an increasing trendP < .001
The Pennsylvania CIAA was associated with an immediate decrease in adjusted special food services sales (β 22 = −0.030, P = .02) in the rest of the state ( Table 1 , Figure 1 ), along with an increasing trend for the number of special food services restaurants in the 4 surrounding counties (β 32 = 0.030, P < .001)( Table 2 , Figure 2 ).