Progress 06/15/12 to 06/14/18
Outputs
Target Audience:Extension Agents, EFNEP and SNAP-Ed professionals, Academics, School Lunch Professionals. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided?Smarter Lunchrooms training for Cooperative Extension staff and School Lunchroom Staff, as well as invitation for Cooperative Extension staff and school food service directors to additional Smarter Lunchrooms training after intervention completion. How have the results been disseminated to communities of interest?In additionto the papers published, conferences presentations and posters, the Community of Practice (http://articles.extension.org/healthy_food_choices_in_schools) that we developed as part of this grant has hosted dozens of webinars and published roughly 500articles related to school lunch. Many of these were direct results from the grant, while some were the result of the community created by the CoP. Press releases have been developed and distributed to previously participating schools and Cooperative Extension offices, and press releases for current schools have been developed. During the course of the grant, over 100 trainings that utilized results from the grant have been conducted in locations across the country. Over 10,000 people have been training in person. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
Major accomplishment for the final year of the project included dissemination of the results via multiple trainings conducted for School Nutrition, Extension and Nutrition Professionals via over 20 day long training session (totaling over 2000 individuals) a 2.5 day symposium held on the Cornell Campus (120 attendees) and mutilple webinars and articles published on the Extension website through the Community of Practice that was created as partof the grant.https://articles.extension.org/healthy_food_choices_in_schools
Publications
- Type:
Other
Status:
Other
Year Published:
2017
Citation:
Gaines, A., Hill, T., & Dollahite, J. (2017). Process evaluation of a smarter lunchrooms RCT comparing school-selected cafeteria changes with assigned changes. Oral presentation at the International Society for Behavioral Nutrition and Physical Activity annual conference.
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Progress 06/15/16 to 06/14/17
Outputs
Target Audience:School food Service Professionals, Extension Professionals and other academics researching in this area. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided?Smarter Lunchrooms training for Cooperative Extension staff and School Lunchroom Staff, as well as invitation for Cooperative Extension staff and school food service directors to additional Smarter Lunchrooms training after intervention completion. How have the results been disseminated to communities of interest?In the past year, four papers have been published, with several more in process or submitted. The Community of Practice (http://articles.extension.org/healthy_food_choices_in_schools) that we developed as part of this grant has hosted 12 webinars and published roughly 65 articles related to school lunch. Many of these were direct results from the grant, while some were the result of the community created by the CoP. Press releases have been developed and distributed to previously participating schools and Cooperative Extension offices, and press releases for current schools have been developed. What do you plan to do during the next reporting period to accomplish the goals?June 2017 - December 2017: Complete analysis of collected data - Complete initial draft of all relevant papers. September 2017 to December 2017: Complete data collection NRC via Nutrislice in Florida Schools as detailed above. January 2018 - June 2018: Complete and submit final round of papers. Analyze data from NRC, draft and submit data from results of NRC study.
Impacts
What was accomplished under these goals?
Phase one data analysis of both process evaluation and intervention testing data was completed. Additionalanalysisis needed and will be completed in the coming year. The Community of Practice, "Healthy Food Choices in Schools" hosted 12 webinars and published over 6oarticles related to school food. Contacts were made with schools in Florida for testing of Nutritional Report Card. Results of process evaluation were used to assist in the creation/modification of the Smarter Lunchrooms national training program.
Publications
- Type:
Journal Articles
Status:
Published
Year Published:
2017
Citation:
Fruit-Promoting Smarter Lunchrooms Interventions: Results from a Cluster RCT, American Journal of Preventive Medicine 52(4):451 458
- Type:
Journal Articles
Status:
Submitted
Year Published:
2016
Citation:
Vegetable-Promoting Smarter Lunchroom RCT Positively Impacts Healthy Food Items
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2016
Citation:
Smarter Lunchrooms: Does Changing Environments Really Give More Nutritional Bang for the Buck? (SNEB)
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2016
Citation:
Process Evaluation of The Smarter Lunchrooms Randomized Control Trial: Year 4 Results (SNEB)
- Type:
Journal Articles
Status:
Published
Year Published:
2016
Citation:
Process Evaluation of the Smarter Lunchrooms Randomized Controlled Trial: Years 1-3. Journal of Nutrition Education and Behavior, 48(7), S119.
- Type:
Journal Articles
Status:
Published
Year Published:
2016
Citation:
). Implementing Smarter Lunchrooms Makeovers in New York state middle schools: an initial process evaluation. Archives of Public Health, 74(1), 41.
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Progress 06/15/15 to 06/14/16
Outputs
Target Audience:School food Service Professionals, Extension Professionals and other academics researching in this area. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided? Smarter Lunchrooms training for Cooperative Extension staff and School Lunchroom Staff, as well as invitation for Cooperative Extension staff and school food service directors to additional Smarter Lunchrooms training after intervention completion. How have the results been disseminated to communities of interest? Results from Year 2 of the intervention (SY 2013-2014) have been developed into two papers, and submitted and under review for publication in academic journals. Press releases have been developed and distributed to previously participating schools and Cooperative Extension offices, and press releases for current schools will be developed upon completion of intervention and analysis of results. Conference presentations for previous years have been developed, and results from the current year will be developed into upcoming presentations, including the annual Society for Nutrition Education and Behavior conference. What do you plan to do during the next reporting period to accomplish the goals? In year 5, the project will focus on analyzing and disseminating both outcome and process evaluation data from the lunchroom interventions in years 1-4 to project stakeholders. Findings will be used to develop resources and tools for stakeholders and will be made available on the eXtension Healthy Food Choices in Schools Community of Practice. Formative parent messaging research will continue, working with middle school students and their parents to determine the types of food children report consuming at home and school, home food discourse and dynamics, nutrition information sought, and electronic platforms used. In partnership with the company Nutrislice, we will send nutrition report cards to participating parents at a sample of Florida middle schools. Selection data will be analyzed to determine the impact of the report cards on food selection.
Impacts
What was accomplished under these goals?
Year 4: Smarter Lunchrooms Intervention Overview: Based on previous process evaluation findings of varying implementation fidelity, a new research objective was identified to test the impacts of the intervention with a.) fewer intervention protocols to implement, and b.) food service staff ownership of intervention. 18 New York middle schools participated in the research project during the Spring 2016 semester (February-May). Schools were allocated into three groups: selection, matched/ assigned, and control Schools in the selection group were allowed to pick from a list of Smarter Lunchrooms intervention protocols (described below), and select which protocols to implement in their cafeterias. Schools in the matched/ assigned group were matched with a "selection" school based upon their existing lunchroom practices, and were assigned the same intervention protocols to implement. Schools in the control group made no changes to their existing cafeteria set up. The schools either selected or were assigned two protocols from each category (6 total): 1.Promotion of fruits: locating fruit first on the line, locating fruit in multiple locations, using large fruit bowl to display fruit, using attractive serving cups for fruits, labeling fruit with creative names, displaying fruit factoid posters 2.Promotion of vegetables: locating vegetables after entrée, locating vegetables at multiple locations, using attractive serving cups for raw/cut vegetables, labeling vegetables with creative names, displaying vegetable factoid posters 3.Promotion of low-fat white milk: displaying low-fat white milk in front of flavored milk, displaying "ice cold white milk" signs, displaying low-fat white milk as 1/3 of visible beverages Treatment schools implemented the intervention protocols for a period of 6-weeks with the assistance and support of Cornell Cooperative Extension nutrition education staff. Selection, waste, and consumption of food items were measured pre and post intervention by trained researchers using the quarter-waste method of visual estimation. Process evaluation was conducted to determine treatment implantation, and investigate barriers and facilitators. All schools were visited pre, during, and post-intervention to assess fidelity. Post-intervention, semi-structured interviews will be conducted with extension nutrition educators, school food service directors, and cafeteria staff. Intervention will be complete in May 2016. Year 4: Parent Messaging Development Formative parent messaging research continued, working with middle school students and their parents. Nutrition messages continue to be developed to help parents engage with their middle school children around food in a positive way, and encourage them to make healthier food choices at home and school. Results will guide development of nutrition message package, and forthcoming investigation of parent-child dyad research.
Publications
- Type:
Journal Articles
Status:
Submitted
Year Published:
2015
Citation:
Smarter lunchrooms: Environmental changes that increase vegetable selection(American Journal of Public Health)
- Type:
Journal Articles
Status:
Submitted
Year Published:
2015
Citation:
Fruit-related Interventions in Smarter Lunchrooms Also Increase Milk and Vegetable Intake (American Journal of Preventive Medicine)
- Type:
Conference Papers and Presentations
Status:
Accepted
Year Published:
2015
Citation:
Smarter Lunchrooms: Does Changing Environments Really Give More Nutritional Bang for the Buck? (SNEB)
- Type:
Conference Papers and Presentations
Status:
Accepted
Year Published:
2015
Citation:
Process Evaluation of The Smarter Lunchrooms Randomized Control Trial: Year 3 Results (SNEB)
- Type:
Conference Papers and Presentations
Status:
Accepted
Year Published:
2015
Citation:
Process Evaluation of The Smarter Lunchrooms RCT: Unique Aolications of the Re-Aim Framework Year 3 (SNEB)
- Type:
Journal Articles
Status:
Submitted
Year Published:
2015
Citation:
Implementing Smarter Lunchrooms Makeovers in New York Middle Schools: an Initial Process Evaluation (Implementation Sciences)
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Progress 06/15/14 to 06/14/15
Outputs
Target Audience:Middle School Students, Cooperative Extension Professionals Changes/Problems: Due to the introduction of CEP, our ability to utilize the food service management software Nutrikids as planned is eliminated. Nutrikids is unable to actively solicit or recruit parents. With CEP schools, there is no longer motivation or need for parents to log-in to the website. Combined, this results in a significant reduction or complete elimination of our ability to recruit parents to receive messages through Nutrikids. As a result, we propose the following: The research team will no longer utilize Nutrikids, but will now collaborate with Nutrislice- a similar food service management software company operating in Florida state-wide. Nutrislice's system collects individual-level data on student selection, and the company is willing to push out messages to parents. The research team will work with Nutrislice in Year 4 to send non-tailored electronic messages to parents at a selected sample of Florida middle schools. Messages will be developed to address nutrition and economic aspects of school lunch, and will determine which focus effects greater change in student selection. Selection data are collected by cafeterias, and will be sent to the research team. Due to logistical and travel constraints, lunchroom interventions will not be conducted in the Florida schools, and no consumption (plate waste) measures will be obtained. What opportunities for training and professional development has the project provided?Extensive Training for Cooperative Extension staff and School Lunchroom Staff How have the results been disseminated to communities of interest?
Nothing Reported
What do you plan to do during the next reporting period to accomplish the goals? Generic, non-tailored messages supporting the changes occurring in the lunchroom interventions are being developed. These messages are designed to bridge the home-school gap and will include associated strategies for parents to use. They will be acceptable and useful to parents, and informed by interview data from middle school students. Formative research with students will continue throughout Year 4 to determine the types of food children report consuming at home and school, home food discourse and dynamics, nutrition information sought, and electronic platforms used. Products will include a set of messages and associated strategies for parents that will be available for intervention development and for USDA programs to use in outreach. The combination of lunchroom interventions and NRCs will not be completed as planned. Instead, the research team will work with schools to identify and select lunchroom interventions to implement in Year 4. Selection, consumption, and process measures will be collected as previously done in Years 1-3. Process data from Years 2 and 3 consistently reveal issues with cafeteria staff buy-in, particularly in response to being told what to do by an outsider. We propose a novel objective, to determine both the fidelity to intervention components, and the effect of lunchroom changes when school cafeteria staff are able to select the intervention components themselves. Treatment schools will select from a list of Smarter Lunchroom changes, and the control schools will enact no changes in their lunchrooms. These data, combined with data from previous years, will allow us to report on fidelity to and impact of assigned changes as compared to self-selected changes. School sample will be selected on CEP and non-CEP status, with a mix of rural and urban schools in each group.
Impacts
What was accomplished under these goals?
Year 3: Combination Smarter Lunchroom Interventions •Combination of Smarter Lunchroom treatment conditions were tested to determine cumulative effect size. •Outcome and process measures were the same as Year 2. •Six intervention schools (3 urban, 3 rural) and six control schools participated. •Combined intervention included (See Figure 3): 1.Promotion of fruits: locating fruit first & in multiple locations, using large fruit bowl & attractive serving cups for fruits, labeling fruit with creative names, displaying fruit factoid posters; and 2.Promotion of vegetables: locating vegetables after entrée & at multiple locations, using attractive serving cups for raw/cut vegetables, labeling vegetables with creative names, displaying vegetable factoid posters; and 3.Promotion of low-fat white milk: displaying low-fat white milk in front of flavored milk, and as 1/3 of visible beverages. Year 3: Parent Messaging Development •Nutrition messages are being developed to help parents engage with their middle school children around food in a positive way, and encourage them to make healthier food choices at home and school. •Nutrition-related concerns identified by parent focus groups (n=46) were used to inform development of messages and goal setting strategies. •Additional interviews with parents (n=17) and middle school children(n=21) are being conducted to refine messages and solicit information about desired nutrition information and preferred platforms for message delivery. Results will guide development of nutrition message package, and forthcoming investigation of parent-child dyad research Years 2-3: Process Evaluation •Process evaluation was conducted to determine treatment implantation, and investigate barriers and facilitators. •All schools were visited pre, during, and post-intervention to assess fidelity. •Post-intervention, semi-structured interviews were conducted with extension educators, food service directors, and cafeteria managers. •Varying compliance with intervention protocol was identified. •Efforts to enhance communication and buy-in are being explored. Incentives for training and compliance, as well as feedback on intervention impact are thought to increase motivation and improve compliance.
Publications
- Type:
Conference Papers and Presentations
Status:
Accepted
Year Published:
2014
Citation:
SNEB Poster
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Progress 06/15/13 to 06/14/14
Outputs
Target Audience: Researchers in the fields of Nutrition, Education and Behavior Change and Extension Professionals Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided? In year two, opportunities for professional development consisted of field research opportunities for the Post Docs associatedwith the project. In particular, the chance to apply process evaluation to pilot research conducted earlier. In addition, Extension professionals were provided training in the basic of Behavioral Economics and how to apply them in a lunchroom environment. How have the results been disseminated to communities of interest? Posters presented at the 2013 Society of Nutrition Education and Behavior Conference, theInternational Society of Behavioral Nutrition and Physical Activity conference and through training of Extension professionals. What do you plan to do during the next reporting period to accomplish the goals? Year Three: Implementation ofCombination Smarter Lunchroom Interventions,Pilot Testing of Nutritional Report Card parentmessaging. · Fall 2014/Spring 2015: Testing of combination Smarter Lunchroomtreatment conditions to determine effects size of treatment combination. · Interventions will include promotion of fruits and vegetablesthroughgiving them creative names (e.g. "x-ray visioncarrots"), re-packaging inattractive cups, placingfruits first in the line, and placing vegetables afterthe main entrée;promotion of low fat white milk by placing it infront ofother beverages and ensuring it is available in all beveragecoolers. · 6 Intervention Schools (3 Urban and 3 Rural) and 6 controlschools (3Urban and 3 Rural) recruited. · Outcome measures include pre- and post-intervention productionrecords,and plate waste observations. · A number of strategies to enhance validity and reliability willbe employedand process evaluation tools include measuresof fidelity andcontamination. Nutrition Report Card/Parent Messaging Development · Along with findings from peer-reviewed literature, salient foodandnutrition topics identified by parents in seven formative focus groups willbe used to develop concept messages and goals. · Messages and goals will be pilotedwith families at two schools (one rural,one urban) over the course of sixweeks. Families will be randomlyassigned to one of three treatment conditions:1) parents receive weeklymessages and accompanying educational information,including associatedgoals and goal setting instructions 2) children receivemessages and goalchoices 3) parent-child dyads receive messages and goalchoices.Outcomedata will be collectedto assess the relative effectiveness of eachtreatment.
Impacts
What was accomplished under these goals?
Year Two: Implementation of Single Smarter Lunchroom Interventions, Testing of Nutritional Report Card. • Fall 2013/Spring 2014: Testing of single Smarter Lunchroom treatment conditions to determine effects size of each one separately. • Interventions included promotion of fruits and vegetables through giving them creative names (e.g. "x-ray vision carrots"); promotion of the most healthful entrée by placing it first in the serving line; promotion of low fat milk by placing it in front of other beverages and ensuring it is available in all beverage coolers. • 8 Intervention Schools (4 Urban and 4 Rural) and 4 control schools recruited. • Outcome measures include pre- and post-intervention sales and production records, and plate waste observations. • Preliminary analysis of data show positive impacts for all the interventions, particularly those for Milk and Fruit. Schools receiving the milk intervention increased consumption by an average of 9%. Fruit waste decreased by an average of 14%. Healthy Food Choices in SchoolsCommunity Of Practice. • Officially launched in August of 2013. • Total Members of Community 141. • 160 articles (written by members) currently on the E-extension site. • 7 webinars hosted. • 2800 unique visitors have accessed content on the site. Nutrition Report Card and Parent Messaging Development In order to develop the proper messaging to include in the Nutritional Report Card, research was conducted with parent groups to determine their concerns and needs: • Parents have many concerns about the foods that their children eat at school. • Few parents expressed satisfaction with variety, quality, and (in rural areas) cost of lunches. • There are clearly areas for quality improvement in some school cafeterias, but this research has also identified opportunities for increasing parent’s understanding of National School Lunch Program policies and their local implications. • Results indicate that parents’ views of most important/least important food related behaviorsdo not consistently align with federalnutrition guidelines. • Moving forward interventions could aim to narrow these differences through providing more online information to parents.
Publications
- Type:
Conference Papers and Presentations
Status:
Accepted
Year Published:
2013
Citation:
"Using Exploratory Process Evaluation to Aid in the Design of a Complicated School Lunchroom Intervention" Presented at International Society of
Behavioral Nutrition and Physical Activity Conference
"Smarter Lunchrooms: Does Changing Environments Really Give More Nutritional Bang for the Buck" Presented at the Society for Nutrition Education and Behavior Conference
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Progress 06/15/12 to 06/14/13
Outputs
Target Audience:
Nothing Reported
Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided? In year one, opportunities for professional development consisted offield research opportunities for the Post Docs associated with the project. In particular, the chance to apply process evaluation to pilot research conducted earlier. How have the results been disseminated to communities of interest?
Nothing Reported
What do you plan to do during the next reporting period to accomplish the goals? Year Two: Implementation of Single Smarter Lunchroom Interventions, Testing of Nutritional Report Card. • Fall 2013/Spring 2014: Testing of single Smarter Lunchroom treatment conditions to determine effects size of each one separately. • Interventions will include promotion of fruits and vegetables through giving them creative names (e.g. "x-ray vision carrots”); promotion of the most healthful entrée by placing it first in the serving line; promotion of low fat milk by placing it in front of other beverages and ensuring it is available in all beverage coolers. • 8 Intervention Schools (4 Urban and 4 Rural) and 4 control schools recruited. • Outcome measures include pre- and post-intervention sales and production records, and plate waste observations. • A number of strategies to enhance validity and reliability will be employed and process evaluation tools include measures of fidelity and contamination. Nutrition Report Card Development • Elicitation study will be conducted to determine food and nutrition related concerns held by parents in relation to their children using focus group methodology. A formative card sort has been developed (and is currently being piloted) that will aid researchers in identifying salient topics surrounding food and nutrition at home and in the school. • Based on these findings, plus published literature, concept messages will be developed and cognitive testing performed with parents from a variety of settings and backgrounds. • Students will be randomized so parents receive either generic or tailored messages based on what their child has purchased for lunch that week. Outcome measures will include sales records of individual students participating in the NRC treatment as well as the control treatment.
Impacts
What was accomplished under these goals?
Exploratory process evaluation of a pilot study was conducted to help define components of the intervention, and to establish barriers and facilitators that may influence fidelity to the intervention. The findings will be used to enhance reliability and validity in randomized controlled trials in year 2 and beyond. • Intervention: SLs were implemented in the cafeterias of 13 schools in the state of New York. One rural/ suburban (R/SU) county and one urban/suburban (U/SU) county were selected. • With the assistance of extension educators, school food service directors (FSDs) and cafeteria managers implemented low or no cost changes into the lunchrooms, under the guidance of a campus-based team of researchers. • Sales, participation, production, and inventory records were collected along with plate-waste measures. • Methods: Semi-structured interviews were performed with extension educators, school food service directors, and cafeteria managers (n=18) in the two participating counties. • Objective was to capture challenges associated with various components of implementation of lunchroom changes, including training, plate waste studies, staff, maintenance, and potential sources of contamination. • Findings: Compliance with intervention protocol was a major concern. Improved motivation of cafeteria staff and communication among all levels of actors are thought to help increase compliance with intervention delivery. Support, respect, and empowerment appear to be fundamental to increasing cafeteria staff’s motivation and ‘buy-in.’ Further, regular feedback on the impact of the intervention to the cafeteria staff is thought to help increase motivation and improve compliance. Year One: Creation of Healthy Food Choices in Schools Community of Practice (CoP) • A new resource area of the eXtension network. • Designed as an online resource for stakeholders community agencies (e.g.. Cooperative Extension) food service worker/directors, administrators, parents,) concerned with helping schools to encourage more healthful eating by students in cafeterias. • Currently hosting over 100 content items focused on encouraging students to choose and eat healthful foods, promoting parent-school-student dialogues about healthful eating and the business of school food. Created by members of the AFRI team in collaboration with experts from a wide variety of related fields, including school food service, extension, not for profits (e.g. Alliance for a Healthier Generation) and other universities engaged in school research. • Features over 130 FAQs and an “Ask an Expert” forum that allows visitors to ask questions related to school food with a turn-around time of 48 hours for answers to be sent out. • Currently has 86 members providing content. • Official launch for the CoP is August 15th, 2013
Publications
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