Introduction

The Coronavirus Disease 2019 (COVID-19) pandemic is one of the largest public health emergencies the United States (U.S.) has faced. The U.S. Department of Health and Human services has determined this to be a public health emergency since January 27, 2020 [1] and the President of the U.S. issued a proclamation on March 13, 2020 declaring the COVID-19 pandemic to be a national emergency as of March 1, 2020 [2].

Food insecurity is also a serious public health concern in the U.S. that is associated with a variety of negative health consequences [3]. In 2020, 10.5% of U.S. households were food insecure [4]. The COVID-19 pandemic can make individuals more vulnerable to experiencing food insecurity [5]. The U.S. Department of Agriculture (USDA) administers a variety of federal food and nutrition assistance programs to help address food insecurity, such as the Supplemental Nutrition Assistance Program (SNAP); Child Nutrition Programs; and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) [6].

Since the pandemic began, federal nutrition assistance programs have had to adapt rapidly to meet food and nutrition needs among affected communities [7–9]. The Families First Coronavirus Response Act gave USDA the authority to issue nationwide waivers for regulations for federal nutrition programs [10]. Numerous waivers have been issued throughout the pandemic for programs such as SNAP, Child Nutrition Programs, and WIC to help make it more feasible to administer these programs given the context of the COVID-19 pandemic [11]. New programs such pandemic electronic benefit transfer (P-EBT), which provided EBT cards with benefits that families could use to purchase food, and Emergency Meals-to-You, which mailed shelf-stable meals to children in rural communities, have also been developed during the pandemic to help address food insecurity [11]. Many of the waivers, adaptations, and new programs could potentially be beneficial for strengthening the federal nutrition assistance programs and allowing them to better address food and nutrition security beyond the COVID-19 pandemic. With so many waivers and adaptations, evaluation is needed to understand what was effective, what might be able to be adopted permanently, and what might be useful in future disasters or public health emergencies.

Scoping reviews are a useful tool for examining emerging evidence when there is not enough information or research to address more specific research questions through systematic reviews[12]. They can serve a variety of purposes for studying a particular topic including identifying the type of evidence available, examining how research on the topic has been conducted, and identifying gaps in knowledge [12]. Given that research examining federal food assistance programs during the COVID-19 pandemic is still emerging and the scope of the existing literature is not clear, a scoping review is an appropriate methodology to begin to assess the literature on this topic.

A preliminary search of Pubmed and PROSPERO were conducted and no systematic reviews on federal nutrition assistance programs during the COVID-19 pandemic were published or currently underway were identified. There is one scoping review currently published on the topic, although the goals and scope of this review differ from the proposed scoping review. The currently published review covers the time period of 2000 and 2020, includes other types of emergencies in addition to the COVID-19 pandemic, and focuses largely on lessons learned from the available evidence [13]. While this scoping review makes an important contribution to the literature, there are some gaps that would benefit from an additional scoping review including focusing exclusively on the COVID-19 pandemic, describing the characteristics of the currently published studies (i.e., geographic regions, study population, study methodology); an updated literature search as numerous additional studies have been published related to the topic after 2020; and using more health-focused databases in the literature search.

The goal of this scoping review is to examine the published research on federal nutrition assistance programs during the COVID-19 pandemic, in the U.S., U.S. territories, and tribal nations including programs that were developed during the pandemic (i.e, pandemic electronic benefit transfer). The review will identify the scope of the available research and research and policy recommendations. The results will be shared through two primary products—a peer-reviewed journal article and a public facing document with a bibliography and summary of identified studies.

Materials and methods

The scoping review will be conducted following the guidelines for scoping reviews described by the JBI Manual for Evidence Synthesis [12] and Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping review (PRISMA-ScR) [12]. The Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocol (PRISMA-P) checklist can be found in S1 Checklist. Institutional review board approval was not required for this study because human subjects were not involved.

Discussion

This scoping review protocol will allow for a comprehensive review of the published peer-reviewed literature on USDA nutrition assistance programs during the COVID-19 pandemic, which has implications for research and policy recommendations. One of the limitations of this protocol is the exclusion of grey literature. While there has been a lot of grey literature published on the topic, we chose to focus exclusively on the scope of what has been published in the peer-reviewed literature for feasibility and because peer-reviewed sources are traditionally viewed as more credible. Only four databases will be searched which may result in articles not indexed in these databases being missed. This scoping review protocol does not include a critical appraisal of studies, as this is an emerging area of research and the main goal of the review is to understand the scope of the published peer-reviewed research as opposed to assessing risk of bias. It is common for scoping reviews not to include critical appraisal of evidence sources [12]. Despite the limitations, this scoping review will make an important contribution to the literature. Because these results may be of interest to multiple audiences, they will be shared through a public facing document with a bibliography and summary of identified studies in addition to a peer-reviewed journal article.

Supporting information

Acknowledgments

The authors would like to thank members of the Healthy Eating Research (HER) Nutrition & Obesity Policy Research & Evaluation Network (NOPREN) COVID-19 Nutrition Work Group for input on the protocol.