integrated diabetes care, student accommodations in remote learning conditions, extended medication supplies, and increased healthcare access would not only prevent adverse outcomes for children with diabetes in crisis settings, but also lay a durable foundation needed to increase health equity of all children living with chronic conditions

Abstract: Objective: In this investigation, we identify the questions youth in a low-income urban community asked healthcare providers about COVID-19 Methods:This formative qualitative study consisted of analyzing data collected using Poll Everywhere as part of 3 phone town halls with a pulmonary and critical care medicine physician and youth Results: During the 3 town halls, there were 143 participants who asked 43 questions that were divided into 4 codes: Healthcare, Cure, General COVID-19, and Prevention Conclusion: Youth have questions about healthy behaviors and treatment that can be answered in a low technology forum engagement with health professionals These results also underscore the need to continue health education discussions either through traditional school-based or alternate formats, especially as we anticipate COVID-19 to last during the next academic year

Abstract: Objective: In this commentary I argue that rapid reopening of schools for in-person instruction in the United States is unwise and likely to extend the duration of the COVID-19 pandemic Methods: I review various sources of information and raise issues less frequently and thoroughly addressed in noted plans to expedite school reopening Results: Whereas the focus has been on preparing plans of action for in-person instruction on the first day of school that minimize risk to pupils and school personnel, aspects of these plans are operationally unsound Additionally, opinions among school personnel and parents for rapid reopening are far from unanimous Moreover, the potential health impact on teachers, bus drivers, and other school personnel, as well as pupils, and the potential for another shutdown are phenomena with real probability Conclusion: Despite government-led arguments favoring rapid restoration of in-person instruction, I argue that school reopening should take a wiser approach, sustaining remote instruction until pandemic statistics place people at substantially reduced disease risk

Abstract: Objective People who use drugs (PWUD) face increased risk of exposure to COVID-19, but also elevated risk associated from injection drug use. We describe factors underlying their increased risk and identify mechanisms for reducing or minimizing rates of COVID-19 transmission and other health outcomes. Methods Our commentary draws upon empirical data, governmental and other reports, and field-based unpublished data from our own studies to inform our conclusion and recommendations. Results Co-morbid health conditions (eg, diabetes), structural challenges (eg, homelessness, criminal justice involvement), stigma (eg, social devaluation, discrediting), and syndemic clustering of of overdose, HCV, and HIV among PWUD are exacerbated by COVID-19. Conclusions Beyond the many challenges all people face to remain safe and healthy during the COVID-19 pandemic, PWUD face additional barriers to remaining safe not only from COVID-19 but from negative health outcomes associated with their living environments, socioeconomic positions, and injection drug use. Collaborative efforts among governmental agencies, health providers, SSPs, CBOs, and other agencies providing services to PWUD is essential to the development of programs and services to meet the many needs of PWUD, which have been particularly accentuated during the COVID-19 pandemic.

Abstract: Objective: People who work in or who are confined to correctional facilities are at high risk for exposure to COVID-19 In this paper, I describe the at-risk populations in correctional facilities and identify mechanisms for reducing or minimizing rates of COVID-19 transmission Methods: Risk reduction involves careful situational analysis and adaptation of communicable disease control procedures Results: Prevention, identification and quarantine, and treatment are 3 steps that can reduce and minimize risk of infection to correctional facility workers and incarcerated individuals Conclusions: Incarcerated individuals are particularly vulnerable to COVID-19 exposure, infection, and disease consequences due to their high incidence of chronic disease and poor health in general, as well as the conditions of confinement Humane and immediate steps to prevent, diagnose, and treat COVID-19 among individuals in correctional settings are needed © 2020, Paris Scholar Publishing All rights reserved

Abstract: Objective Despite widespread support for salad bars as a means to increase fruit and vegetable (FV 3 without [control]) were randomly selected. Digital imagery plate waste methods assessed FV N = 799 control) from 1st-5th grade students were analyzed (92.5% NSLP participation; 98.6% racial/ethnic minority). Results Salad bar usage varied widely (8.2%-63.8%). Different patterns of FV q < .001) and vegetable consumption higher in 2 salad bar schools (+15.3g [q = .005]; +8.3g [q = .022]), compared with matched controls. Students in 2 salad bar schools selected more fruit than controls (+30.2g and +18g; qs < .001), yet fruit consumption differed across all 3 pairs. Conclusions Salad bar access might facilitate children's vegetable intake. Inconsistent results across school pairs suggest that school food environment factors other than salad bar access influenced F&V consumption.