How Environmental Interventions Influence Behavior in School Lunchrooms
Condition: Child Behavior; Adolescent Behavior; Health Behavior
Study type: Interventional

Summary: 
      The investigators hypothesize that the new United States Department of Agriculture (USDA)
      regulations for lunches served as part of the National School Lunch Program will decrease the
      percentage of enrolled students purchasing lunch, increase the percentage of children taking
      fruit and vegetables, decrease the percentage of fruit and vegetable servings being thrown
      away, and increase the total number of fruit and vegetable servings eaten.

      The investigators also hypothesize that when the regulations are in force, simple behavioral
      interventions can counteract the potentially negative impact on lunch sales and consumption.
      In other words, implementing the regulations and behavioral interventions together, the
      percentage of enrolled students taking a school lunch will increase at least back to baseline
      levels, the percentage of children taking fruits and vegetables will increase, the percentage
      of fruit and vegetable servings wasted will decrease, and the total number of fruit and
      vegetable servings eaten will increase.
    

Detailed description: 
      This study was conducted in 43 schools in the New York City (NYC) School district in the
      spring of 2012. The new regulations for school lunches were scheduled to roll out nationally
      in the fall of the same year, so this study was designed to provide an indication of the
      impact the new regulations would have.

      In addition to the regulations, the investigators also tested additional behavioral
      interventions, in conjunction with the regulations, to determine how the behavioral
      interventions might offset, or magnify, the impacts of the regulations.
    

Intervention name(s): USDA Regulations; Marketing Kit; Smarter Lunchrooms Makeover (SLM)
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Implement new USDA regulations assigned school cafeterias.
Fruit or vegetable on every tray
Meet requirements for vegetable varieties
50% of all grains must be whole grain
Milk must be 1% or skim; flavored milk must be skim; This marketing tool kit is designed to encourage purchasing of school lunches. The marketing tool kit included the following components:
56''x72'' vinyl sign with the words "[school mascot] Cafe"
8.5''x11'' signs describing the foods offered on a specific day
2''x4'' signs used to name all foods. These were to be placed in a visible location near the corresponding food.
Magnetic board displaying a tray onto which magnets shaped as food can be placed to show what foods were being offered during a specific lunch shift.; Implement three basic Smarter Lunchrooms techniques. It consists of the following components:
Place fruit in an attractive bowl or serving dish and set on two places on the line. One of the places should be at or near the register.
Give all vegetables descriptive names and write or type them on a 2''x4'' card. These cards should be visible and placed near the corresponding food.
Make white milk the most prominent milk in the milk coolers by making it the most available milk and easiest to take.
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Other
Keywords: Food Intake Regulation; Fruit; Vegetable