Submitted to: Journal Of The American Dietetic Association
Publication Type: Peer reviewed journal
Publication Acceptance Date: 11/1/2006
Publication Date: 3/1/2007
Citation: Cullen, K.W., Hartstein, J., Reynolds, K.D., Vu, M., Resnicow, K., Greene, N., White, M.A. 2007. Improving the school food environment: Results from a pilot study in middle schools. Journal of the American Dietetic Association. 107(3):484-489. Interpretive Summary: Childhood obesity is increasing at an alarming rate in the US, and different environmental factors are contributing. This study looked at the feasibility of changing the types of foods sold in school food environments. The long-term goal of this research was to improve dietary quality, and prevent obesity and type 2 diabetes in youth. Thirteen potential policy goals were identified after talking with students and school staff, and these goals were implemented the next school semester in 6 schools. Using questionnaires, almost all schools met there achievement objective. Based on these results, plus feedback from students and school staff, healthy school food service changes in the cafeteria and snack bar can be implemented and were acceptable to the staff and students. The next step is to have longer term and more ambitious changes, measure costs, and see whether these changes improve student dietary intake.
Technical Abstract: Our objective for this study was to examine the feasibility of instituting environmental changes during a 6-week pilot in school food service programs, with long-term goals of improving dietary quality and preventing obesity and type 2 diabetes in youth. Participants included students and staff from six middle schools in three states. Formative assessment with students and school staff was conducted in the Spring of 2003 to inform the development of school food service policy changes. Thirteen potential policy goals were delineated. These formed the basis for the environmental change pilot intervention implemented during the Winter/Spring of 2004. Questionnaires were used to assess the extent to which the 13 food service goals were achieved. Success was defined as achieving 75% of goals not met at baseline. Daily data were collected on goal achievement using the schools’ daily food production and sales records. Qualitative data were also collected after the pilot study to obtain feedback from students and staff. Formative research with staff and students identified potential environmental changes. Most schools made substantial changes in the National School Lunch Program meal and snack bar/a la carte offerings. Vending goals were least likely to be achieved. Only one school did not meet the 75% goal achievement objective. Based on the objective data as well as qualitative feedback from student focus groups and interviews with students and school staff, healthful school foodservice changes in the cafeteria and snack bar can be implemented and were acceptable to the staff and students. Implementing longer-term and more ambitious changes and assessing cost issues and the potential enduring impact of these changes on student dietary change and disease risk reduction merits investigation.