Background: Participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is associated with improved health outcomes. However, WIC participation has declined in recent years, prompting the introduction of telehealth services to enhance accessibility.

Methods: Using a mixed-methods approach, we evaluated staff satisfaction, preferences, and willingness to use telehealth in WIC programs across three states: Georgia, Michigan, and Wisconsin. Staff surveys and semi-structured interviews were conducted during the early and late phases of telehealth implementation (2022-2023). Descriptive statistics and multivariate logistic regression were used to analyze survey data, and qualitative interviews were analyzed thematically.

Results: A total of 116 surveys were completed by 89 staff members, significant increases were noted in satisfaction with telehealth services over time (odds ratio [OR] = 2.435) and among staff providing breastfeeding support with or without nutrition education (OR = 2.969) than those providing nutrition education only. Staff from WI (OR = 9.058), those traveling to satellite clinics pre-COVID (OR = 3.738), and those participating in WIC as a client in the past (OR = 4.523) showed a preference for continuing telehealth use. Qualitative data highlighted the user-friendly nature of telehealth platforms, flexibility in service delivery, and the perceived potential for increased caseload, alongside the need to address barriers such as internet connectivity issues hindering satisfaction.

Conclusions: Telehealth services have the potential to improve service delivery within WIC programs. Further research should identify strategies to address technological barriers and the long-term impact of telehealth on service effectiveness in at-risk populations.

Introduction: Healthy default beverage (HDB) policies limit the beverages offered with restaurant children’s meals to healthier options (water, milk, 100% juice), and may decrease sugar-sweetened beverage (SSB) consumption. However, policy awareness and compliance to date is low. This study aims to compare implementation and enforcement provisions across local and state HDB policies.

Methods: We combine policy document analysis with a survey of HDB policy implementers. Policy documents were compiled from an existing SSB policy database and systematic searches of policy databases and websites. Implementation and enforcement mechanisms and equity considerations were extracted from eligible policies. An online survey in currently ongoing among enacted policy jurisdictions covering policy implementation, enforcement, and equity considerations. A comparative analysis across data sources will be conducted, including descriptive statistics and qualitative approaches.

Results: A total of 28 localities and four states (implemented across 149 counties) have HDB policies. Document analysis revealed information gaps about implementation and enforcement procedures such as communication strategy, training and technical assistance, and funding for implementation and enforcement activities. Equity considerations were largely missing; two policies specified that communication and educational materials be developed in multiple languages. At the conference, we will expand on the document analysis by presenting details about implementation and enforcement gathered from the online survey and compare practices across jurisdictions by population size, poverty level, and number of restaurants.

Discussion: Strengthening HDB policy implementation and enforcement mechanisms, including equity considerations for the populations who may benefit most from HDB policies, is needed to increase their effectiveness.

Introduction: School food service departments across the U.S. serve food outside the National School Lunch Program (NSLP), or competitive foods (CFs). While CFs are required to meet USDA nutrition guidelines, they are generally less healthy than school meals and are linked with lower school meal participation. We examined the prevalence of CF in schools before and after the onset of the COVID-19 pandemic.

Methods: Surveys were conducted in public schools in four New Jersey cities, examining the school food environment from school year (SY) 2014-15 to SY 2023-24. An interrupted time series analysis compared trends in CF prevalence pre-COVID-19 (SY 2014-15 to SY 2019-20, n =152) to post-COVID-19 (SY 2021-22 to SY 2023-24, n=85).

Results: Under the assumption that the pre-COVID trend would have continued if the COVID pandemic (i.e., the interruption in our time series) did not occur, we would have expected 76.5 % of schools to offer CF in 2021. Instead, only 45% did—a 31.5 percentage point decline (p<0.001).

Discussion: These findings suggest that COVID-related disruptions, including the provision of Universal Fee Meal (UFM) programs, supply chain challenges, and increased meal reimbursements, likely reduced the availability of CF in schools. CFs are often less healthy than meals served in the NSLP, and their presence results in lower meal participation. Identifying strategies that allow schools to remove CF, such as UFM programs and increased meal reimbursements, could help create healthier school food environments.

INTRODUCTION: Federally Qualified Health Centers (FQHC) provide accessible healthcare services primarily to underserved populations. Many of these patients are resource deprived beyond simple access to care, reporting food insecurity impacting 13.5% of the United States. With 1 in 5 Arkansas residents facing similar challenges, Community Clinic NWA, a local FQHC, is dedicated to addressing both food security and healthcare access for underserved populations throughout their region of the state. METHODS: In a pilot study (N=43) that provided low income, Marshallese patients weekly produce bags at no cost, through a cost-offset Community Supported Agriculture (CSA) program, and healthy recipes utilizing its contents. The program offered access to healthy foods to a local community with known health disparities exacerbated by poverty, access to care, and educational attainment. RESULTS: Findings from this pilot, while not statistically significant, highlight the importance of patient-centered, intersectional approaches to the social determinants of health identified in at-risk populations. DISCUSSION: Most often, patients diagnosed with chronic illness reported skipping meals due to financial constraint, utilization of local foodbanks, utilization of public assistance programs, and a desire to enroll in health programs that coordinate provider directed care in congruence with access to healthy foods.

Introduction:
Food security solutions are not just about food — they are about creating a reliable system led by community leaders who drive initiatives for food access and justice. The Neighborhood Food Action Collaborative, a network of 30 community based organizations and 50 residents, has flipped the traditional food security model by leading with community-driven solutions that improve immediate food access, build community power, and drive sustainable systems change.

Approach:
In this session, we will review the four components of our community-driven health equity model along with key lessons learned, fast failures, and successes in implementing food security work: (1) identifying barriers, assets, and opportunities, (2) co-designing and incubating community-led solutions with empowered community members, (3) testing proposed solutions for impact and sector-wide shifts, and (4) transitioning initiatives for sustainability.

Results:
Presenters will share how this model has improved food access, health equity, and community power, including: (1) hiring and training 3 community leaders, 31 peer advocates, and supporting 12 members in becoming certified Community Health Workers, (2) co-designing a replicable peer-to-peer public benefit access program that assisted 325 community residents apply for SNAP, (3) recovering and distributing over 300,000lbs of food, serving nearly 20,000 families with culturally relevant food in 2024, and (4) over 80% of coalition members contributing to state and local food policy improvements.

Discussion:
Through the successes of this effort, attendees will learn how this approach can be replicated and applied to food access and other social drivers of health improvement work.

Introduction
Food and nutrition literacy is defined as the knowledge, skills, and behaviors needed to make informed food choices and comprehend the impact of food on one’s health. Adopting healthy eating habits can help prevent or manage conditions like obesity, diabetes and heart disease. According to the recent Community Health Assessment for Prince George’s County, Maryland, chronic conditions continue to lead in poor health outcomes for many county residents. An estimated 71% of adults in the county are obese or overweight. Behaviors that promote good health, such as healthy eating and active living are not accessible to all residents, and not all that do have access have adopted healthy lifestyles.
Approach
The Prince George’s County Health Department (PGCHD) advocates for food and nutrition literacy by implementing evidence-based strategies and interventions to assist individuals and communities in improving their quality of life, making healthier lifestyle choices to manage their chronic disease, and achieving a healthy weight. PGCHD also partners with community organizations to implement and expand outreach efforts to improve health outcomes.
Results
In 2024, an average of 80 participants attended monthly sessions, with a 61% survey response rate. Eighty percent reported making at least one healthier decision post previous session and increased confidence levels for practical application outside and between sessions.
Discussion
• List three valuable tools for making healthier and informed food choices
• Identify food and nutrition literacy self-management activities that support program retention
• Demonstrate a collaborative partnership model that promotes food and nutrition literacy practices

Background:
Despite decades of policy efforts such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), diet-related health issues among children remain a pressing public health concern. Only 51.2% participate. One of the most frequently cited barriers is transportation—especially for single mothers with infants or young children living in food deserts. While some WIC-approved grocery stores offer food delivery services, delivery fees may reduce the perceived and actual value of these benefits. Moreover, policymakers often overlook the spatial distribution of child populations and transportation needs when designing food access policies, limiting the effectiveness of interventions.

Methods:
This study adopts a spatial analytical framework to quantify and visualize the distribution of young children (under age 1) in areas experiencing transportation barriers. Data sources include the U.S. Census Bureau, USDA food desert maps, and community transportation indices. Geographic Information Systems (GIS) are used for analysis.

Results:
Preliminary findings identify clusters of high child population densities in communities with both limited grocery access and poor transportation infrastructure. These areas are underserved despite WIC eligibility, and the lack of delivery options or affordability constraints further limits program efficacy.

Conclusion:
This study highlights the critical need to incorporate neighborhood age structure and transportation data into food policy planning. By identifying geographic gaps in food access for WIC-eligible families, particularly mothers with infants, the findings support targeted delivery subsidies or mobile food services to enhance WIC effectiveness.

Introduction: Front-of-Pack Nutrition Labeling (FOPNL) can help curb the global rise in noncommunicable diseases by promoting nutrition understanding and improving diets. Codex Alimentarius recently published international FOPNL Guidelines. However, commercial interest groups (CIGs), including the food industry, influence Codex processes by joining country delegations or participating as observers, resulting in ambiguous standards, weakened scientific evidence, and enables industry interference in national policymaking. We examined CIG and Public Health Interest Group (PHIG) participation in Codex discussions to understand how they shaped these Guidelines.

Methods: We analyzed CIG and PHIG arguments in 18 publicly available Codex documents from 2019 to 2021. We conducted thematic analyses of the Guidelines’ most contested provisions, identified inductively based on their relevance across the documents. We also traced the Guidelines' drafts to analyze changes during the consensus-building process leading to the final version.

Results: Key provisions included: FOPNL definitions (mandatory vs. voluntary); exclusions (e.g., excluding baby food); conflict of interest (COI) safeguards (e.g., whether FOPNL should be government-led, in collaboration with industry stakeholders); sources of evidence to underpin FOPNL; and trade concerns (e.g., global harmonization). CIG wins included ambiguous voluntary vs. mandatory language, which can undermine compliance and hinder FOPNL effectiveness. PHIGs defended government leadership and stakeholder consultation rather than collaboration in FOPNL policymaking.

Discussion: CIG influence on Codex FOPNL Guidelines led to industry-friendly compromises like the option for ineffective voluntary schemes, while PHIGs supported stronger measures to help prevent COI. PHIG participation in Codex can protect public health from commercial interests and ensure health-driven international standards.

Introduction: Food insecurity is a significant, overlooked challenge in higher education, impacting students’ well-being and academic success. There has been an upward trend in food insecurity rates among college students due to the increasing cost of living and the financial strain of balancing work and school. Despite these challenges, many universities lack institutional efforts and funding for sustainable, programmatic interventions to alleviate food insecurity among college students.
Methods: The student-led group conducted an online mixed-methods survey between February-March 2025 to assess food insecurity and evaluate its impact on students. The survey included the USDA 6-item Food Security Survey Module (FSSM) and questions on barriers to food access, mental health implications, and additional covariates.
Results: Of the 837 respondents, 58% reported experiencing low or very low food security, reflecting a stark increase in food insecurity rates over the past five years. Findings indicate that food insecurity affects student mental health, contributing to feelings of stress, anxiety, and fatigue. Many students also reported that food insecurity negatively impacted their academic performance, limited their participation in an extracurricular activity, or led them to miss a social event. Key barriers to food access included a lack of time to shop or prepare food, transportation challenges, or the high cost of food.
Conclusion: Universities must invest in food security initiatives, like food pantries, shuttles to grocery stores, and meal-assistance programs. In addition, institutions should address root causes of food insecurity by expanding financial aid, fostering collaborations with community organizations, and advocating for local policy changes.

Introduction
Peanut allergies affect approximately 2% of U.S. children. Research, including the LEAP (Learning Early About Peanut allergy) study series, shows early and consistent peanut introduction can reduce the risk of allergy development by up to 86%. Despite this, outdated medical guidance, fear-driven food policies, and misinformation continue to delay or prevent early introduction recommendations, especially in under-resourced communities.

Approach
This session explores community-driven strategies to support safe, timely peanut introduction, including:

• Engaging healthcare providers to promote evidence-based guidance.
• Reframing food allergy policies in schools and childcare centers to allow continued exposure while ensuring safety.
• Using culturally responsive education to increase awareness, build trust, and improve implementation.

These strategies combine scientific recommendations with real-world application, ensuring prevention efforts are inclusive, accessible, and effective.

Results
Programs using these strategies have shown increased parental confidence, higher adoption rates of early introduction practices, and policy shifts toward more inclusive, evidence-based allergy management in public settings. Culturally responsive education and community-based interventions have also proven effective in encouraging peanut exposure among families who may be hesitant due to fear or misinformation.

Discussion
To reduce peanut allergies, we must shift from fear-based messaging to equitable, evidence-based approaches. This requires collaboration between healthcare professionals, educators, and communities to promote safety, access, and confidence in allergy prevention.

Learning Objectives
By the end of this session, participants will be able to:

• Explain key barriers to early peanut introduction.
• Discuss two community-driven strategies for early allergen exposure.
• Evaluate policy approaches that support both allergy safety and continued exposure.