Methods and Fidelity of Smarter Lunchrooms Program to Decrease Plate Waste in Children’s School Lunch Meal
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Date
2015-05
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The Ohio State University
Abstract
Obesity is the most common chronic disease among children. National School Lunch Program (NSLP) plate waste may contribute to caloric overconsumption as students compensate for wasted calories by selecting energy-dense, nutrient-deficient alternatives. The purpose of this study was to develop and implement Smarter Lunchrooms (SL) programming in Ohio to promote healthier food selection and lessen plate waste among children participating in the NSLP. SL was a pre-post intervention trial targeting school-aged children at a convenience sample of 12 schools (mostly grades K-5). Rooted in behavioral economics theory, SL employs multi-component interventions individualized to each school. Trained researchers conducted pre- and post-analysis of SL practices at each school using a standardized tool, developed by the Cornell Center for Behavioral Economics in Child Nutrition Programs, in which researchers rate (0-5) the level of SL practices across five categories (Fruit, Vegetable, White Milk, Target Entrée, and Reimbursable Meal) for a possible total of 25 points. Scores were averaged (mean+SD) across schools and categories. Process evaluations were completed at a subset of schools weekly for 3 weeks post-intervention to determine fidelity of program implementation. SL practice scores increased from 7.4+3.3 pre-intervention to 13.8+2.3 post-intervention. All categories showed improvement post-intervention with the largest advancement in Fruit (+3.3) and Vegetable (+1.5) practices. Process evaluation data showed 69% compliance overall. Compliance was lowest for SL strategies of increasing the number of locations fruit is offered (55%), labeling fruit (44%) and targeted entrée (17%) with creative, age-appropriate names, and offering equal amounts of white and chocolate milk (38%). These results demonstrate SL programming was developed and implemented across Ohio schools with moderate implementation fidelity. Future research is needed to evaluate factors related to the fidelity and development of effective tactics to improve programming fidelity.