The Impact of a Multipronged Intervention to Increase School Lunch Participation among Secondary School Students in an Urban Public School District

Impact of a Teacher Intervention to Encourage Students to Eat School Lunch

While school meals are often the healthiest option for students, lunch participation remains relatively low. Few approaches for increasing participation have leveraged teachers' potential social influence. We determined if a teacher intervention about the benefits of school lunch could improve teachers' perceptions of, and participation in, school lunch, and encouragement of students to eat school lunch. This repeated cross-sectional study included teacher/student survey administration in spring of 2016 and 2018 in 19 public secondary schools (9 intervention, 10 comparison) educating students of ages ≈ 11-18. Intervention teachers received monthly newsletters; lunch taste tests; and a promotional video and website. Mixed effects models with a random effect for school showed the proportion of teachers that reported eating with students increased in intervention schools relative to control schools (difference-in-change: 7.6%; 95% CI: 3.578%, 14.861%), as did student agreement that adults at their schools encouraged them to eat school lunch (difference-in-change: 0.15 on a 5-point scale; 95% CI: 0.061, 0.244). There were no between-group differences in teachers' perceptions of school meals or teachers' lunch participation. These findings suggest that teachers' perceptions of school meals do not necessarily need to improve to promote the school lunch program to students. However, to see meaningful change in teacher lunch participation, the taste of school meals likely needs improving.

Impact of introducing a farm to school program on the number of school lunches served

Farm to school (FTS) programs are becoming more prevalent throughout the United States. Yet, their impacts on students' behaviors are still not well understood. This study analyzes the impacts of introducing the local procurement aspect of a FTS program in a Florida school district on the number of National School Lunch Program (NSLP) meals served and the selection of salad meals prepared with FTS products using daily school-level point of sale (POS) data, product procurement records, NSLP menu data and linear panel regression analyses. The study district implemented the FTS program in 15 of its 22 elementary schools between mid-October of 2015 and mid-January of 2016. Weighted difference in differences regressions that account for the non-random assignment of the district's elementary schools into the FTS program and variation in the timing of implementation across schools indicate that the introduction of the FTS program did not affect the number of NSLP meals served or type of meals served at schools with FTS programs. We find some evidence that students selected more NSLP salad offerings on days when these meals were prepared with FTS products; however, these findings were no longer significant when school-level fixed effects were included in the model.

The Impact of a Multi-Pronged Intervention on Students' Perceptions of School Lunch Quality and Convenience and Self-Reported Fruit and Vegetable Consumption

School lunch programs provide an opportunity to improve students' diets. We sought to determine the impact of a multifaceted intervention (cafeteria redesigns, increased points-of-sale and teacher education) on secondary students' perceptions of school-lunch quality and convenience and fruit and vegetable intake. Surveys (n = 12,827) from middle and high school students in 12 intervention and 11 control schools were analyzed. We investigated change in school-lunch perceptions and lunchtime and daily fruit and vegetable consumption from 2016 to 2018. Among 8th graders, perceptions that school lunch tastes good and that school lunch was enough to make students feel full increased 0.2 points (on a 5-point scale; p < 0.01) in intervention schools relative to control schools. Among 10th graders, lunchtime fruit and vegetable consumption increased 6% in intervention relative to control schools (p < 0.05 and p < 0.01 respectively). Daily fruit intake increased 0.1 cups/day in intervention relative to control schools among 9th graders (p < 0.01). This study provides important evidence on the limited effect of design approaches in the absence of meal changes. We observed only modest changes in school lunch perceptions and fruit and vegetable consumption that were not consistent across grades, suggesting that additional efforts are needed to improve school-lunch uptake.