Associations Between the US Department of Agriculture COVID-19 Pandemic Waivers and Summer Meal Programs Access and Participation: A Systematic Review

Background: The US Department of Agriculture (USDA) Summer Meal Programs (SMPs) are funded to ensure children from low-income households continue to have access to food over the summer months when most schools are closed for instruction. However, these programs are underutilized compared with school meal programs, in part due to barriers to accessing SMPs. During the COVID-19 pandemic, USDA waived several restrictions related to area eligibility and meal distribution. Objectives: To systematically review the evidence of the association between USDA pandemic waivers and SMPs access (ie, scope and coverage) and participation. Methods: Three electronic databases were searched (PubMed, Education Resources Information Center, and Thomson Reuters Web of Science) to identify peer-reviewed and government studies that examined associations between USDA pandemic waivers and changes in the number of SMP sponsors, sites, participants, and/or meals served. Inclusion criteria included studies conducted in the United States and published in English between August 2021 and June 2024. Qualitative studies, studies conducted only during the school year, or studies that did not examine the association between the waivers and relevant outcomes were excluded. Risk of bias was assessed using an adapted version of the Newcastle-Ottawa Scale. Articles were narratively synthesized. Results: Twelve articles met the inclusion criteria. The majority found increases in the number of SMP sites that were sponsored by public schools after the pandemic waivers. However, some studies found decreases specifically among nonpublic school-sponsored sites. The majority also found increases in the number of children and/or meals served, even in the presence of fewer sites. Conclusions: Evidence suggests that the pandemic waivers were associated with improvements in scope, coverage, and participation in SMPs. Continued support of state agencies to administer SMPs using flexible and innovative strategies should be considered.