Impact of portion-size control for school a la carte items: changes in kilocalories and macronutrients purchased by middle school students

We assessed the impact of a pilot middle school a la carte intervention on food and beverage purchases, kilocalories, fat, carbohydrate, and protein sold per student, and nutrient density of the foods sold. A la carte sales were obtained from six middle schools in three states for 1 baseline week and daily during the 6-week intervention. Intervention goals included reducing sizes of sweetened beverages and chips, and increasing the availability of water and reduced-fat/baked chips. Nutrients sold per day were computed and weekly nutrient means per student and per number of items sold were calculated and compared between baseline and week 6. Five schools achieved all goals at 6 weeks. Four schools showed increases in the percentage of kilocalories from protein and decreases in the amount of sweetened beverages sold; five showed substantial increases in water sales. Changes in regular chips varied by school. There were significant changes in energy density of foods sold. School foodservice changes in middle school snack bar/a la carte lines can be implemented and can lead to a reduction in the caloric density of foods purchased.     

Creating health-promoting schools in China with a focus on nutrition

This pilot project in Zhejiang Province, China, aimed at improving the nutrition and health status of students, school personnel and parents, and developing a model project for nutrition interventions for the development of health-promoting schools (HPS) in China. Three primary and three secondary schools participated. Interventions included establishing school-based working groups, nutrition training for school staff, distribution of materials on nutrition, nutrition education for students, student competitions, school-wide health promotion efforts and outreach to families and communities. Results of a pre- and post-intervention survey one and a half years apart showed improvements in nutrition knowledge, attitudes and behavior among all target groups. Primary school students at the pilot schools made the greatest knowledge gains in the areas of Chinese dietary guidelines (increased from 49.2 to 78.0%, p < 0.01) and adequate dietary principles (increased from 42.9 to 68.0%, p < 0.01). Scores of secondary school students who reported liking school lunches rose at pilot schools from 17.9 to 45.2% (p < 0.01). School staff at control schools who reported taking breakfast declined from 81.4 to 66.6% (p < 0.01), while staff who reported taking lunch at school increased in pilot schools from 87.5% at baseline to 93.9% (p < 0.01). The largest increases in nutrition knowledge among all target groups occurred among parents and guardians. At the pilot schools parents increased their knowledge in the areas of nutritional deficiencies (from 35.0 to 66.2%, p < 0.01) and nutrient-rich foods (from 38.8 to 66.8%, p < 0.01). Talks with target groups confirmed changes in attitudes and behavior, and school visits revealed improvements to school facilities and school health services, establishing of school policies and a positive school climate. This study suggests that nutrition can effectively serve as an entry point to establish HPS in China and that the HPS concept is feasible to improve the dietary knowledge, attitudes and behavior of students, parents and school personnel.     

Variables Affecting High School Students’ Perceptions of School Foodservice

Objective To determine if student satisfaction with high school foodservice is directly related to participation in the foodservice.

Design A valid and reliable survey was conducted in a variety of classes such as English, history, and health science in grades 9 through 12, representing students aged 13 through 19 years. Students were asked 38 questions concerning variety of food, food quality, foodservice staff, aesthetics of the serving and dining area, and demographics.

Subjects/setting The study was conducted with 1,823 students from 9 schools representing 4 geographic regions.

Statistical analysis Stepwise multiple regression was used to determine the independent variables (attributes desired by the students) that most highly correlated with the dependent variable (satisfaction with the school foodservice overall).

Results Variables most highly correlated with overall satisfaction were variety of food offered, flavor of food, attractiveness of food on the serving line, staff smiling and greeting students, quality of food choices, choices that allow students to meet cultural and ethnic preferences, courteousness of the staff, and quality of ingredients. Variety of food offered was the best predictor of satisfaction. A statistically significant difference was found (P<.01) between groups that never ate school lunch and those that ate school lunch 3 to 5 times per week on dining ambiance, food quality, and staff. The results indicate that satisfaction with foodservice is associated with purchase behavior in school foodservice programs.

Applications School foodservice and nutrition programs are critically important for providing nutrition to millions of our future leaders. Today it is not enough to prepare healthful, good-tasting food. High school students are sophisticated and are exposed at an early age to a variety of dining experiences including fast foods, ethnic cuisine, and fine dining. These factors have influenced the attributes students use to evaluate school foodservice. To maintain participation levels and financial stability, school foodservice professionals should evaluate student satisfaction with food quality, variety, and other variables that affect overall satisfaction and participation. These data may then be incorporated into continuous quality improvement and strategic planning. Marketing must be incorporated into the strategic plan to influence student participation. J Am Diet Assoc. 1998;98:1424–1428,1431.     

Building Relationships and Capacity in Rural Lunchrooms: Lessons from a Process Evaluation of a Pilot Behavioral Economics-Based Intervention

We aimed to describe the successes and challenges of implementing a pilot program by working with students and food service staff in four rural high schools to encourage healthy eating among rural adolescents. The pilot program engaged students and school food service directors (FSDs) in identifying and making changes to the school lunchroom environment based on behavioral economics. As part of a multi-method evaluation, we conducted interviews with FSDs and staff, held focus groups with students, and recorded our observations as researchers. The lessons learned highlighted the importance of (1) the FSD’s role in the school, (2) a faculty partner involved in the project, (3) the characteristics of the student group, and (4) setting realistic goals for the students. Our findings can guide future interventions designed to improve food choices in school lunchrooms and increase adolescents’ fruit and vegetable consumption.     

A Culturally Appropriate School Wellness Initiative: Results of a 2-Year Pilot Intervention in 2 Jewish Schools

BACKGROUND: Despite the growing number of school-based interventions designed to reduce childhood obesity or otherwise promote health, no models or materials were found for Jewish schools. The current study describes an effort within a Jewish school system in Chicago to create, implement, and evaluate a school-based intervention tailored to the unique characteristics of Jewish religion, culture, and school structures. METHODS: Two schools (with approximately 600 students) were selected for the 2-year pilot study. The schools were required to form a wellness council, write a wellness policy, and implement policy changes or activities in 5 target areas (health education, physical education, school environment, family involvement, and staff wellness). Objectives were measured using pre- and postintervention surveys for students, as well as the School Health Index and other tools. RESULTS: Findings showed several significant increases in student knowledge, as well as an increase in the percentage of older students regularly meeting physical activity guidelines. Few changes in attitudes, other behaviors, or environmental factors were seen. CONCLUSIONS: Due to a strong partnership between researchers, schools, and community organizations, meaningful changes were made within the pilot schools. These changes were reflected in a limited number of improvements in student knowledge and activity levels. Future work is needed to determine how to bring about behavioral changes, how to increase the sustainability of all of the changes, and how to disseminate the model and products of this intervention to other day schools.     

Environmental interventions for eating and physical activity: a randomized controlled trial in middle schools

BACKGROUND: Our objective was to evaluate the effects of environmental, policy, and social marketing interventions on physical activity and fat intake of middle school students on campus. DESIGN: Twenty-four middle schools were randomly assigned to intervention or control conditions. Baseline measures were collected in spring 1997, and interventions were conducted during the 1997-1998 and 1998-1999 school years SETTING/PARTICIPATION: The schools had mean enrollments of 1109, with 44.5% nonwhite students.Over 2 years, physical activity interventions were designed to increase physical activity in physical education classes and throughout the school day. Nutrition interventions were designed to provide and market low-fat foods at all school food sources, including cafeteria breakfasts and lunches, a la carte sources, school stores, and bag lunches. School staff and students were engaged in policy change efforts, but there was no classroom health education. MAIN OUTCOMES MEASURES: Primary outcomes were measured by direct observation and existing records. RESULTS: Randomized regression models (N =24 schools) revealed a significant intervention effect for physical activity for the total group (p <0.009) and boys (p <0.001), but not girls (p <0.40). The intervention was not effective for total fat (p <0.91) or saturated fat (p <0.79). Survey data indicated that the interventions reduced reported body mass index for boys (p <0.05). CONCLUSIONS: Environmental and policy interventions were effective in increasing physical activity at school among boys but not girls. The interventions were not effective in reducing fat intake at school. School environmental and policy interventions have the potential to improve health behavior of the student population, but barriers to full implementation need to be better understood and overcome.     

A Mixed-Methods Evaluation of a School Wellness Initiative: An Examination of Longer Lunch Periods and More Physical Activity Opportunities

BackgroundThere are currently no national standards for lunch period lengths or physical activity in schools. Research is needed to better understand the impact of school initiatives that improve policies related to lunch and movement opportunities on student outcomes. Additionally, best practices are necessary to support schools that are considering initiatives that address these factors.ObjectiveThis study examined the impact of implementing longer lunch periods, recess, and other movement opportunities on student outcomes and best practices for implementation.DesignA mixed-methods study including surveys and semistructured interviews and focus groups conducted during the 2019-2020 school year.Participants/settingSurveys (n = 5107) from students in grades 3 and 4 attending 19 pilot and 11 matched control elementary schools and interviews/focus groups among principals, cafeteria managers, teachers, and parents in a representative subsample (n = 6) of pilot schools in Anchorage Alaska.Main outcome measuresStudents’ self-reported hunger levels and mood and perceptions and supportive strategies from school principals, cafeteria staff, teachers, and parents were examined.Statistical analyses performedMixed-model analysis of variance accounting for student demographics with students as a random effect (students nested within schools) were used to examine differences in hunger and mood. For interviews/focus groups, responses were analyzed qualitatively using principles of content analysis.ResultsLonger lunch periods were associated with significantly reduced hunger at the end of lunch period and significantly increased self-reported happiness in the cafeteria. Based on interviews/focus groups with school staff and parents, the initiative was generally perceived positively with reported benefits including reductions in disciplinary issues and improvements in student focus, social and emotional learning, and overall student happiness and well-being. Several supportive strategies were identified.ConclusionsInitiatives that increase lunch period lengths and physical activity opportunities have the potential to reduce students’ hunger levels and improve focus and behaviors in the classroom. Schools should consider similar initiatives that incorporate the suggested strategies to potentially improve outcomes among students.     

Short-term impact of experience Corps<Superscript>®</Superscript> participation on children and schools: Results from a pilot randomized trial

This article reports on the short-term impact of a school-based program using older adult volunteers and aimed at improved academic achievement and reduced disruptive classroom behavior in urban elementary school students. The Experience Corps^® Baltimore (Maryland) program places a critical mass of older adult volunteers, serving 15 hours or more per week, in public schools to perform meaningful and important roles to improve the educational outcomes of children and the health and well-being of the volunteers. This article reports on the preliminary impact of the program on children in grades K-3. A total of 1,194 children in grades K-3 from six urban elementary schools participated in this pilot trial. At follow-up, third grade children whose schools were randomly selected for the program had significantly higher scores on a standardized reading test than children in the control schools, and there was a nonsignificant trend for improvement in alphabet recognition and vocabulary ability among kindergarten children in the program. Office referrals for classroom misbehavior decreased by about half in the Experience Corps schools, but remained the same in the control schools. Teachers had somewhat more favorable attitudes toward senior volunteers as a result of having older volunteers in the classroom, although the difference between the intervention and control schools was not statistically significant. In this pilot trial, the Experience Corps program led to selective improvements in student reading/academic achievement and classroom behavior while not burdening the school staff.     

Airborne asbestos levels in school buildings in Italy

This article provides a summary of environmental investigations carried out from 1992 to 2002 by the National Institute for Occupational Prevention and Safety on airborne asbestos fiber concentrations in Italian schools. The monitoring was performed to evaluate the risk from asbestos exposure to students and school staff. Fifty-nine schools located in several Italian regions were studied. A detailed visual examination assisted with locating asbestos-containing materials in different school areas. Asbestos was mainly present in the vinyl floor coverings and in the asbestos-cement products (roofs, facades, and heating ducts). After the identification of the potential sources of exposure, several bulk and air samplings were performed in the areas where the contamination was suspected. All air samplings were collected on membrane filters and analyzed by phase contrast optical microscopy and scanning electron microscopy. During the course of the samplings, the schools were in operation and normal student activities took place. Most of the results provided no significant evidence of airborne asbestos fibers, although some dispersion was found in a few school buildings where, during the past years, monitoring and safety programs had not been implemented.     

Reducing fat and sodium in school lunch programs: the LUNCHPOWER! Intervention Study.

This study developed, implemented, and evaluated a healthful school lunch program that provided tasty food choices that were lower in fat and sodium. The LUNCHPOWER! Intervention Program was implemented in 34 elementary schools in four school districts that represented diverse geographic areas of Minnesota. A team of registered dietitians, foodservice directors, and cook managers reduced the fat and sodium content of school lunches by modifying recipes and food preparation methods and by identifying and selecting vendor products (prepared food products) that were lower in fat and sodium. Nutrition education messages for students and parents were developed for the 5-month intervention. Monthly menus were analyzed for fat, sodium, and energy content before and after the intervention. There was a significant decrease in both total grams of fat and percent of energy from fat between baseline and follow-up. At all 34 schools, mean daily amount of total fat in the lunch menu decreased 39% (from 32 g to 20 g) and percent of energy from fat decreased 29% (from 40% to 28%). We found that schools could serve lower-sodium and lower-fat meals and retain student participation in the school lunch program.     

Program characteristics and organizational factors affecting the implementation of a school-based indicated prevention program

Reconnecting Youth (RY) is a school-based drug prevention program designed to address academic, substance use and mood management goals among youth at risk of dropping out of high school. This paper presents the organizational factors and RY program characteristics that either promoted or hindered the implementation of the program during a randomized controlled effectiveness trial in 10 schools in two school districts in the United States. Data were collected using surveys and interviews from teachers and school and district staff who participated in the implementation of the RY program in these schools. Results suggest that certain RY program characteristics made it difficult to implement. Small class size, resource-intensive procedures for student selection and recruitment and special training, qualities and skills needed to be an effective RY teacher meant that schools had to significantly change their usual practices to implement the program. Organizational barriers included a lack of financial resources and leadership support for program implementation, and low priority for non-academic courses for high-risk students. Transient student populations, staff turnover and district-wide scheduling and curriculum changes all resulted in high levels of organizational turbulence at most schools, further hindering program implementation.     

Peer Reviewed: Increasing Access to Places for Physical Activity Through a Joint Use Agreement: A Case Study in Urban Honolulu

Background

To increase levels of physical activity (PA), interventions that create or enhance access to places for PA are recommended. Establishing a joint use agreement is one way to increase access to existing PA and recreational facilities. The purpose of this article is to present a case study of In-Motion, a pilot joint use agreement project at one urban high school in Honolulu, Hawaii.

Context

Residents of urban Honolulu are underserved by the amount of parkland and recreational facilities available for their use. The Honolulu County Department of Parks and Recreation sought to implement a joint use agreement to use the facilities of one urban high school for a recreational program. The high school selected for the pilot project has a student population primarily from low-income and ethnic minority backgrounds.

Methods

An assessment of the potential of 7 urban high schools to implement a joint use agreement was conducted to select the pilot site. In-Motion developed and implemented a joint use agreement. PA preferences of students, staff, and community members were assessed to guide recreational program offerings. Various recreational classes were offered free to the school community.

Consequences

Several barriers to implementing the joint use agreement and recreational program were encountered. However, participants were satisfied with the recreational classes they attended and said that the In-Motion program helped them to engage in more PA. Program awareness by high school students and staff was high.

Interpretation

In-Motion has successfully modeled a pilot joint use agreement and provided new opportunities for PA to the high school''s students, teachers, and staff, and to community residents.     

Texas school food policy changes related to middle school a la carte/snack bar foods: potential savings in kilocalories

The potential impact of a school food policy change reducing sweetened beverage and high-fat, salty, and sweet food portions on energy consumption of middle-school students was assessed. Snack bar sales for one school year were obtained from 23 schools. Energy content was calculated for each item and energy savings from reduced portion size was determined. Per student, about 111 kcal per day was purchased; 47 kcal per day was saved when reduced portion sizes were substituted for the large servings. These findings should provide some assurance that changes in food portion sizes in school food environments could impact energy balance.     

Using Achievement Goal Theory to assess an elementary physical education running program

Using Achievement Goal Theory as a theoretical framework, this study examined an elementary physical education running program called Roadrunners and assessed relationships among achievement goals, perceived motivational climate, and student achievement behavior. Roadrunners promotes cardiovascular health, physical active lifestyles, and mastery behaviors such as persistence and effort. Students were required to run/walk once a week during the school year in their regularly scheduled physical education classes. Participants included 116 fourth graders (67 boys, 49 girls), who participated in Roadrunners since kindergarten. Near the end of spring semester, students completed a 36-item questionnaire assessing achievement goals and perceived motivational climate of Roadrunners. Student persistence/effort was assessed by the number of run/walk laps over the year-long program. Performance was measured by a timed, one-mile run. Results revealed the mastery goal related positively to student persistence/effort for Roadrunners and to their one-mile run performance. Interaction between the mastery goal and perception of a mastery-focused climate emerged as a positive predictor of student one-mile run performance. Results provided additional empirical support for mastery goals and perceptions of a mastery-focused climate as beneficial to student motivation and learning.     

Evaluation of a fruit and vegetable distribution program--Mississippi, 2004-05 school year

Although diets high in fruit and vegetables are associated with decreased risk for many chronic diseases, consumption of fruit and vegetables among children is below recommended levels. During the 2004-05 school year, the Mississippi Department of Education Child Nutrition Program initiated the Mississippi Fresh Fruit and Vegetable Pilot Program. The program was designed to 1) increase student access to fresh fruit and vegetables, 2) increase the degree of student preference for fruit and vegetables, and 3) increase fruit and vegetable consumption. The 25 schools selected to participate in the program distributed fresh fruit and vegetables free of charge during the school day and provided nutrition education activities to promote and support consumption of fruit and vegetables. An evaluation of the program was conducted using a pretest in the fall (before the program was implemented by the schools) and a posttest in the spring (at the end of the school year). This report summarizes the findings of that evaluation, which indicated that the program might have 1) increased the variety of fruit and vegetables ever tried by students from all three grades sampled (5th, 8th, and 10th); 2) increased the degree of preference for fruit among 8th-grade and 10th-grade students; 3) promoted positive attitudes toward eating fruit among 8th-grade students; 4) increased consumption of fruit, but not vegetables, among 8th-grade and 10th-grade students; and 5) decreased preference for fruit and vegetables, the belief that they could eat more vegetables, and willingness to try new fruit and vegetables among 5th-grade students. The results of this evaluation suggest that the distribution of fresh fruit at school free of charge to secondary school students might be an effective component of a comprehensive approach for improving student dietary behaviors; however, distribution of fresh vegetables might be more effective with changes in program implementation.     

Factors influencing implementation of the Coordinated Approach to Child Health (CATCH) Eat Smart School Nutrition Program in Texas

The purpose of this research was to evaluate factors influencing the implementation of the Coordinated Approach to Child Health (CATCH) Eat Smart School Nutrition Program in Texas using data from the CATCH dissemination study. A mail survey was sent to school foodservice personnel (N=213) who attended a CATCH training from August 2000 through January 2002. A response rate of 40% (n=85) was achieved. The mean score for the percentage of CATCH Eat Smart guidelines implemented was 80.44. Multivariate linear regression analysis revealed that, after adjusting for age and number of years employed in school foodservice, the following factors were significantly associated with the percentage of CATCH Eat Smart guidelines implemented: utility of CATCH and CATCH Eat Smart in meeting requirements for Coordinated School Health Programs (P=0.006), school foodservice personnel’s satisfaction with food made using the CATCH Eat Smart guidelines (P=0.008), utility of CATCH in facilitating interschool communication about children’s health (P=0.019), and perceived student satisfaction with food made using the CATCH Eat Smart guidelines (P=0.046). These results suggest that dissemination approaches for Coordinated School Health Programs should focus on ways to enhance program satisfaction, be consistent with legislated mandates, and increase interschool staff communication to increase program implementation by school foodservice personnel.