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. 2020 Oct 8;135(6):728–736. doi: 10.1177/0033354920959285

Table.

The US Department of Agriculture congressionally authorized COVID-19 waivers and related RE-AIM research questions for policy and practice change, United States, 2020a

Domain and description Research aim
Reach: number, proportion, and representativeness of eligible students who participated in programs during COVID-19
  • Determine the number and proportion of children who receive meals during COVID-19 school closures.

  • Determine representativeness among children receiving meals during COVID-19 closures of (1) children receiving free meals through the Free and Reduced-Price Meals program or the Community Eligibility Provision and (2) children who had not previously participated in the Summer Meals Program, with attention to race/ethnicity, immigration status, income, and rurality.

  • Describe methods used by state and local authorities to recruit children/families to participate.

Effectiveness: impact of programs on participating students’ quality of life and economic outcomes, including variability across subgroups
  • Compare food insecurity trends between states and localities to describe the variable impact of programs.

  • Identify the impact of other complementary programs (eg, pandemic electronic benefits transfer) on adoption, reach, and implementation of school meals programs.

  • Describe unintended consequences for students (eg, lower nutritional quality of meals, reallocation of funds to nonmeal programs).

Adoption: number, proportion, and representativeness of local authorities who operated during COVID-19
  • Describe organizational characteristics (eg, personnel, readiness, leadership) and geographic distribution of local authorities who mobilized during COVID-19 compared with those who did not.

  • Determine representativeness among local authorities who operated during COVID-19 closures compared with authorities who had previously opened during summer periods.

Implementation: local authorities’ implementation of program requirements and waiver changes, including consistency, time, costs, and adaptations/fidelity
  • Describe common implementation strategies (eg, grab-and-go, delivery, multiple meals) allowable by waivers and used by local authorities.

  • Identify innovative or culturally specific implementation strategies and adaptations used by local authorities serving subpopulations with high rates of food insecurity (eg, rural areas).

  • Describe operational costs of various implementation strategies.

Maintenance: whether student impact is sustained and whether program operations during COVID-19 become part of routine practice
  • Compare long-term child food insecurity trends between states and localities to describe the variable impact of programs.

  • Describe the extent to which implementation strategies fit within the capacity of sites/sponsors during and beyond the waiver period.

  • Describe long-term costs associated with unanticipated mobilization of sponsors/sites during COVID-19 closures.

Abbreviation: COVID, coronavirus disease 2019.

aBased on the RE-AIM (reach, efficacy, adoption, implementation, maintenance) framework.26