How Environmental Interventions Influence Behavior in School Lunchrooms

Study Overview
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Brief Summary
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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
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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.

Official Title
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Evaluating the Impact on Lunch Sales and Consumption of New School Lunch Guidelines and Behavioral Interventions in NYC Schools

Conditions
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Child Behavior, Adolescent Behavior, Health Behavior

Intervention / Treatment
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* Behavioral: USDA Regulations
* Behavioral: Marketing Kit
* Behavioral: Smarter Lunchrooms Makeover (SLM)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Public schools with any combination of grades K-12 Exclusion Criteria: No point of sale system in school Satellite school Feeder school

Ages Eligible for Study
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Minimum Age: 5 Years
Maximum Age: 19 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: USDA Regulations Only<br>Implement USDA Regulations in assigned school cafeterias during the intervention period. | Behavioral: USDA Regulations<br>* 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<br>|
| Experimental: USDA Regulations and Marketing Kit<br>Implement new USDA regulations in assigned schools along with the Marketing Kit during the intervention period. | Behavioral: USDA Regulations<br>* 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<br>Behavioral: Marketing Kit<br>* 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.<br>|
| Experimental: USDA Regulations and SLM<br>Implement USDA Regulations and Smarter Lunchrooms Makeover in assigned schools during intervention period. | Behavioral: USDA Regulations<br>* 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<br>Behavioral: Smarter Lunchrooms Makeover (SLM)<br>* 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.<br>|
| No Intervention: Control<br>Schools assigned to this intervention made no changes to their lunchroom or menus. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in percent fruit or vegetable waste by student | In the twelve schools, tray waste data were collected twice in April 2012 and once in May 2012. Results were generated and reported in September 2012. | Six months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in lunch sales | Lunch sales data were collected each school day in the 43 schools from March through May 2012. Results were generated and reported in September 2012. | Six months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Food Intake Regulation, Fruit, Vegetable