Institutionalization of children’s feeding programs in Atlantic Canada, The

institutionalization of children’s feeding programs in Atlantic Canada, The

McIntyre, Lynn

Abstract/Resume

This study traces the evolution of children’s feeding programs established in Atlantic Canada from a few months to over 15 years ago. Our qualitative analysis of nine children’s feeding programs in Atlantic Canada revealed that they began as an ad hoc, communitybased effort to feed hungry children. All subsequently experienced stress related to community mobilization. In order to recover from this stress, programs “routinized,” often with fewer volunteers or by adopting measures that ensured efficiency and stability. While one program remained routinized, others gradually assumed more features of institutionalization as a response to externally or internally imposed crises. They did so by adopting professional management strategies and often hiring professional personnel.

As the institutionalized programs continued, they became driven by the need to feed themselves, which was often greater than their mission to feed hungry children. The challenge for dietitians assisting children’s feeding program operators, policy makers, children’s advocates, and citizens is to reflect upon which organizational models of children’s feeding programs should be supported.

(Can J Diet Prac Res 2001; 62:53-57)

Cette etude decrit l’evolution de programmes d’alimentation pour enfants dont la mise sur pied dans les provinces de l’Atlantique remonte de quelques mois ii plus de 15 ans. Notre analyse qualitative de neuf programmes a revele que ces derniers ont demarre ii la suite d’une initiative communautaire visant a nourrir des enfants affames. Tons les programmes ont ensuite souffert d’un desinteret communautaire. Pour surmonter cet obstacle, les programmes ont regularise leurs activites, souvent en faisant appel a moins de benevoles ou en adoptant des mesures pour assurer leur efficience et leur stabilite. Un seul programme a garde ses activites regulieres; les autres se sons graduellement institutionnalises en reaction a des tensions imposees par l’exteme ou l’interne. Its font fait en adoptant des strategies de gestion professionnelle et en engageant souvent du personnel professionnel. Avec le temps, les programmes institutionnalises devenaient davantage axes sur leur besoin de se maintenir que sur leur mission de nourrir des enfants affames. Les dietetistes qui aident les responsables de programmes d’alimentation pour enfants, les decideurs, les defenseurs des enfants et les citoyens ont pour defi de reflechir aux modeles organisationnels de programmes qui devraient etre soutenus.

(Rev can prat rech dieter 2001; 62:53-57)

INTRODUCTION

Child poverty is unacceptably high in Canada and it has been the focus of advocacy and political attention as part of the National Children’s Agenda (1). Child poverty and the association of food insecurity with low income (2) has spurred the development of children’s feeding programs ostensibly to provide food necessary to support the learning of disadvantaged school children (3-5). As early as 1989, the Canadian Education Association reported that school-based nutrition programs had been established throughout Canada to provide food to thousands of children across the country (6). Funded through a variety of ad hoc mechanisms, this largely volunteer-initiated social movement has expanded into virtually every Canadian jurisdiction.

The purpose of this paper is to explore the operations of children’s feeding programs over time using data collected from a multi-site qualitative study of diverse children’s feeding programs in Atlantic Canada. We wanted to determine the stages of development of such programs from inception to long-term sustainability.

METHODOLOGY

The data from this study arise from a larger study that utilized a critical interpretation of qualitative case studies of nine children’s feeding programs in Atlantic Canadian (7). The programs were studied between November 1994 and June 1995. A variety of program operators, volunteers, staff, administrators, and Board members agreed to be interviewed in person, in groups or individually by one of two study researchers. Their accounts, along with daily field notes recorded using participant observation methods, formed the basis of our analysis of the development of each program over time. We also included a document review of program promotional literature, operational reports, and media articles. All participants gave consent for their participation and audiotaping according to the consent process approved by the Dalhousie University Faculty of Health Professions’ ethics committee.

The programs were selected to represent urban, rural and suburban settings; the provinces of Newfoundland, New Brunswick and Nova Scotia; both school and community lunch and breakfast programs, and programs that were established within the last two years, within the past five years, and for longer periods. After eight programs were identified, we learned of a new program that began operating during the course of data collection and added it for its unique inception features.

All data were coded by a third researcher and organized using QRS NUD-IST qualitative data analysis software. Analysis and critical interpretation of the data utilized constant comparison methods of Glaser and Strauss (8) and inductive and logical analyses of others (9-12). Trustworthiness of the data was established by the multiple readers (including two further researchers) and revisions to the coding framework, and through group research meetings held throughout the data analysis period. The overall findings of our study and for the site were returned to participants approximately one year after data collection.

A detailed description of the programs is presented elsewhere (7). Briefly, of the nine programs, six served breakfast and three served lunch. The majority of programs had been established for between five and seven years. The newest program was observed four months after commencement; the oldest program had been in operation for over 23 years. Seven programs were school-based or school-administered, one was church-based, and the last was community-based. Six of nine programs served poor neighbourhoods. All programs served children aged five to 12. Three programs served fewer than 20 meals per day; four served between 20 and 60 meals per day, and the other two programs served 92 and 800 meals daily. Funding sources were mixed and generally included government, charities, organizations, and individuals. Annual operating costs of a majority of sites were between $2,000 and $8,000.

RESULTS

Figure 1 represents the program development timeline derived from our data. The timeline suggests that programs begin as ad hoc community-based efforts to feed hungry children, but over time modify their operations inorder to run more efficiently. Most programs move beyond a routine stage and engage in institutionalizing processes, with some programs appearing ultimately to

be more concerned about their own continuity than about feeding hungry children.

1. Ad hoc and Community-based Effort to Feed Hungry Children

All programs indicated that they began with a small group of dedicated volunteers with one main purpose – to feed hungry children in the community.

“…I mean you.. just need a couple of people that are really committed to the concerns of the children…”

(Community Volunteer Founder)

2. Community Mobilization Stress

Programs were not always successful in the start-up period. “…the attempt that we made a year ago – it kind of fell flat on its face!…[]…there was too many people involved…[] …nobody ever took ownership of it…” (Program Organizer)

Even if successfully launched, programs inevitably found that the daily operations needed fewer volunteers than were required for the start-up period.

“…well, well see it’s gotten sort of broken down and mixed up and we are in the process of trying to get organized again. We started out, because we had no money – we had nothing that there was a bunch of parents and the Principal and teachers involved and then after a while when we got started up, we realized that we didn’t need all these people so the parents just disappeared except X and l, but they are still there to call on like you know if we need anything.”

(Community Volunteer Founder)

Sometimes, as well, the volunteers serving children were not perceived as acceptable to the community.

“…I thought to have parents or grandparents come in from the community as a way of getting the community within the program and accepted, you know a bit more. That worked out for a few weeks and grandparents and parents came to me individually and as a group at the end and said, ‘You know they didn’t feel right about doing it because they had heard things [from the children] and parents were phoning [the volunteers] and saving: How come mv son is over there?’…”

(Teacher Founder)

There was also the natural waning of enthusiasm that new ventures encounter.

1. “I find that you get a lot of volunteers in the beginning.”

2. “Everybody is very enthusiastic in the beginning but I think when the novelty wears off, you just have the same set of people who are still there.” (Community Volunteers)

“Two of the regular volunteers did not show up today. One apparently had a headache while the other one was just absent. X commented that she and Y were always there, but the other two were not quite so diligent.” (Field Note)

Programs also drove away some volunteers who didn’t feel needed. Unfortunately, these were usually parent volunteers.

“…and the parents, they sort of fall by the wayside because the school becomes more actively involved in the program… ”

(Principal)

“She [parent] used to come in every day, OK, she used to come in every day, every day and I used to have a Mrs. X used to come in every day – faithful, she was here every morning before I was setting stuff up. But here is what happened, they looked and saw all the people that were there, they saw the teachers and they saw the kids and they started saying, well you don’t need me’ and you see, that is what happened…”

(Principal)

3. Routinization

The routinization phase is characterized by regular menu schedules, clearly articulated protocols, and stability of volunteers and recipients. In order to “run smoothly,” programs developed routines and reduced annoyances and inefficiencies.

“Oh yes, our food has definitely changed because first of all I don’t have as many volunteers as I did when I first started, like there was a lot of people there when we first started, now we are down to just two of us and I don’t have the time to cook stuff ahead of time… ” (Program Organizer)

“All of those things have sort of made it run smoothly. …So the fact that the teachers don’t have to be involved with it, the organization of it, the running of it. It’s just one less responsibility that they don’t need fl. So from that point of view I think that it is running very smoothly.” (Principal)

Routinized programs were a model of clockwork operations.

“The volunteers get to the program for 8-8:15 am and the children arrive at 8:25 and have to be in class for 8:40, thus the whole breakfast is done at breakneck speed!” (Field Note)

“The overwhelming feature of the [lunch] program is the speed at which everything is done. The children arrive, eat, and leave in 15-20 minutes. Within 10-15 minutes the place is cleared and cleaned and ready for the next day. Things just happen so quickly and smoothly.” (Field Note)

Routinized programs were predictable, usually simple programs.

“Today’s fare was a choice of cereal and apple juice. This really is a very uncomplicated program that runs quite smoothly with little effort from anyone.” (Field Note)

4. Early Institutionalization

The phase of early institutionalization emerged when routine programs seemingly tired of their daily operations. Factors that encouraged early institutionalization included the introduction of more complicated menus, e.g., cooked foods; new services, such as clothing exchanges; a new influx of students from promotion of the program; and volunteer turnover. Features of this stage included providing a more formal organizational structure such as a Board, and shifting from volunteers to reliance on paid staff.

Interviewer: “…you don’t have a Board or anything, do you?”

1. “No, but we need to.”

2. “We are going to set something up.”

1. “Yea, definitely, this Fall.”

2. “In the Fall.” (Program Organizers)

“..we have some teachers, who are also parents within the program. We have a dietitian…, we have somebody who is from the food service industry who happens to be one of our suppliers, and is also a parent… We have a lawyer and an accountant, an insurance agent… you are kind of juggling government funding, fund raising, resource development, staffing, lease negotiations, legal matters, food quality, so you really need the areas of expertise that sit on our board.”

(Program Operator)

The early institutionalization stage tolerated some inefficiencies.

Interviewer. “But by and large it seems to run pretty smoothly?”

Respondent: “Yes, I mean, the children just love the older, grandparent volunteers and of course whatever they want, the grandparent volunteers will give them. In a way, you really have to be gentle with these people and you don’t want to hurt anybody’s feelings. But it does kind of mess up the system as far as grocery purchases are concerned.” (Program Organizer)

Interviewer. “Who is responsible for the accounting of the money? Who is accountable to it, for it, and from whom?” Respondent: “What a question! I don’t know, I think I am accountable for it, I guess… because there is no treasurer per se right now…” (Program Organizer)

Despite five years of operation, we found resistance to early institutionalization in one program. It was entirely managed by two parent volunteers, one of whom was the program founder. The program did not attempt to expand its client base. It had restricted its menu rather than expand its workforce or facilities. It did not concentrate on its external image, and did not attend much to fund-raising. Program operators insisted that the program “would not be beholden to Canadian Living [a foundation that supports children’s feeding programs].”

5. Structural Stress

Institutionalizing programs were susceptible to structural stresses that threatened their organizational structure and resource base.

“…there were four or five key board members that put an awful lot of energy into bringing this place into fruition, the facility, and then stepped down. Our Chairperson, our Treasurer, our fundraising all stepped down at the same time. And you know people that could have generally the right connections to get government funding in there and things like that.

So now, we are more on our own…” (Program Operator)

Having volunteers take on a paid role was one way of overcoming stress, in this case, loss of a founding volunteer program operator:

“… they asked me if I would be the Coordinator and I thought, I thought about it first and thought `no, I can’t take on that kind of responsibility’ and then I thought well I’ve volunteered my services all these years, this, you’re going to get paid for it, for heaven’s sake take advantage of it, you could use the money,’ so I said yes,” I would do it… ” (Program Operator)

6. Institutionalization: Programs Feed Themselves

The phase of institutionalization introduces increased bureaucratic mechanisms that assert greater control over program operators while at the same time maximizing resource acquisition and utilization. Institutionalized programs were driven to perpetuate themselves. They sometimes recognized their loss of service to children as a consequence.

“…when we initially had the first staff they got very attached to the children, they got to know them on a first name basis… and they would always be making sure that the children were eating their meals and you know finishing their meals before they eat their dessert and things like that. They were quite personally involved and I find that we don’t have that calibre of person serving now.” (Teacher)

A program remaining open when no children were there to be fed was one example of a program feeding itself, albeit to keep itself solvent for the next year.

“…last year was our first year remaining open for the entire year. Most of the time we are only open for the school year, but with this facility and me, I wanted to stay working all year and really you just need to have somebody oversee the office now for the two months that we are closed as well.”

(Program Operator)

“…They made an application to the about nine, ten years ago and they got their first, the first money was about $10,000. This has grown since that time – it is an annual, annual application. It was supposed to be a one year type of program, but every year we apply, and every year they continue to give us money, and this year it was $35,000, and it has gone from ten to fifteen children, four years ago it was fifty children, and every year we have gone up ten or twelve because of the demand is so great. Last year it was 80 and now this year it is 92.”

(Program Operator)

We speculate that programs cycle between structural stress and further strengthening of the institution, in order to prevent their demise.

We observed that community mobilization stress occurred within months but rarely later than the second year of operations. Routinization was usually established by the second year, after the program experimented with a variety of server delivery models and menus. The transition from routinization to early institutionalization was just a matter of time and was apparent within three to five years unless, as seen in one of the programs, external influences were resisted. Some programs stabilized at the early institutionalization stage, but most were sooner or later confronted with a major stress that needed to be overcome. This stress could result from the loss of key personnel, fund-raising difficulties, facility problems, and too rapid program expansion. Every decision that responded to this stress seems to drive the process of institutionalization and program survival forward. Everyone who had known a program from its beginning would recognize that ‘something had been lost,’ such as the personal relationship between volunteers and children, or the participation of community volunteers; however, there seemed to be no way for a program to turn back the clock, and program closure was unthinkable, not only because of what it would mean for the children but for staff, schools, industry providers, and public figures who had a stake in its continuance.

DISCUSSION

As early as 1990, Tarasuk and MacLean described the institutionalization of food banks in Canada (13). Their use of the term ‘institutionalization’ referred to the integration and dependency of these programs as part of the Canadian food security network, rather than their inner workings. Riches also wrote of the institutionalization of community responses to hunger as becoming extensions of a failing public welfare system (14). In describing the proliferation of soup kitchens in the United States, Poppendieck (15) commented that “…emergency programs have a way of becoming institutionalized.”

The process of institutionalization of children’s feeding programs that we have observed at the level of individual programs follows the pattern of bureaucratization and professionalization commonly observed in other community settings and volunteer organizations, such as AIDS service organizations and anti-poverty groups (16). The essential levers of institutionalization are seen as reliance on state funding, a concern for organizational sustainability, the career interests of workers in such programs, and competition with others for scarce resources. Such forces undermine the ability of community organizations to maintain a strong connection with their communities and remain true to their original program mission (16).

Tucker’s long-term analysis of social service organizations revealed that successful voluntary organizations had a tendency to develop into bureaucratic mechanisms over time (17). “…The organization becomes an institution valued by its members as an end in itself” (17). On the other hand, Tucker also found that voluntary organizations that resisted structural change often suffered from inertia, which could result in the organization’s demise (17). His analysis of death rates among voluntary organizations indicated that they experienced excessive amounts of stress in both their first and fifth years of operation, comparable with the stresses observed in children’s feeding programs.

So children’s feeding programs are not unique. They individually move along an institutionalizing development timeline, sometimes stopping short of full institutionalization, but always vulnerable to stresses that demand organizational, rather than ad hoc, responsiveness. Campbell (18) said the challenge for the 1990s was to stop the institutionalization of the alternate food system, of which children’s feeding programs play a part. Poppendieck (15) cautioned, “We must learn to use the political opportunities generated by emergencies to make sure the programs that emerge are worth institutionalizing.” The children’s feeding program movement in Canada is institutionalizing, program by program, and jurisdiction by jurisdiction. The natural history of such organizations indicates that this phenomenon cannot be stopped but that it might be better supported to preserve its most worthwhile inception features – namely, community participation in children’s food assistance.

RELEVANCE TO PRACTICE

The practice opportunities for dietitians assisting children’s feeding programs are to encourage program deliberation around ambitious menu expansions, reflect upon their own role as an instrument of program professionalization, and suggest strategies that preserve program sustainability while not disenfranchising providers and recipients.

References

1. Federal-Provincial-Territorial Council of Ministers on Social Policy Renewal, A National Children’s Agenda – Developing a shared vision, Spring 1999. www.children-enfants.org Accessed September 9, 1999.

2. Riches G. Responding to hunger in a wealthy society: Issues and options. J Can Diet Assoc 1989;50:150-54.

3. Meyers AF, Sampson AE, Weitzman M, et al. School breakfast program and school performance. Am J Dis Child 1989;143:1234-1239.

4. Pollitt E, Gersovitz M., Gargiulo M. Educational benefits of the United States school feeding program: A critical review of the literature. Am Public Health 1978;68:477-481.

5. Slavin K, Whale W, Baker H, et al. Development of a long-term strategy for the Saskatoon child hunger and education program. A report of a study conducted for the Child Hunger and Education Program Committee, by the Division of Extension and Community Relations, University of Saskatchewan, Saskatoon, 1990.

6. Canadian Education Association. Food for thought: School board nutrition policies and programs for hungry children. CEA Information Note, Toronto, 1989.

7. McIntyre L, Travers K, Dayle JB. Children’s feeding programs in Atlantic Canada: reducing or reproducing inequities? Can J Public Health 1999;90:196-200.

8. Glaser BG, Strauss AL. The discovery of grounded theory. Strategies for qualitative research. Chicago: Aldine, 1967.

9. Miles MB, Huberman AM. Qualitative data analysis: A sourcebook of new methods. Beverly Hills: Sage, 1984.

10. Achterberg C. Qualitative methods in nutrition education evaluation research. J Nutr Ed 1988;20:244-250.

11. Marshall C, Rossman GB. Designing qualitative research. London: Sage, 1989.

12. Strauss A, Corbin J. Basics of qualitative research: Grounded theory procedures and techniques. Newbury Park, CA: Sage, 1990.

13. Tarasuk VS, MacLean H. The institutionalization of food banks in Canada. Can J Public Health 1990;81:331-332.

14. Riches G. Hunger, food security and welfare policies: issues and debates in First World societies. Proceedings of the Nutrition Society 1997;56:63-74.

15. Poppendieck JE. Hunger and public policy: Lessons from the Great Depression. J Nutr Ed 1992:24 Suppl:6S-11 1S.

16. Cain R. Community-based AIDS services: Formalization and depoliticization. Int J Health Serv 1993;23:665-684.

17. Tucker D & Associates. An ecological analysis of voluntary social service organizations: Their births, growth and deaths. Hamilton, Ontario: Program for the Study of Human Services Organizations, McMaster University, 1984.

18. Campbell CC. Food security from the consumer’s perspective: An agenda for the 1990s. J Can Diet Assoc 1991;52:83-88.

LYNN McINTYRE, MD, MHSc, FRCPC, Faculty of Health Professions, Dalhousie University, Halifax, Nova Scotia; KIM RAINE, PhD, RD, Department of Agricultural, Food and Nutritional Science, and Centre for Health Promotion Studies,

University of Alberta, Edmonton, AB; JUTrA B. DAYLE, PhD, Department of Anthropology, Saint Mary’s University, Halifax, NS This study was funded by NHRDP No. 6603-1461-201.

Reprints available upon request: Lynn McIntyre, Professor, Faculty of Health Professions, Dalhousie University, 5968 College St., 3rd Floor, Halifax, NS, B3H W5 or Lynn.Mclntyre@dal.ca.

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