Technology and Design Innovation for School Lunch

Study Overview
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Brief Summary
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This study will evaluate an innovative school lunch intervention that is designed to increase school meal participation and improve dietary intake among middle and high school students.

Detailed Description
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Improving dietary intake among low-income youth is critical to reducing obesity, and schools are arguably the most important system in which to intervene. In 2010, Congress passed the Healthy, Hunger-Free Kids Act to better align school meal standards with the Dietary Guidelines, making school meals a nutritious option for students. Increasing participation in the school meal program, therefore, especially among low-income youth, has the potential to improve dietary intake among students and ultimately reduce childhood obesity. Over three school years, the University of California (Berkeley's School of Public Health and the Division of Agriculture and Natural Resources' Nutrition Policy Institute) will evaluate an innovative, student-centered school-lunch intervention to increase school lunch participation and improve dietary intake among low-income middle and high school students. The project will be conducted in the San Francisco Unified School District (SFUSD), a large and diverse urban district serving over 32,000 students (70% of total) eligible for free or reduced-price meals. The intervention, developed in partnership with the global design firm IDEO, aims to promote healthier habits by leveraging principals of behavior economics. The intervention involves the following three components: 1) a smartphone application (SmartMeal) that allows students to pre-order school lunches, receive nutrition information about school lunch options, and provide feedback about meals to food service staff, 2) distributed points of sale for school meals, achieved through the addition of mobile food carts and vending machines, and 3) a staff wellness curriculum that encourages staff to promote school meals and model healthful eating behaviors to students.

Official Title
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Technology and Design Innovation to Support 21st Century School Nutrition

Conditions
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Childhood Obesity

Intervention / Treatment
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* Behavioral: SmartMeal application
* Behavioral: Distributed points of sale
* Behavioral: Staff wellness curriculum


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All 7th-10th grade students at participating schools are eligible to participate in the student survey All 6th-12th grade students who eat the school lunch are eligible to participate in plate waste data collection All 7th-10th grade teachers are eligible to participate in the teacher survey Exclusion Criteria: There are no exclusion criteria
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: School lunch intervention<br>Intervention schools (6 middle and 6 high) will receive the complete school lunch intervention for two school years. | Behavioral: SmartMeal application<br>* The SmartMeal application is a smartphone application that will allow students to pre-order school meals, receive nutrition information about school meals, and provide feedback about school meals to Student Nutrition Services.<br>Behavioral: Distributed points of sale<br>* To increase points of sale for school meals (outside the cafeteria), school meals will be sold at hot and cold mobile food carts and vending machines throughout the school.<br>Behavioral: Staff wellness curriculum<br>* A wellness curriculum will be implemented that encourages teachers and staff members to eat school meals and promote them to students.<br>|
| No Intervention: School lunch control<br>Control schools (6 middle and 6 high) will not receive the school lunch intervention for two school years. Lunch delivery will proceed as normal. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in school lunch participation | Daily school lunch participation records broken down by grade, gender, and free or reduced-price meal eligibility at each school. | 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in plate waste during lunch among students who eat school lunch | Individual-level waste of food components achieved through visual estimation and aggregate waste of food components achieved through weighing. | 2 school years | 
| Change in fruit consumption at lunch | Student survey that asks about fruits consumed at lunch yesterday | 2 school years | 
| Change in vegetable consumption at lunch | Student survey that asks about vegetables consumed at lunch yesterday | 2 school years | 
| Change in weekly fruit consumption | Student survey that asks about fruits consumed during a typical week | 2 school years | 
| Change in weekly vegetable consumption | Student survey that asks about vegetables consumed during a typical week | 2 school years | 
| Change in variety of fruits consumed by students at lunch | Student survey that asks about fruits consumed at lunch yesterday | 2 school years | 
| Change in variety of vegetables consumed by students at lunch | Student survey that asks about vegetables consumed at lunch yesterday | 2 school years | 
| Change in variety of fruits consumed by students each week | Student survey that asks about fruits consumed during a typical week | 2 school years | 
| Change in variety of vegetables consumed by students each week | Student survey that asks about vegetables consumed during a typical week | 2 school years | 
| Change in body mass index (index) | BMI data collected each year on 7th and 9th grade students via the California Physical Fitness Test | 2 school years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Secondary schools, School lunch, Plate waste