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Summer 2017Policy Report

University of Iowa Public Policy Center •209 South Quadrangle, Iowa City, IA 52242-1192 O - 319.335.6800 • F - 319.335.6801 • www.ppc.uiowa.edu

Communication and Behavioral Economics Lunchroom Intervention in Iowa:Evaluation results and recommendations Report to Iowa Department of Education, Team NutritionPatrick Brady, MSDepartment of Community & Behavioral Health Public Policy Center The University of Iowa

Grace Ryan, MPHDepartment of Community & Behavioral Health The University of Iowa

Natoshia M. Askelson, PhD, MPH Department of Community & Behavioral Health Public Policy Center The University of Iowa

Wensday Worth, BSDepartment of Community & Behavioral Health The University of Iowa

Amanda Janson MAT, BSDepartment of Community & Behavioral Health The University of Iowa

Felicia Pieper, AADepartment of Community & Behavioral Health The University of Iowa

Natalie VeldhouseSchool of Social Work The University of Iowa

Isabella De Soriano, MPHDepartment of Community & Behavioral Health The University of Iowa

Laurel Tuggle, MPHDepartment of Community & Behavioral Health The University of Iowa

ContentsList of Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Communication and Behavioral Economics in the Lunchroom . . . . . . 4

Description of the Intervention in Iowa . . . . . . . . . . . . . . . . . . . . . . 5 Description of Communication and Behavioral Economics Intervention . . . . . . .5

Description of Participating Schools . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Description of changes made . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Data Collection Activities: Methods, Analysis, and Results . . . . . . . 7 School Wide Student Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7

Parent Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

Food Service Staff Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

School Lunch IOWA Assessment Tool . . . . . . . . . . . . . . . . . . . . . . . . . 9 Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 Results by School . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

Production Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

Food Service Director Interviews . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Methods & Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 Sample Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12 Perceptions of The Communication and Behavioral Economics intervention . . .12 Training preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12 Student Involvement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12 Challenges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

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Appendix 1: School Lunch Iowa Tool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17Appendix 2: Student-Staff Who Am I Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18Appendix 3: Pictures of Lunchroom Changes School 1 . . . . . . . . . . . . . . . . . . . . . . .19Appendix 4: Pictures of Lunchroom Changes School 2 . . . . . . . . . . . . . . . . . . . . . . .21Appendix 5: Pictures of Lunchroom Changes School 3 . . . . . . . . . . . . . . . . . . . . . . .22Appendix 6: Pictures of Lunchroom Changes School 4 . . . . . . . . . . . . . . . . . . . . . . .23Appendix 7: Pictures of Lunchroom Changes School 5 . . . . . . . . . . . . . . . . . . . . . . .24Appendix 8: Pictures of Lunchroom Changes School 6 . . . . . . . . . . . . . . . . . . . . . . .27Appendix 9: Student Pre/Post Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29Appendix 10: Pre-Survey Results All Schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32Appendix 11: Post-Survey Results All Schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33Appendix 12: Pre-Survey Results School 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34Appendix 13: Post-Survey Results School 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35Appendix 14: Pre-Survey Results School 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36Appendix 15: Post-Survey Results School 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37Appendix 16: Pre-Survey Results School 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38Appendix 17: Post-Survey Results School 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39Appendix 18: Pre-Survey Results School 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40Appendix 19: Post-Survey Results School 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41Appendix 20: Pre-Survey Results School 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42Appendix 21: Post-Survey Results School 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43Appendix 22: Pre-Survey Results School 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44Appendix 23: Post-Survey Results School 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45Appendix 24: Parent Pre/Post Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46Appendix 25: Parent Survey Pre-Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52Appendix 26: Parent Survey Post-Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59Appendix 27: Food Service Staff Pre-Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .67Appendix 28: Food Service Staff Pre-Survey Results . . . . . . . . . . . . . . . . . . . . . . . .70Appendix 29: School 1 Lunchroom Assessment Pre- and Post-Report . . . . . . . . . . . .73Appendix 30: School 2 Lunchroom Assessment Pre- and Post-Report . . . . . . . . . . . .74Appendix 31: School 3 Lunchroom Assessment Pre- and Post-Report . . . . . . . . . . . . .75Appendix 32: School 4 Lunchroom Assessment Pre- and Post-Report . . . . . . . . . . . .76Appendix 33: School 5 Lunchroom Assessment Pre- and Post-Report . . . . . . . . . . . .77Appendix 34: School 6 Lunchroom Assessment Pre- and Post-Report . . . . . . . . . . . .78Appendix 35: Iowa Lunchroom Food Production Record Template . . . . . . . . . . . . . . .79Appendix 36: Production Records Results School 1 . . . . . . . . . . . . . . . . . . . . . . . . .80Appendix 37: Production Records Results School 2 . . . . . . . . . . . . . . . . . . . . . . . . .81Appendix 38: Production Records Results School 3 . . . . . . . . . . . . . . . . . . . . . . . . .82Appendix 39: Production Records Results School 5 . . . . . . . . . . . . . . . . . . . . . . . . .83Appendix 40: Production Records Results School 6 . . . . . . . . . . . . . . . . . . . . . . . . .84Appendix 41: Food Service Director/Other Adult: Phone Interview Guide . . . . . . . . . .85

List of Appendices

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Introduction

Communication and Behavioral Economics in the Lunchroom

Behavioral economics interventions use free or low cost, evidence-based changes to lunchrooms to improve school lunch participation, profits, and students’ healthy food choices.1-3 Implementing these changes in school lunchrooms has increased purchases of white milk, vegetables, and fruit.4-6

One common component of behavioral economics based interventions is suggestive selling; the use of verbal nudges to prompt specific food choices.7 Food service staff have the potential to play an important role in suggestive selling, as they have many opportunities to communicate with students during the lunch period. Training food service staff, particularly in under-resourced, rural schools can be an effective strategy to help food service staff become better communicators and enable them to utilize suggestive selling techniques with their students.8

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Description of the Intervention in Iowa

Description of Communication and Behavioral Economics Intervention

Planning for the Communication and Behavioral Economics project began in spring of 2016. Schools across Iowa were encouraged to apply to participate in this pilot project. Six schools were selected by Team Nutrition staff in early summer 2016 to participate in the project. Selected schools were expected to have regular communication with the team from the University of Iowa, participate in on-site visits, organize a student group to assist in the planning and implementation of the project, implement behavioral economics focused changes based on lunchroom assessments and student group feedback, encourage communication between food service staff and students through staff training and meetings between students and staff, and participate in the evaluation of the project. Schools were expected to participate in the project for the entire 2016-2017 school year and were encouraged to apply for sub-grants that would help fund their changes.

In fall 2016, the team visited each school to train students on the principles of behavioral economics and how to complete the School Lunch IOWA Assessment Tool (Appendix 1). Students then completed the lunchroom assessment in order to assess their lunchroom for behavioral economics target areas for improvement. Students were encouraged to take photos of the lunchroom and target areas. The team provided each school with a report reviewing their assessment tool results with suggestions for areas to target for changes. Following the assessment, students met with staff to complete a getting to know you exercise (Appendix 2).

In winter and early spring 2017, student groups and food service directors from each school met to identify the changes they would like to focus on, and ensured that changes would be made by early April 2017. Schools were offered the option of a second visit by the team during this time to discuss the intended changes with the students.

Throughout the school year, three webinars provided information and techniques to food service staff to improve communicate and engage their students. These webinars included information about the intervention and its importance, as well as adolescent development, communication strategies, and the role of food service staff in promoting healthy eating and combating obesity. In addition, clings for the service line featuring communication cues were provided to be utilized with food service staff. These cues were developed based on focus groups from a previous project.

In late spring 2017, the team returned to the schools for one final visit in order to have students complete the assessment tool to evaluate lunchroom changes. Students were encouraged to photograph the changes they made to their lunchrooms.

Description of Participating Schools

Five of the six participating schools were located in rural areas. Table 1 reports school characteristics free and reduced lunch eligibility data reported by the Department of Education.9

Table 1: School Characteristics

School Number

Grades served by

schoolEnrollment % FRL

eligibleNational Center for Health Statistics Ur-

ban-Rural Classification

1 6-8 515 22 .46% Rural, Fringe

2 6-8 360 38 .75% Town, Remote

3 k-12 441 25 .53% Rural, Distant

4 7-8 341 18 .45% Town, Distant

5 6-8 1140 23 .40% City, Small

6 5-8 529 42 .34% Town, Remote

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Description of changes made

Each school identified behavioral economics changes to make to their lunchroom based on the results of the lunchroom assessment described below. Table 2 reports the changes made by each school.

Table 2. Changes made by each school

School Number Changes Appendix with

pictures

1 Fruit display cart, new menu boards, tabletop stands for promoting fruits and vegetables 23

2 Utilizing fruit display bowls, employing fun, attractive names for menu items 24

3 Utilizing fruit display bowls, displaying milk promoting signs, rear-ranged milk order 25

4 Added screen to display menu, rearranged line, rearranged milk order 26

5 Utilize bright, colorful signage promoting healthy eating, rearrange milk order, utilizing fruit display bowls 27

6 Rearranging milk order, purchasing a sectionizer in order to make fruit more desirable, purchasing colorful bins to display fruit 28

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Data Collection Activities: Methods, Analysis, and ResultsA multi-faceted approach was utilized to evaluate the Communication and Behavioral Economics pilot project. Each data collection activity is described in full including the methods, analysis, and results per section. The data collection activities that will be described in this section include school-wide surveys with the student body, surveys with parents, surveys with food service staff, lunchroom assessment with the School Lunch IOWA assessment tool, production records, and telephone interviews with food service directors.

School Wide Student Survey

Methods

To assess student perceptions and attitudes of the lunchroom, an online survey was administered pre- and post-intervention. In October 2016, an email with a link to the online survey was sent to students via email by a school administrator or students were asked to complete the survey as part of a class. Students were asked to complete a 3-5 minute survey about their perceptions of the school lunchrooms and staff, how often students consumed school lunch, what factors were important in determining what they chose for school lunch, and reasons why school lunch was eaten. The complete survey can be viewed in Appendix 3. The post-survey was administered in the spring of 2017.

Analysis

In order to examine school-wide survey data, descriptive statistics were generated for all students. Frequencies of responses were calculated for every question both for the overall sample and for individual schools. These results are reported in Appendices 4 to 17. To compare the overall pre- and post-surveys, logistic regression was used to compare pre- and post-survey means for individual questions adjusting for the effects of the individual school. To compare pre- and post-survey results for individual schools, independent sample T-tests and Chi square tests were used. Significance was set at p<0.05.

Results

The results of the pre- and post-surveys completed by students at the six participating schools are described in this section including school response rates and pre- and post-survey responses.

Pre-and Post-Survey Response Rates

A total of 1,120 students initiated the pre-survey. It was necessary to exclude 63 responses from the sample due to failure to identify which school the respondent attended. An additional 68 responses were excluded due to respondents’ failure to complete a question beyond identifying the school they attended. These exclusions resulted in a final sample of N=989 students. The overall response rate for the pretest was 29.7% estimated from the overall enrollment for each participating middle school. The individual participation rates of each school were: School 1 (n =82) 15.9%, School 2 (n=56) 15.6%, School 3 (n=113) 25.6%, School 4 (n=130) 38.1%, School 5 (n=135) 11.8%, and School 6 (n=473) 89.4%.

A total of 1,029 students initiated the post-survey. It was necessary to exclude 25 responses due to failure to identify which school the respondent attended. An additional 78 responses were excluded due to the respondents’ failure to complete a single question. This exclusion resulted in a final sample of N = 926 students. The overall response rate for the post-test was 27.8%, estimated from the overall enrollment for each participating middle school. The individual participation rates of each school were: School 1 (n=20) 3.9%, School 2 (n=60) 16.7%, School 3 (n=88) 20.0%, School 4 (n=191) 56.0%, School 5 (n=112) 9.8%, and School 6 (n=455) 86.0%.

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Pre- and Post-Survey Results

For complete reporting of pre- and post-survey responses please see Appendices 4 to 17. Analysis of pre- and post-student surveys do not indicate any intervention effects on students’ perceptions and attitudes.

Parent Survey

Methods

To assess changes in parents’ perceptions and attitudes of the lunchroom surveys were administered pre- and post-intervention. An email with a link to the online survey was sent to parents in October 2016 by an onsite school administrator. Parents were asked to complete a 5-10-minute survey about their child’s participation in the school meals, why their child eats school lunch, communication of school lunch, the purpose of school lunch, perceptions of school lunchrooms and staff, and factors for keeping their child healthy. The complete survey can be viewed in Appendix 18. The post-survey was administered in the spring of 2017.

Analysis

In order to examine school-wide survey data, descriptive statistics were generated for all parents. In order to examine school-wide survey data, pre- and post-survey results were used to generate descriptive statistics for all students. Frequencies of response were calculated for every question for the overall sample. These results are reported in Appendices 19-20. To compare the overall pre- and post-surveys, logistic regression was used to compare pre- and post-survey responses for individual questions adjusting for the effects of the individual school. Significance was set at p<0.05.

Results

The results of the pre- and post-surveys completed by parents at the six participating schools are described in this section including response rates, student characteristics, and pre- and post-survey responses.

Pre- and Post-Survey Response Rates

A total of 637 parents initiated the pre-survey. It was necessary to exclude 59 respondents from the final sample due to their failure to identify which school their child attended and further necessary to exclude 1 respondent for their failure to answer a question beyond identifying their child’s school. These exclusions resulted in a final sample of N = 577 parents.

A total of 394 parents initiated the post-survey. It was necessary to exclude 41 respondents from the final sample due to identify which school their child attended. These exclusions resulted in a final sample of N = 353 parents.

Pre- and Post -Survey Results

For complete reporting of pre- and post-survey responses please see Appendices 19 and 20. Analysis of pre- and post-parent surveys do not indicate any intervention effects on parents’ perceptions and attitudes.

Results of Free Response Questions

Parents were asked two free response questions. In response to the question If your middle school child said anything to you about changes to school meals that occurred during the current school year, what did they say?, the majority who replied reported that their child stated the food tasted bad or bland. Students also reportedly complained about being hungry even after consuming lunch and not having enough time to finish their lunches. There were also positive reports regarding school lunch, including enjoying the variety of options provided. In response to the question Do you have any further thoughts

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or ideas about improving school meals at your middle school child’s school?, parents reported a number of strategies. Recommendations include: allowing more time for lunch, providing larger portion sizes, increasing the quality of food used, offering food that students want, removing vending machines with unhealthy options, incorporating locally grown foods, and providing incentives for trying new and healthy foods. There were no significant differences between pre- and post-survey responses.

Food Service Staff Survey

Methods

To assess the perceptions and attitudes of the Food Service Staff (FSS) an online survey was administered. Because of a low post-test response rate, only pre-test results are available. The pre-survey was sent via email to all FSS at the six participating middle schools by an onsite school administrator in October 2016. FSS were asked to complete a 5-10 minute-survey about the importance and promotion of fruit and vegetable consumption, perceived job responsibilities, barriers to fruit and vegetable preparation or promotion, and perception of students. The complete survey can be viewed in Appendix 21. The post-survey was administered in the spring of 2017.

Analysis

In order to examine school-wide survey data, descriptive statistics were generated. Due to a low response rate for the post survey, no pre- and post-analysis was performed.

Results

The results of the pre- and post-surveys completed by food service staff at the six participating schools are described in this section.

Pre- and Post-Survey Response Rates

A total of 33 food service staff initiated the pre-survey. It was necessary to exclude 3 responses from the sample due to failure to identify the school at which the respondent worked. These exclusions resulted in a final sample of N = 30. Individual school participation rates included School 1 (n=7), School 2 (n=12), School 3 (n=0), School 4 (n=3), School 5 (n=3), and School 6 (n=5).

A total of 16 food service staff initiated the post-survey. It was necessary to exclude 1 response from the sample due to failure to identify the school at which the respondent worked. This resulted in a final sample of N = 15. Individual school participation rates included School 1 (n=3), School 4 (n=4), School 5 (n=2) and School 6 (n=6). There were no responses from Schools 2 or 3.

Pre-Survey Results

For complete reporting of pre-survey responses please see Appendix 22.

School Lunch IOWA Assessment Tool

Methods

The School Lunch IOWA assessment tool (Appendix 1) is a self-assessment tool that can be used to evaluate school lunchrooms and help identify successes and areas for improvement. The tool was developed in order to be easily completed by middle school students and is based on evidence identifying aspects of the lunchroom that could be improved in order to promote healthy eating.10-20 All six participating schools administered the School Lunch IOWA assessment tool in the fall of 2016. Students completed the tool in small groups of two or three. When completing the tool, students were instructed to read the question, circle their response (always, sometimes, or never) and then indicate whether or not they took a picture of the item. Students were instructed to take pictures that illustrated items included in the assessment tool, unless directed not to. Finally, students were

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encouraged to supply additional comments in the notes section. The assessment tool data was used to identify potential areas for improvement during the intervention. Using pre-assessment tool responses provided by each school, the team identified areas that could be improved by low- or no-cost changes. The recommended areas for improvement were reported to the food service director, who passed them on to the student groups. In spring 2017, post-assessments were completed at six school sites. Student groups followed the same protocol for the pre- and post-assessments.

Analysis

Responses were scored as 2 for always, 1 for sometimes, and 0 for never. Average scores were calculated. Scores in the fall were compared to scores in the spring to assess the areas in which schools improved.

Results by School

School 1

The student group at School 1 completed a total of 3 assessments in the fall, prior to making any lunchroom changes. Scores ranged from 16-17, with a mean of 16.3. During late spring, the scorecards were administered again to assess the lunchroom. A total of 5 scorecards were completed by the student group. Student scorecards totals increased (range 25-28), with a mean of 25.8. Pre- and post-comparison reports can be seen in of these changes can be seen in Appendix 29.

School 2

The student group at School 2 completed a total of 4 assessments in the fall, prior to making any lunchroom changes. Scores ranged from 11-17, with a mean of 15. During late spring, the scorecards were administered again to assess the lunchroom. A total of 4 scorecards were completed by the student group. Student scorecards totals increased (range 16-21), with a mean of 18.3. Pre- and post-comparison reports can be seen in of these changes can be seen in Appendix 30.

School 3

The student group at School 3 completed a total of 4 assessments in the fall, prior to making any lunchroom changes. Scores ranged from 15-19, with a mean of 16.7. During late spring, the scorecards were administered again to assess the lunchroom. A total of 4 scorecards were completed by the student group. Student scorecards totals did not increase nor decrease (range 14-18), with a mean of 16. Pre- and post-comparison reports can be seen in of these changes can be seen in Appendix 31.

School 4

The student group at School 4 completed a total of 3 assessments in the fall, prior to making any lunchroom changes. Scores ranged from 13-16, with a mean of 14.7. During late spring, the scorecards were administered again to assess the lunchroom. A total of 4 scorecards were completed by the student group. Student scorecards totals increased (range 13-17), with a mean of 16.5. Pre- and post-comparison reports can be seen in of these changes can be seen in Appendix 32.

School 5

The student group at School 5 completed a total of 4 assessments in the fall, prior to making any lunchroom changes. Scores ranges from 9-11, with a mean of 10.3. During late spring, the scorecards were administered again to assess the lunchroom. A total of 4 scorecards were completed by the student group. Student scorecards totals increased (range 15-21), with a mean of 18. Pre- and post-comparison reports can be seen in of these changes can be seen in Appendix 33.

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School 6

The student groups at School 6 completed a total of 3 assessments in the fall, prior to making any lunchroom changes. Scores ranges from 10-12, with a mean of 11. During late spring, the scorecards were administered again to assess the lunchroom. A total of 4 scorecards were completed by the student group. Student scorecards totals increased (range 16-20), with a mean of 18.5. Pre- and post-comparison reports can be seen in of these changes can be seen in Appendix 34.

Production Records

Methods

Food service directors were asked to complete food production record templates (Appendix 29) to report vegetable, fruit, and milk production for one week in the fall and one week in the spring. The number of servings for each vegetable component, fruit, and milk initially prepared and the number of servings leftover were calculated. To determine the number of servings produced, the number of servings left over was subtracted from the number of servings prepared. Because some schools completed production records during a shortened week, the results for those schools were transformed to be representative of a five-day week to allow for a comparison between fall and spring.

Analysis

The number of servings of each meal component produced were compared in the fall and spring.

Results

Five schools provided production data that was able to be analyzed. Two schools increased servings of fruit and three schools increased servings of total vegetables and total milk. Increases for each component are shown in Table 3. More detailed results for each school can be found in Appendix 30 to 34.

Table 3. Increase in production of meal components. (A plus sign indicates an increase in production in spring compared to fall)

Meal Component

School DG Veg

RO Veg

BP Veg

S Veg O Veg Total

VegTotal Fruit

1% white

Skim White

Skim Choc

Total Milk

1 + + + + +

2 + + + + + + +

3 +

5 + + + + + + + +

6 + + + + + + +

Food Service Director Interviews

Methods & Analysis

Telephone interviews were conducted to assess the experiences and perceptions of food service directors (n=6). Interviews were conducted by a team member who had no previous interaction with staff at the participating schools. Interviews lasted approximately 13 to 27 minutes and assessed whether directors thought the project worked, what the outcomes were, and what preferred training methods were (see Appendix 35 for interview guide). Interviews were recorded and transcribed. Transcripts were reviewed by a social scientist not involved in the program or data collection. Themes and trends in the transcripts are highlighted below.

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Sample Characteristics

All but one participant had a job title that included “Director” (as in Food Service Director or Child Nutrition Director). Four of the six participants had one year or less of experience in their position. Of the two remaining participants, one had two years of experience and one had 15 years.

Perceptions of The Communication and Behavioral Economics intervention

All participants described the program as successful. They specifically mentioned positive outcomes of focusing on milk placement, fresh fruit presentation, and signage.

Redesigned the milk cooler situation So now kids have better access to the milk, so they’re taking more milk. […] Now that we have some additional displays, it grabs the kids’ attention more. So I think that they’re taking more whole fruit. 140616_0030 I think that the kids really enjoyed fruit baskets that I bought, and they said that the, um, that was something that they really enjoyed having, that they could grab fresh fruit out of every day. FSD1_CM_5_22_17We saw a, definitely a more orderly lunchroom and that created a, um, it just created a more at-ease lunchroom. FSD6_CM

Training preferences

All participants mentioned in-person training as one of their preferred methods. Two of the six participants also talked about the benefits of webinar training either as a stand-alone method or as an important aspect of a mixture of methods. One participant said, “I think the staff really enjoyed the in-person, just because... you know, they’re people people. You know, technology, they have to use it, but it doesn’t always work the best” (140616_0030). Other participants mentioned that the in-person training forced people to focus on it or devote time to the training and that it allowed participants to ask questions.

Student Involvement

All six participants noted improved communication and relationships with students as one of the best outcomes of the program. Several mentioned the value of the feedback that students provided and how much they enjoyed getting to personally interact with students. They felt that the students were very interested in participating in the program and enthusiastic about learning about how they get their food.

I really liked working with the students. […] I enjoyed the interaction that our staff had with the students. 140616_0031The best part of it that worked was the student involvement. 140616_0032I really like, I just liked, um, communicating with the kids. I think they gave a lotta good feed-back. FSD1_CM_5_22_17

One important theme that emerged was that directors believed the program, specifically activities like working with student groups and personalizing interactions (in one case wearing stick-on milk mustaches) with staff, served to humanize the school workers.

The kids met my staff, my staff met the kids, they’re on a first-name basis. 140619_0033I think that makes ‘em [the lunch staff] human to the students and not just that lady who’s serving me lunch. 140616_0031I think they know now that, you know, the lunch ladies aren’t mean, and they’re not out to get them and they’re not grumpy, you know. 140616_0030

Another important theme related to student involvement was that directors expressed a belief that by building interpersonal relationships between students and staff, students felt more empowered. Directors talked not only about the value of the feedback that students provided but that students also now sought out the staff to share ideas, insights, and opinions about their lunch experiences. Several participants mentioned their plans to continue these interactions in some form in the future.

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It opened those lines of communication and introduced them to each other and made the kids feel a lot more comfortable with, you know, letting us know what they want 140619_0033We have ambassadors in our students now 140616_0031

Challenges

Each interviewee mentioned time and scheduling as the most salient challenge related to participating in this program. Given the preference for in-person training and the interviewees’ belief that one of the main positive outcomes was improved interpersonal communication between staff and students, this is a particularly important challenge to address.

It’s hard to come up with a time where everybody can meet together. 140616_0030Extra time for my staff and students to get together. […] Coordinating schedules […] We are on a skeleton crew […] they are just swamped. 140616_0031It was a huge challenge to be able to get the staff involved. Because the part of their day, you know, was spent, you know, getting the meal production done. 140616_0032Some of the follow up is hard to, when we’re winding down at the end of the year, sometimes it’s hard to get all of those things done, all of the reports done. 140619_0033I think it’s, was challenging to not have to pull the kids out of much, er, out of school. […] Just pulling ‘em outside of school was, and getting them all there, was kind of a challenge some-times. FSD1_CM_5_22_17What got really difficult is, you know, in any, um, school, the scheduling. It’s very difficult. Everything is so tight. […] that would be my only suggestion, is that the wrap-up and the ending surveys and stuff got quite late into the school year FSD6_CM

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LimitationsThere are several important limitations to note that impacted this project, which also influenced the evaluation results. These limitations included delivering trainings, involving staff in the project, response rates to online surveys, completing production records accurately, and scheduling difficulties.

Trainings

While each school was provided with trainings about communication not all staff received the same amount and depth of training. This was primarily due to the difficulties encountered in finding time for the staff to view the webinars introduced. Webinars were not equally attended. Additionally, trainings with students were not held at the same time of day or for the same amount of time between trainings.

Involvement of Staff

Involvement of staff with the project varied between schools. This includes participation in activities directly interacting with students as well as trainings that were delivered through webinars. Because a major focus of this intervention was increasing communication between staff and students, higher levels of staff involvement may have increased intervention effects on student’s perception and attitudes towards the lunchroom.

Survey Response

Due to time constraints and staff changes, the post response rates for the student, parents, and Food Service Staff surveys were lower than expected and as a result pre-post comparisons could not be made for the Food Service Staff survey.

Production records

The production record template was not filled out by schools consistently. Increased training on completing the production record template could improve completing and reporting of production data.

Scheduling

All FSD noted that scheduling both student groups and food service staff was difficult and a major challenge in the project. This resulted in student groups meeting with FSS differing amounts between schools and students not being able to attend meetings with the evaluation team.

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RecommendationsBased on the results of the evaluation and taking into consideration the limitations, there are several recommendations to consider in future projects. These include increasing the amount of planning time, increasing the level of communication and involvement of student group members, additional training on the Communication and Behavioral Economics intervention concepts for students and food service staff, implementing surveys more effectively, and a standardized method for reporting production data.

Encourage student participation and involvement: Student participation and interactions with food service staff was noted as a major benefit by food service directors. Future projects should implement the intervention in order to facilitate student participation and to expand student-staff interaction.

Allow flexibility for food service staff to participate: Participation for food service staff was variable, and providing more options or flexibility on how or when to complete activities could increase engagement in the project. Additionally, utilizing more environmental cues for school staff has the potential to increase communication without high level of staff involvement.

Encourage Students to take Pre- and Post-Surveys During Class Time: In the future, a best practice would be to encourage schools to administer pre- and post-surveys during class. School 6 did this and it resulted in the highest response rate of all project schools.

Survey Data Collection: Providing separate links for each school building would have improved the response rate for the student and parent survey

Production Record Data Collection: Creating a standardized tool to collect this data was important for the purposes of this project. However, not all schools successfully completed it. Simplifying the template and providing food service directors and their staff with more training on how to fill out the production record template would be beneficial in future project.

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References1) Smarter Lunchrooms Movement. (No date). About us. Retrieved from http://

smarterlunchrooms.org/about-us2) Just, D., & Price, J. (2013). Default options, incentives and food choices: evidence from

elementary-school children. Public Health Nutrition, 16(12), 2281-2288.3) List, J. A., & Samek, A. S. (2015). The behavioralist as nutritionist: leveraging behavioral

economics to improve child food choice and consumption. Journal of Health Economics, 39, 135-146.

4) Greene, K. N., Gabrielyan, G., Just, D. R., & Wansink, B. (2017). Fruit-promoting smarter lunchrooms interventions: results from a cluster RCT. American Journal of Preventive Medicine, 52(4), 451-458

5) Goto, K., Waite, A., Wolff, C., Chan, K., & Giovanni, M. (2013). Do environmental interventions impact elementary school students’ lunchtime milk selection? Applied Economic Perspectives and Policy, ppt004.

6) Wansink, B., Just, D. R., Payne, C. R., & Klinger, M. Z. (2012). Attractive names sustain increased vegetable intake in schools. Preventive Medicine 55, 330-332.

7) Schwartz, M. B. (2007). The influence of a verbal prompt on school lunch fruit consumption: a pilot study. International Journal of Behavioral Nutrition and Physical Activity, 4(1), 6.

8) The Pew Charitable Trust & The Robert Wood Johnson Foundation. (2015). Serving Healthy School Meals: Staff development and training needs. Retrieved from http://www.pewtrusts.org/~/media/assets/2015/08/serving_healthy_school_meals_report.pdf

9) Iowa Department of Education. (No date). Iowa department of education public reporting website. Retrieved from http://reports.educateiowa.gov/Home/

10) Wansink, B. (2015). Change their choice! Changing behavior using the CAN approach and activism research. Psychology & Marketing, 32(5), 486-500.

11) Hanks, A. S., Just, D. R., Smith, L. E., & Wansink, B. (2012). Healthy convenience: nudging students toward healthier choices in the lunchroom. Journal of Public Health, 34(3), 370-376.

12) 1Hakim, S. M., & Meissen, G. (2013). Increasing consumption of fruits and vegetables in the school cafeteria: the influence of active choice. Journal of health care for the poor and underserved, 24(2), 145-157.

13) Just, D., & Wansink, B. (2010). Better school meals on a budget: using behavioral economics and food psychology to improve meal selection.

14) Bucher, T., Siegrist, M., & Van der Horst, K. (2014). Vegetable variety: an effective strategy to increase vegetable choice in children. Public health nutrition, 17(6), 1232-1236.

15) Cárdenas, M. K., Benziger, C. P., Pillay, T. D., & Miranda, J. J. (2015). The effect of changes in visibility and price on fruit purchasing at a university cafeteria in Lima, Peru. Public health nutrition, 18(15), 2742-2749.

16) Perry, C. L., Bishop, D. B., Taylor, G. L., Davis, M., Story, M., Gray, C., ... & Harnack, L. (2004). A randomized school trial of environmental strategies to encourage fruit and vegetable consumption among children. Health education & behavior, 31(1), 65-76.

17) Jansen, E., Mulkens, S., & Jansen, A. (2010). How to promote fruit consumption in children. Visual appeal versus restriction. Appetite, 54(3), 599-602.

18) Wansink, B., Just, D. R., Payne, C. R., & Klinger, M. Z. (2012). Attractive names sustain increased vegetable intake in schools. Preventive medicine, 55(4), 330-332.

19) Wansink, B., Van Ittersum, K., & Painter, J. E. (2005). How descriptive food names bias sensory perceptions in restaurants. Food quality and preference, 16(5), 393-400.

20) Stroebele, N., & De Castro, J. M. (2004). Effect of ambience on food intake and food choice. Nutrition, 20(9), 821-838.

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22

Appendix1SchoolLunchIowaTool

Appendix 1: School Lunch Iowa Tool

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23

Appendix2Student-StaffWhoAmIActivity

Appendix 2: Student-Staff Who Am I Activity

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24

Appendix3PicturesofLunchroomChangesSchool1

Attractivechalkboardtodisplaymenuplacedinlunchline

Attractivefruitbasketdisplayaddednexttoregister

Appendix 3: Pictures of Lunchroom Changes School 1

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25

Tabletentsdisplayingmenuandfunnutritionfacts(onreverseside)addedtoeachtable

Milkrearrangedsothatwhitemilkisthefirstkindencounteredinthelunchline

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26


Menuupdatedtoincludefunandappetizingnamessuchas“Pizza

Crunchers”,“OregonBerryBlend”,“TwisterFries”,and“HotBeefSundae”

Attractivebowlwaspurchasedtodisplayfruit


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27


Attractivebasketwaspurchasedtodisplayfruit

Artpromotingmilkwasadded


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28


Flatscreenwaspurchasedtodisplaytheday’slunchmenuandotherannouncementsinthelunchroom

Milkwasrearrangedsothatwhitemilkwasthefirstkindencounteredinthelunchline


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29


Attractivebasketwaspurchasedtodisplayfruit

Milkwasrearrangedsothatwhitemilkwasthefirstkindencounteredinthelunchline


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30

Bannerspromotingfruitwereadded

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31

Attractiveartpromotingnutritionwereaddedtolunchroomwalls

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32


Attractivebasketswerepurchasedtodisplayfruit

Milkwasrearrangedsothatwhitemilkwasmoreeasilyreachedbystudents


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33

Asectionizerwasboughtinordertomakefruitmoreattractivetostudents

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34

Appendix9StudentPre/PostSurvey

WeinviteyoutoparticipateinaresearchstudybeingconductedbyinvestigatorsfromtheUniversityofIowa.Thepurposeofthestudyistobetterunderstandmiddleschoolstudents’perceptionsoftheirlunchroom.Weareinvitingyoutobeinthisstudybecauseyouareamiddleschoolstudent.Studentsatyourschoolarebeinginvitedtoparticipateinthisstudybecauseyourschoolisparticipatinginaschoollunchroomintervention.Approximately1700studentswilltakepartinthisstudyattheUniversityofIowa.Ifyouagreetoparticipate,wewouldlikeyoutocompleteabriefonlinesurvey.Itwilltake3-5minutestocomplete.Youarefreetoskipanyquestionsthatyouprefernottoanswer.Wewillkeeptheinformationyouprovideconfidential,howeverfederalregulatoryagenciesandtheUniversityofIowaInstitutionalReviewBoard(acommitteethatreviewsandapprovesresearchstudies)mayinspectandcopyrecordspertainingtothisresearch.Wewillnotcollectyournameofanyidentifyinginformationaboutyou.Ifwewriteareportaboutthisstudywewilldosoinsuchawaythatyoucannotbeidentified.Therearenoknownrisksfrombeinginthisstudy,andyouwillnotbenefitpersonally.Howeverwehopethatothersmaybenefitinthefuturefromwhatwelearnasaresultofthisstudy.Youwillnothaveanycostsforbeinginthisresearchstudy.Youwillnotbepaidforbeinginthisresearchstudy.Takingpartinthisresearchstudyiscompletelyvoluntary.Ifyoudecidenottobeinthisstudy,orifyoustopparticipatingatanytime,youwon’tbepenalizedorloseanybenefitsforwhichyouotherwisequalify.Ifyouhaveanyquestionsabouttheresearchstudyitself,pleasecontactNatoshiaAskelson,(319)335-6887,Email:Natoshia-Askelson@uiowa.edu.Ifyouexperiencearesearch-relatedinjury,pleasecontact:NatoshiaAskelson,(319)335-6887,Email:Natoshia-Askelson@uiowa.eduIfyouhavequestionsabouttherightsofresearchsubjects,pleasecontacttheHumanSubjectsOffice,105HardinLibraryfortheHealthSciences,600NewtonRd,TheUniversityofIowa,IowaCity,IA52242-1098,(319)335-6564,ore-mailirb@uiowa.edu.Toofferinputaboutyourexperiencesasaresearchsubjectortospeaktosomeoneotherthantheresearchstaff,calltheHumanSubjectsOfficeatthenumberabove.Thankyouverymuchforyourconsideration.Ifyouwouldliketoparticipateinthisstudy,pleaseclickonthearrowboxbelow.Ifyouchoosenottoparticipate,youmaycloseyourInternetbrowser.

Appendix 9: Student Pre/Post Survey

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35

1.WhatSchooldoyouattend?Thefollowingquestionsaskaboutyourperceptionsoftheschoollunchroomandstaff.Pleaseselecttheanswerthatbestfits.

Question

Stro

ngly

Di

sagr

ee

Stro

ngly

Ag

ree

2. Theschoollunchroomstaffisfriendly.

3. IknowthatIcanoffersuggestionstoschoollunchroomstaff.

4. TheschoollunchroomstaffofferssuggestionswhenIamselectingmymeal.

5. Iusuallylikethefoodservedintheschoollunchroom. 6. Oneoftheschoollunchroomstaffknowsmyname.

7. Ithinktheschoollunchroomstaffcareaboutthestudentsinmyschool.

8. IfIhadaproblem-Icouldgotooneoftheschoollunchstaffforhelp.

9. SchoollunchroomstaffregularlyspeaktomeasIgothroughthelunchline.

10. Theschoollunchroomservesagoodvarietyoffood. 11. Theschoollunchusuallytastesgood. 12. Thefoodlooksappealing.

13. IknowwhatisforlunchbeforeIgettotheschoollunchroom.

14. WhenIpurchaseaschoollunch,Ihaveplentyoftimetoeatmyfood.

15. Thelinesintheschoollunchroomaretoolong.

16. Theschoollunchroomrunsoutofpopularfoodsbeforeeveryoneisserved.

17. Theschoollunchroomisclean. 18. Theschoollunchroomisfuntohangoutin.

19. Duringatypicalschoolweek,Idrinkwhitemilkmostofthedayswithmyschoollunch.

20.Haveyoueatenschoollunchatleastonceduringthepastweek?

o Yes,Ihaveeatenschoollunchatleastonceinthelastweek(Gotonextquestion)o NoIhavenoteatenschoollunch

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36

21.Howmuchofyourschoollunchdidyoueatthelasttimeyouhadschoollunch?o 100%(Allofit)o 75%(Mostofit)o 50%(Halfofit)o 25%(Someofit)o 0%(Noneofit)

Question St

rong

ly

Disa

gree

Stro

ngly

Ag

ree

22

Duringatypicalschoolweek,Idrinkwhitemilkmostofthedayswithmyschoollunch.

23

Duringatypicalschoolweek,Ieatwholefruitmostofthedayswithmyschoollunch.

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37

Appendix10Pre-SurveyResultsAllSchools

Question StronglyDisagree(1)

Disagree(2)

Agree(3)

StronglyAgree(4)

MeanStDev n

Theschoollunchroomstaffisfriendly. 262.6%

686.9%

35035.4%

54455.1%

3.430.74

988

IknowthatIcanoffersuggestionstoschoollunchroomstaff.

18518.9%

26827.4%

37838.7%

14715.0%

2.500.96

978

TheschoollunchroomstaffofferssuggestionswhenIamselectingmymeal.

26026.6%

21321.8%

27728.4%

22723.2%

2.481.12

977

Iusuallylikethefoodservedintheschoollunchroom.

15515.9%

22723.2%

40741.7%

18819.2%

2.640.97

977

Oneoftheschoollunchroomstaffknowsmyname.

19920.3%

13113.4%

19620.0%

45246.2%

2.921.19

978

Ithinktheschoollunchroomstaffcareaboutthestudentsinmyschool.

515.2%

10310.5%

36437.0%

46547.3%

3.260.85

983

IfIhadaproblem-Icouldgotooneoftheschoollunchstaffforhelp.

16817.1%

23824.2%

29630.1%

28128.6%

2.701.06

983

SchoollunchroomstaffregularlyspeaktomeasIgothroughthelunchline.

17517.9%

21822.2%

32132.8%

26627.1%

2.691.06

980

Theschoollunchroomservesagoodvarietyoffood.

10510.7%

22422.8%

36937.5%

28529.0%

2.850.96

983

Theschoollunchusuallytastesgood. 16716.9%

22723.0%

37838.3%

21421.7%

2.651.00

986

Thefoodlooksappealing. 15916.5%

24925.8%

41442.9%

14414.9%

2.560.94

966

IknowwhatisforlunchbeforeIgettotheschoollunchroom.

909.4%

13714.3%

25426.5%

47849.8%

3.171.00

959

WhenIpurchaseaschoollunch,Ihaveplentyoftimetoeatmyfood.

23023.9%

21422.2%

30131.2%

21922.7%

2.531.09

964

Thelinesintheschoollunchroomaretoolong.

11311.8%

19220.1%

30431.8%

34836.4%

2.931.02

957

Theschoollunchroomrunsoutofpopularfoodsbeforeeveryoneisserved.

24925.9%

24725.7%

30531.7%

16016.6%

2.391.04

961

Theschoollunchroomisclean. 596.1%

10911.2%

37738.9%

42443.8%

3.200.87

969

Theschoollunchroomisfuntohangoutin. 919.4%

12713.1%

35436.6%

39540.8%

3.090.95

967


46857.0%

11013.4%

9912.1%

14417.5%

1.901.18

821


13816.9%

15919.5%

30237.0%

21826.7%

2.731.03

817

Question Yes No nHaveyoueatenschoollunchatleastonceduringthepast

week?82885.7%

13814.3%

966

Question 100%(All)

75%(Most)

50%(Half)

25%(Some)

0%(None) n

Howmuchofyourschoollunchdidyoueatyesterday? 13215.8%

39447.3%

19423.3%

10612.7%

70.8%

833

Appendix 10: Pre-Survey Results All Schools

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38

Appendix11Post-SurveyResultsAllSchools


Disagree(2)

Agree(3)

StronglyAgree(4)

MeanStDev n


626.7%

35338.1%

48051.8%

3.380.76

926


20322.0%

29632.1%

32134.8%

10211.1%

2.350.94

922


23225.2%

22424.4%

26829.2%

19521.2%

2.461.09

919


14615.9%

24526.6%

37440.6%

15616.9%

2.590.95

921


17319.0%

12213.4%

20122.1%

41345.4%

2.941.16

909


566.1%

10611.5%

33836.7%

42145.7%

3.220.88

921


21523.4%

21923.8%

28230.7%

20422.2%

2.521.08

920


16317.8%

20622.4%

30433.1%

24526.7%

2.691.05

918


14015.2%

21122.9%

37140.2%

20121.8%

2.690.98

923


23625.7%

37040.2%

16017.4%

2.580.96

920


25328.1%

39343.7%

10611.8%

2.510.90

900


667.4%

13815.4%

25928.9%

43348.3%

3.180.95

896


20122.4%

22825.4%

27530.6%

19421.6%

2.511.06

898


859.6%

16218.2%

27631.1%

36541.1%

3.040.99

888


16718.7%

21123.6%

35940.2%

15617.5%

2.560.99

893


11612.9%

35239.1%

38042.2%

3.180.87

901


12113.5%

36941.1%

32936.6%

3.060.92

898


46761.2%

8010.5%

8310.9%

13317.4%

1.851.18

763


9212.1%

15920.8%

29438.5%

21828.6%

2.840.98

763

Question Yes No n

Haveyoueatenschoollunchatleastonceduringthepastweek?

77485.4%

13214.6%

906

Question 100%(All)

75%(Most)

50%(Half)

25%(Some)

0%(None) n


38149.3%

14719.0%

9011.6%

91.2%

773

Appendix 11: Post-Survey Results All Schools

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39

Appendix12

Pre-SurveyResultsSchool1

QuestionStrongly

Disagree(1)

Disagree(2)

Agree(3)StronglyAgree(4)

MeanStDev n


22.4%

1113.4%

6882.9%

3.780.55

82


1012.2%

1315.9%

4352.4%

1619.5%

2.790.90

82


1012.3%

1619.8%

3037.0%

2530.9%

2.861.00

81


56.2%

1619.8%

3745.7%

2328.4%

2.960.86

81


56.3%

1012.5%

1518.8%

5062.5%

3.380.93

80


22.4%

44.9%

2024.4%

5668.3%

3.590.70

82


1113.6%

2024.7%

3644.4%

1417.3%

2.650.92

81


33.7%

44.9%

1721.0%

5770.4%

3.580.76

81


33.7%

1012.2%

3745.1%

3239.0%

3.200.79

82


2024.4%

2935.4%

2834.1%

2.980.92

82


1215.2%

4455.7%

1721.5%

2.910.82

79


67.6%

1822.8%

3139.2%

2430.4%

2.920.92

79


78.9%

2227.8%

2632.9%

2430.4%

2.850.96

79


45.1%

1519.0%

2835.4%

3240.5%

3.110.89

79


4557.7%

2126.9%

810.3%

45.1%

1.630.87

78


67.6%

1924.1%

5164.6%

3.490.80

79


22.5%

2227.8%

5367.1%

3.590.67

79


3751.4%

1013.9%

79.7%

1825.0%

2.081.28

72


811.3%

1115.5%

2535.2%

2738.0%

3.001.00

71


week?74

93.7%5

6.3%79

Question 100%(All)

75%(Most)

50%(Half)

25%(Some)

0%(None) n


4054.1%

1723.0%

810.8%

00.0%

74

Appendix 12: Pre-Survey Results School 1

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40

Appendix13Post-SurveyResultsSchool1

QuestionStrongly

Disagree(1)

Disagree(2)

Agree(3)StronglyAgree(4)

MeanStDev n


00.0%

420.0%

1680.0%

3.800.41

20


525.0%

525.0%

840.0%

210.0%

2.350.99

20


315.8%

631.6%

631.6%

421.1%

2.581.02

19


419.0%

942.9%

628.6%

29.5%

2.290.90

21


315.0%

525.0%

525.0%

735.0%

2.801.11

20


00.0%

631.6%

421.1%

947.4%

3.160.90

19


315.8%

631.6%

842.1%

210.5%

2.470.91

19


15.0%

210.0%

735.0%

1050.0%

3.300.87

20


419.0%

628.6%

523.8%

628.6%

2.621.12

21


838.1%

733.3%

29.5%

2.330.91

21


735.0%

630.0%

15.0%

2.100.91

20


15.3%

315.8%

947.4%

631.6%

3.050.85

19


525.0%

210.0%

630.0%

735.0%

2.751.21

20


00.0%

526.3%

526.3%

947.4%

3.210.86

19


421.1%

210.5%

1157.9%

210.5%

2.580.96

19


00.0%

736.8%

1263.2%

3.630.50

19


00.0%

631.6%

1157.9%

3.370.96

19


844.4%

211.1%

422.2%

422.2%

2.221.26

18


15.6%

316.7%

633.3%

844.4%

3.170.92

18


week?18

90.0%2

10.0%20

Question 100%(All)

75%(Most)

50%(Half)

25%(Some)

0%(None) n

Howmuchofyourschoollunchdidyoueatyesterday> 15.6%

844.4%

633.3%

316.7%

00.0%

18

Appendix 13: Post-Survey Results School 1

Return to TOC

41

Appendix14Pre-SurveyResultsSchool2


Disagree(2)

Agree(3)

StronglyAgree(4)

MeanStDev n


35.5%

2545.5%

2749.1%

3.440.60

55


917.0%

1018.9%

2139.6%

1324.5%

2.721.03

53


1324.5%

1528.3%

1120.8%

1426.4%

2.491.14

53


814.5%

1323.6%

2341.8%

1120.0%

2.670.96

55


1425.0%

814.3%

1017.9%

2442.9%

2.791.25

56


11.8%

814.3%

2239.3%

2544.6%

3.270.77

56


814.8%

1629.6%

1425.9%

1629.6%

2.701.06

54


1221.8%

1730.9%

1425.5%

1221.8%

2.471.07

55


610.7%

1221.4%

2341.1%

1526.8%

2.840.95

56


1323.2%

2442.9%

1221.4%

2.730.94

56


1222.2%

2648.1%

814.8%

2.630.98

54


59.4%

1426.4%

1935.8%

1528.3%

2.830.96

53


1425.9%

1833.3%

1425.9%

814.8%

2.301.02

54


23.7%

59.3%

1222.2%

3564.8%

3.480.82

54


59.1%

47.3%

2036.4%

2647.3%

3.220.94

55


712.7%

2138.2%

2647.3%

3.310.77

55


1018.2%

1934.5%

1934.5%

2.911.02

55


2455.8%

49.3%

614.0%

920.9%

2.001.25

43


24.5%

715.9%

1636.4%

1943.2%

3.180.87

44


week?44

81.5%10

18.5%54

Question 100%(All)

75%(Most)

50%(Half)

25%(Some)

0%(None) n


2352.3%

613.6%

613.6%

00.0%

44


Return to TOC

42



Disagree(2)

Agree(3)

StronglyAgree(4)

MeanStDev n


35.0%

2135.0%

3660.0%

3.550.59

60


712.1%

2136.2%

2237.9%

813.8%

2.530.88

58


1423.7%

1322.0%

1728.8%

1525.4%

2.561.12

59


610.2%

1932.2%

2440.7%

1016.9%

2.640.89

59


1728.8%

915.3%

1525.4%

1830.5%

2.581.21

59


46.8%

46.8%

2237.3%

2949.2%

3.290.87

59


1525.4%

1220.3%

1627.1%

1627.1%

2.561.15

59


1220.3%

1118.6%

1220.3%

2440.7%

2.811.18

59


610.2%

1322.0%

2542.4%

1525.4%

2.830.93

59


1220.3%

2339.0%

1220.3%

2.591.04

59


1120.8%

2241.5%

1120.8%

2.661.00

53


713.2%

917.0%

1834.0%

1935.8%

2.921.06

53


1426.4%

1324.5%

2139.6%

59.4%

2.320.98

53


23.8%

611.5%

1426.9%

3057.7%

3.380.84

52


815.1%

47.5%

2343.4%

1834.0%

2.961.02

53


47.5%

2954.7%

1834.0%

3.190.74

53


1018.9%

1732.1%

1935.8%

2.911.04

53


3777.1%

12.1%

36.3%

714.6%

1.581.13

48


612.5%

612.5%

1633.3%

2041.7%

3.041.03

48


week?47

90.4%5

9.6%52

Question 100%(All)

75%(Most)

50%(Half)

25%(Some)

0%(None) n


2552.1%

816.7%

510.4%

00.0%

58


Return to TOC

43



Disagree(2)

Agree(3)

StronglyAgree(4)

MeanStDev n


1311.5%

5145.1%

4338.1%

3.160.83

113


2925.9%

3934.8%

3833.9%

65.4%

2.190.89

112


2017.7%

3127.4%

3329.2%

2925.7%

2.631.05

113


2522.5%

4036.0%

3935.1%

76.3%

2.250.88

111


98.1%

109.0%

3127.9%

6155.0%

3.300.94

111


119.7%

2017.7%

4741.6%

3531.0%

2.940.94

113


3228.3%

3833.6%

2623.0%

1715.0%

2.251.03

113


1715.0%

3127.4%

3430.1%

3127.4%

2.701.03

113


2118.6%

2925.7%

4035.4%

2320.4%

2.581.02

113


3430.1%

4136.3%

65.3%

2.190.91

113


4036.0%

4036.0%

87.2%

2.300.88

111


1210.9%

1311.8%

3834.5%

4742.7%

3.090.99

110


2119.1%

2522.7%

3632.7%

2825.5%

2.651.06

110


1211.0%

1715.6%

3330.3%

4743.1%

3.061.02

109


1513.5%

2623.4%

4641.4%

2421.6%

2.710.96

111


1614.4%

5448.6%

2320.7%

2.740.97

111


1816.2%

4439.6%

3430.6%

2.871.00

111


6158.7%

1514.4%

1514.4%

1312.5%

1.811.10

104


2725.7%

2422.9%

3634.3%

1817.1%

2.431.06

105


week?10592.9%

87.1%

113

Question 100%(All)

75%(Most)

50%(Half)

25%(Some)

0%(None) n


4139.0%

3028.6%

2120.0%

32.9%

105


Return to TOC

44



Disagree(2)

Agree(3)

StronglyAgree(4)

MeanStDev n


1517.0%

3438.6%

3034.1%

2.970.96

88


3438.6%

2730.7%

2225.0%

55.7%

1.980.93

88


2427.3%

1719.3%

3135.2%

1618.2%

2.441.08

88


2528.4%

2730.7%

2933.0%

78.0%

2.200.95

88


1112.6%

1213.8%

2124.1%

4349.4%

3.101.07

87


1415.9%

2427.3%

2629.5%

2427.3%

2.681.05

88


3540.2%

2225.3%

2023.0%

1011.5%

2.061.05

87


2326.1%

2022.7%

2225.0%

2326.1%

2.511.15

88


2225.0%

2427.3%

3236.4%

1011.4%

2.340.98

88


2427.3%

3236.4%

910.2%

2.310.98

88


2831.8%

3236.4%

66.8%

2.250.91

88


1011.4%

2225.0%

3337.5%

2326.1%

2.780.96

88


2528.4%

1517.0%

2933.0%

`1921.6%

2.481.12

88


89.1%

2730.7%

1415.9%

3944.3%

2.951.06

88


910.3%

1618.4%

4349.4%

1921.8%

2.830.89

87


2427.3%

3742.0%

1213.6%

2.520.93

88


1213.6%

4146.6%

2123.9%

2.780.99

88


4360.6%

912.7%

1216.9%

79.9%

1.761.06

71


1014.1%

1926.8%

3245.1%

1014.1%

2.590.90

71


week?72

81.8%16

18.2%88

Question 100%(All)

75%(Most)

50%(Half)

25%(Some)

0%(None) n

Howmuchofyourschoollunchdidyoueatyesterday? 1013.9

4055.6%

1419.4%

79.7%

11.4%

72


Return to TOC

45



Disagree(2)

Agree(3)

StronglyAgree(4)

MeanStDev n


32.3%

3325.4%

9270.8%

3.650.61

130


1713.4%

4535.4%

5442.5%

118.7%

2.460.83

127


3124.0%

3527.1%

3728.7%

2620.2%

2.451.07

129


1914.6%

3325.4%

5643.1%

2216.9%

2.620.93

130


2015.4%

1612.3%

3023.1%

6449.2%

3.061.11

130


43.1%

86.2%

4534.9%

7255.8%

3.430.75

129


2015.4%

4131.5%

3829.2%

3123.8%

2.621.02

130


2116.4%

2318.0%

4535.2%

3930.5%

2.801.05

128


1511.5%

3526.9%

4433.8%

3627.7%

2.780.98

130


3526.9%

5240.0%

2620.0%

2.670.94

130


3730.6%

5041.3%

2016.5%

2.630.90

121


108.3%

3125.8%

3025.0%

4940.8%

2.981.00

120


108.3%

2621.5%

4436.4%

4133.9%

2.960.94

121


86.6%

97.4%

4436.4%

6049.6%

3.290.87

121


1310.7%

2218.2%

5747.1%

2924.0%

2.840.91

121


97.4%

4436.4%

6654.5%

3.440.71

121


1411.8%

4437.0%

5243.7%

3.170.91

119


5151.5%

1515.2%

1111.1%

2222.2%

2.041.24

99


1313.1%

1818.2%

3333.3%

3535.4%

2.911.03

99

Question Yes No NHaveyoueatenschoollunchatleastonceduringthepast

week?10182.8%

2117.2%

122

Question 100%(All)

75%(Most)

50%(Half)

25%(Some)

0%(None) N


5453.5%

2019.8%

109.9%

11.0%

101


Return to TOC

46



Disagree(2)

Agree(3)

StronglyAgree(4)

MeanStDev n


94.7%

6534.0%

11258.6%

3.490.71

191


2613.7%

7941.6%

6634.7%

1910.0%

2.410.85

190


4322.5%

6232.5%

5930.9%

2714.1%

2.370.99

191


2312.0%

5930.9%

8242.9%

2714.1%

2.590.88

191


137.0%

168.6%

4423.5%

11461.0%

3.390.91

187


52.6%

136.8%

7639.8%

9750.8%

3.390.73

191


3015.7%

5930.9%

7036.6%

3216.8%

2.540.95

191


178.9%

4322.5%

7036.6%

6131.9%

2.920.95

191


2211.5%

4523.6%

8343.5%

4121.5%

2.750.92

191


6031.6%

8042.1%

2915.3%

2.620.88

190


6234.1%

8747.8%

158.2%

2.540.78

182


179.3%

4826.2%

6032.8%

5831.7%

2.870.97

182


1910.4%

5127.9%

6837.2%

4524.6%

2.760.94

185


52.8%

189.9%

6737.0%

9150.3%

3.350.77

181


168.7%

5127.9%

7742.1%

3921.3%

2.760.89

183


94.9%

8144.3%

8647.0%

3.340.75

183


2614.3%

8446.2%

6535.7%

3.140.80

182


9361.2%

1610.5%

138.6%

3019.7%

1.871.22

152


159.9%

3019.7%

5938.8%

4831.6%

2.920.95

152


week?15382.7%

3217.3%

185

Question 100%(All)

75%(Most)

50%(Half)

25%(Some)

0%(None) n


8052.3%

2818.3%

1610.5%

00.0%

153


Return to TOC

47


Question

StronglyDisagree

(1)

Disagree

(2)

Agree

(3)

StronglyAgree

(4)

MeanStDev n


139.6%

5238.5%

6447.4%

3.290.82

135


4433.3%

3526.5%

3627.3%

1712.9%

2.201.04

132


6750.4%

2418.0%

3123.3%

118.3%

1.891.03

133


3324.8%

3828.6%

4231.6%

2015.0%

2.371.02

133


5037.3%

118.2%

139.7%

6044.8%

2.621.38

134


139.8%

1813.5%

5541.4%

4735.3%

3.020.94

133


2921.6%

2921.6%

3727.6%

3929.1%

2.641.12

134


4131.1%

2720.5%

3224.2%

3224.2%

2.421.17

132


2619.4%

3324.6%

4029.9%

3526.1%

2.631.07

134


2921.6%

3828.4%

2317.2%

2.301.10

134


3929.5%

3627.3%

1410.6%

2.161.00

132


2821.4%

2922.1%

3829.0%

3627.5%

2.631.11

131


2619.5%

2518.8%

4231.6%

4030.1%

2.721.10

133


3022.7%

3728.0%

3929.5%

2619.7%

2.461.05

132


4836.9%

3930.0%

2720.8%

1612.3%

2.081.04

130


1914.3%

6145.9%

3627.1%

2.870.96

133


1813.5%

4533.8%

4533.8%

2.831.10

133


7865.0%

1815.0%

75.8%

1714.2%

1.691.09

120


2319.2%

2722.5%

3630.0%

3428.3%

2.681.09

120

Question Yes No NHaveyoueatenschoollunchatleastonceduringthepast

week?12090.2%

139.8%

133

Question 100%(All)

75%(Most)

50%(Half)

25%(Some)

0%(None) N


5243.7%

2420.2%

119.2%

21.7%

119


Return to TOC

48



Disagree(2)

Agree(3)

StronglyAgree(4)

MeanStDev n


43.6%

4035.7%

6053.6%

3.360.86

112


3127.7%

3127.7%

3833.9%

1210.7%

2.280.99

112


6053.6%

2825.0%

108.9%

1412.5%

1.801.05

112


2724.1%

3127.7%

3228.6%

2219.6%

2.441.07

112


2118.8%

98.0%

2320.5%

5952.7%

3.071.17

112


1210.7%

1917.0%

3127.7%

5044.6%

3.061.03

112


2724.1%

1917.0%

3632.1%

3026.8%

2.621.13

112


2925.9%

3329.5%

2925.9%

2118.8%

2.381.07

112


2825.0%

2320.5%

3934.8%

2219.6%

2.491.07

112


2623.4%

3027.0%

1715.3%

2.231.09

111


2827.2%

3029.1%

1312.6%

2.231.03

103


1716.7%

2019.6%

3938.2%

2625.5%

2.731.03

102


1615.5%

2726.2%

3433.0%

2625.2%

2.681.02

103


1918.6%

3130.4%

3130.4%

2120.6%

2.531.02

102


3534.3%

2322.5%

2623.5%

1817.6%

2.261.12

102


1615.4%

4846.2%

2826.9%

2.880.94

104


1413.5%

3634.6%

3937.5%

2.951.05

104


6167.0%

1011.0%

66.6%

1415.4%

1.701.13

91


2021.7%

1112.0%

3032.6%

3133.7%

2.781.14

92


week?95

88.8%12

11.2%107

Question 100%(All)

75%(Most)

50%(Half)

25%(Some)

0%(None) n


4851.6%

1010.8%

44.3%

33.2%

93


Return to TOC

49



Disagree(2)

Agree(3)

StronglyAgree(4)

MeanStDev n


347.2%

17837.6%

25052.9%

3.410.73

473


7616.1%

12626.7%

18639.4%

8417.8%

2.590.96

472


11925.4%

9219.7%

13528.8%

12226.1%

2.561.13

468


6513.9%

8718.6%

21045.0%

10522.5%

2.760.96

467


10121.6%

7616.3%

9720.8%

19341.3%

2.821.19

467


204.3%

459.6%

17537.2%

23048.9%

3.310.81

470


6814.4%

9420.0%

14530.8%

16434.8%

2.861.05

471


8117.2%

11624.6%

17938.0%

9520.2%

2.610.99

471


347.3%

10522.4%

18539.5%

14430.8%

2.940.91

468


9620.4%

19441.2%

11925.3%

2.790.97

471


10923.2%

21846.5%

7716.4%

2.650.91

469


296.2%

326.9%

9821.0%

30765.9%

3.470.87

466


15232.5%

9821.0%

13929.8%

7816.7%

2.311.10

467


5712.3%

10923.6%

14832.0%

14832.0%

2.841.01

462


12326.4%

13529.0%

14731.5%

6113.1%

2.311.00

466


5211.1%

17837.9%

22247.2%

3.290.81

470


6513.8%

18038.3%

19240.9%

3.130.90

470


21756.7%

4812.5%

5313.8%

6517.0%

1.911.18

383


6517.2%

7219.0%

15641.3%

8522.5%

2.691.01

378


week?38482.6%

8117.4%

465

Question 100%(All)

75%(Most)

50%(Half)

25%(Some)

0%(None) n


18447.2%

9724.9%

5012.8%

10.3%

390


Return to TOC

50



Disagree(2)

Agree(3)

StronglyAgree(4)

MeanStDev n


316.8%

18941.5%

22649.7%

3.390.70

455


10022.0%

13329.3%

16536.3%

5612.3%

2.390.96

454


8819.6%

9821.8%

14532.2%

11926.4%

2.661.07

450


6113.6%

10022.2%

20144.7%

8819.6%

2.700.93

450


10824.3%

7116.0%

9320.9%

17238.7%

2.741.21

444


214.6%

408.8%

17939.6%

21246.9%

3.290.81

452


10523.2%

10122.3%

13229.2%

11425.2%

2.561.10

452


8118.1%

9721.7%

16436.6%

10623.7%

2.661.03

448


5812.8%

10022.1%

18741.4%

10723.7%

2.760.96

452


10623.5%

19843.9%

9120.2%

2.720.93

451


11725.8%

21647.6%

6013.2%

2.610.88

454


143.1%

368.0%

10022.2%

30166.7%

3.530.77

451


12227.1%

12026.6%

11725.9%

9220.4%

2.401.09

451


5111.4%

7516.8%

14532.5%

17539.2%

3.001.01

446


9521.2%

11525.6%

17939.9%

6013.4%

2.450.97

449


6313.9%

15033.0%

22449.3%

3.280.84

454


5913.1%

18540.9%

17438.5%

3.100.90

452


22558.6%

4210.9%

4511.7%

7218.8%

1.911.20

384


4010.4%

9023.5%

15139.4%

10226.6%

2.820.94

383


week?39085.7%

6514.3%

455

Question 100%(All)

75%(Most)

50%(Half)

25%(Some)

0%(None) n


18046.2%

8221.0%

5514.1%

51.3%

390


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51

Appendix24ParentPre/PostSurvey

WeinviteyoutoparticipateinaresearchstudybeingconductedbyinvestigatorsfromtheUniversityofIowa.Thepurposeofthestudyistobetterunderstandparents'attitudestowardsschoolmealsattheschoolwhereyourmiddleschoolchildattends.Weareinvitingyoutobeinthisstudybecauseyouareaparentofamiddleschoolstudent.Parentsofamiddleschoolstudentarebeinginvitedtoparticipateinthisstudybecauseyourchild'sschoolisparticipatinginaschoollunchroomintervention.Thissurveyasksyourattitudestowardsschoolmeals.Itasksaboutschoolmealsattheschoolwhereyourmiddleschoolchildattends.ThesurveyisconductedfortheIowaDepartmentofEducationbytheUniversityofIowaPublicPolicyCenterandCollegeofPublicHealth.Theinformationgatheredfromthesurveywillbeusedtohelpschoolsimprovetheirmeals.Ifyouagreetoparticipate,wewouldlikeyoutocompleteabriefonlinesurvey.Itwilltake5-10minutestocomplete.Youarefreetoskipanyquestionsthatyouprefernottoanswer.Ifyoudonotwanttodothissurvey,youmaystoptakingitatanytime.Wewillkeeptheinformationyouprovideconfidential,howeverfederalregulatoryagenciesandtheUniversityofIowaInstitutionalReviewBoard(acommitteethatreviewsandapprovesresearchstudies)mayinspectandcopyrecordspertainingtothisresearch.Wewillnotcollectyournameofanyidentifyinginformationaboutyou.Ifwewriteareportaboutthisstudywewilldosoinsuchawaythatyoucannotbeidentified.Therearenoknownrisksfrombeinginthisstudy,andyouwillnotbenefitpersonally.Howeverwehopethatothersmaybenefitinthefuturefromwhatwelearnasaresultofthisstudy.Youwillnothaveanycostsforbeinginthisresearchstudy.Youwillnotbepaidforbeinginthisresearchstudy.Takingpartinthisresearchstudyiscompletelyvoluntary.Ifyoudecidenottobeinthisstudy,orifyoustopparticipatingatanytime,youwon’tbepenalizedorloseanybenefitsforwhichyouotherwisequalify.Ifyouhaveanyquestionsabouttheresearchstudyitself,pleasecontactNatoshiaAskelson,(319)335-6867,Email:Natoshia-Askelson@uiowa.edu.Ifyouexperiencearesearch-relatedinjury,pleasecontact:NatoshiaAskelson,(319)335-6867,Email:Natoshia-Askelson@uiowa.eduIfyouhavequestionsabouttherightsofresearchsubjects,pleasecontacttheHumanSubjectsOffice,105HardinLibraryfortheHealthSciences,600NewtonRd,TheUniversityofIowa,IowaCity,IA52242-1098,(319)335-6564,ore-mailirb@uiowa.edu.Toofferinputaboutyourexperiencesasaresearchsubjectortospeaktosomeoneotherthantheresearchstaff,calltheHumanSubjectsOfficeatthenumberabove.Thankyouverymuchforyourconsideration.Ifyouwouldliketoparticipateinthisstudy,pleaseclickonthearrowboxbelow.

Appendix 24: Parent Pre/Post Survey

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52

Ifyouchoosenottoparticipate,youmaycloseyourInternetbrowser.Thefollowingquestionsaskforinformationregardingyourmiddleschoolstudent.Ifyouhavemultiplechildreninmiddleschool,thinkofyouroldestmiddleschoolchild.1.Whichschooldoesyourmiddleschoolchildattend?2.Isyoumiddleschoolchildinthefreeorreducedlunchprogramattheirschool?

o Yeso No

3.Lastweek,howmanydaysdidyourmiddleschoolchildeatschoolbreakfast?o 5daysaweeko 4daysaweeko 3daysaweeko 2daysaweeko 1dayaweeko 0days

4.Lastweek,howmanydaysdidyourmiddleschoolchildeatschoollunch?o 5daysaweeko 4daysaweeko 3daysaweeko 2daysaweeko 1dayaweeko 0days

Thenexttwoquestionsaskaboutwhyorwhynotyourmiddleschoolchildeatsschoollunch.Pleasecheckallthatapply.5.Whymychilddoesnotbringfoodfromhometoeatatschool(checkallthatapply)

o Thereisnotimetopackalunchfromhomeo Wedonothavemoneytopackalunchfromhomeo Mychildreceivedfreeorreducedcostluncho Mychildlikesschoolluncho Mychild’sfriendseatschoolluncho Schoollunchishealthymealo Schoollunchisagoodvalueformymoneyo Schoollunchisbetterformychildthanwhatwecouldmakeathomeo Mychilddoesnotlikethefoodpackedinalunchfromhomeo Mychilddoesnoteatschoolfood

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53

6.Whymychildbringslunchfromhometoeatatschool?(checkallthatapply)o Mychildsometimesdoesn’tlikewhatisbeingservedatschoolluncho Mychilddoesnotlikeschoolluncho Lunchfromhomeischeaperthanschoolluncho Lunchfromhomeismadewithloveo Lunchfromhomeisahealthymealo MakinglunchfromhomemeansIknowwhatmychildiseatingo Bringingalunchfromhomegivesmychildmoretimetoeato Mychild’sfriendsbringlunchfromhomeo Mychildneedsmorefoodthanschoollunchprovideso Mychildwillnoteatthefruitsandvegetablestheschoollunchprovideso Mychilddoesnotbringfoodfromhometoeatatschoolo Schoollunchdoesnotmeetmychild’sspecificdietaryrestrictionsand/orallergies

7.Hasyourmiddleschoolchildsaidanythingtoyouaboutchangestoschoolmealsthatoccurredduringthecurrentschoolyear?

o Yes(Gotoquestion7A)o No(Gotoquestion8)

7A.Whatdidyourchildsay?8.Inyouropinion,whatisthepurposeoftheschoolmealsprogram?(checkallthatapply)

o Toprovideschoolchildrenwithhealthyfoodo Tomakesureschoolchildrenhavesomethingtoeatduringthedayo Tohelpfamilieswhoarestrugglingtofeedtheirchildrenbecausetheydonothaveenough

moneyo Tohelpfamilieswhoarestrugglingtofeedtheirchildrenbecausetheydonothaveenoughtimeo Tosetanexampleforwhatahealthymeallookslikeo Touseupsurplusfoodproducedbyfarmerso Togiveschoolchildrenabreakfromtheirlessons

9.Thinkingbacktowhenyouwereinschool,doyouthinkschoolmealshavechangedmuch?(checkallthatapply)

o SchoolsmealsareprettymuchthesameaswhenIwenttoschoolo SchoolsmealshavegottenalothealthiercomparedtowhenIwenttoschoolo SchoolsmealslookmoreappealingsinceIwenttoschoolo SchoolmealsarenotashealthyastheyusedtobewhenIwasinschoolo SchoolmealslooklessappealingsinceIwenttoschoolo IwouldbelesslikelytoeatschoolmealsnowthanwhenIwasinschoolo IwouldbemorelikelytoeatschoolmealsnowthanwhenIwasinschoolo PortionsizesinschoolmealsarelargerinsizethanwhenIwenttoschoolo PortionsizesinschoolmealsaresmallerthanwhenIwenttoschoolo IneverateschoolmealswhenIwasinschool/myschooldidnotprovideschoollunch

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54

Thefollowingquestionsaskhowimportantdifferentcomponentsofyourmiddleschoolchild'sluncharewith1beingnotimportantatalland7beingveryimportant.Pleaseselectthelevelofimportancethatfitsmostcloselywithyouropinion.

Not

Impo

rtant

atall

Very

Impo

rtant

11. Freshfruitsandvegetablesareavailableforyourmiddleschoolchild’sschoollunch

12. Protein-richfoods(liketurkey,fish,beans,cheese,nuts)areavailableforyourmiddleschoolchild’sschoollunch

13. Wholegrainbreadproductsareavailableforyourmiddleschoolchild’sschoolmeal

14. Foodsinyourmiddleschoolchild’sschoolmealsarepreparedfromscratchbyschoolfoodservicestaff

15. Yourmiddleschoolchildthinksschoolmealstastegood

Thefollowingquestionsaskaboutyourperceptionsofschoollunch.Pleaseselectthelevelofagreementthatfitsmostcloselywithyouropinion.21.Doesyoumiddleschoolchildthinkschoolmealstastegood?

o No,doesnottastegoodatallo No,tastesbado Doesnottastegoodbutdoesnottastebado Yes,tastesgoodo Yes,verytastyo Idonotknowo Mychilddoesnoteatschoolmeals

St

rong

ly

Disa

gree

Stro

ngly

Ag

ree

16. Eatinghealthyschoolmealswillmakemymiddleschoolchildhealthier

17. Healthyschoolmealswillhelpimprovemymiddleschoolchild’sschoolperformance

18. Mymiddleschoolchildgetsenoughtoeatatschoolmeals

19. Icantellifthefoodmymiddleschoolchildeatsatschoolishealthy

20. Thefoodservicestaffatmychild’sschoolseemswell-informedaboutschoolmealnutrition

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55

22.Doesyourmiddleschoolchildthinkthatfoodintheschoollunchlinelooksgood?o Definitelynoto Probablynoto Mightormightnoto Probablyyeso Definitelyyeso Idonotknowo Mychilddoesnoteatschoolmeals

23.Sincethestartofthecurrentschoolyear,onatypicaldaydoesyourmiddleschoolchildgetamorenutritiousmealathomeoratschool?

o Schoolo Homeo Botho Mymiddleschoolchilddoesnotusuallyeatschoolmeals

24.Howwouldyouratethecostofschoolmealsatyourmiddleschoolchild’sschool?

o Veryexpensiveo Expensiveo Reasonableo Veryreasonableo Bestvalueformydollaro Noopiniono Notsurewhatthecostofaschoolmealiso Mychildparticipatesinthefreeorreducedmealprogram

25.Arethereanyspecifichealthyfoodsyouwouldliketoseeofferedatyourmiddleschoolchild’sschoolmeals?

Thefollowingquestionsaskaboutyourperceptionsoftheschoollunchroomandstaffatyourmiddleschoolchild’sschool.Pleaseselectthelevelofagreementthatfitsmostcloselywithyouropinion.

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56

St

rong

ly

Disa

gree

Stro

ngly

Ag

ree

Id

on’t

know

26. Theschoollunchroomstaffisfriendly 27. IknowthatIcanoffersuggestionstoschoollunchroomstaff

28. Theschoollunchroomstaffofferssuggestionstomychildaboutwhichfoodtotry

29. Mychildusuallylikesthefoodservedintheschoollunchroom 30. Theschoollunchroomstaffknowmychild’sname

31. Ithinktheschoollunchroomstaffcareaboutthestudentsinmychild’sschool

32. Ifmychildhadaproblem-she/hecouldgotooneoftheschoollunchstaffforhelp

33. Schoollunchroomstaffregularlyspeaktomychildinthelunchline

34. Theschoollunchroomservesagoodvarietyoffood

35. Whenmychildpurchasesaschoollunch,she/hehasplentyoftimetobuyandeatfood

36. Thelinesintheschoollunchroomaretoolong

37. Theschoollunchroomrunsoutpopularfoodsbeforeeveryoneisserved

38. Whenmychildpurchasesaschoollunch,she/hefeelsforcedtotakehealthyfoods

Ofthefollowingitems,whichareimportanttoyouforkeepingyourchildhealthywith1beingnotimportantatalland5beingextremelyimportant.

Not

Impo

rtant

atall

Very

Impo

rtant

39. Stayingcurrentonimmunizations/shots 40. Goingtothedoctorforcheck-ups 41. Gettingenoughsleep 42. Healthyeating 43. Drinkingenoughwater 44. Washinghandsregularly 45. Brushingteeth 46. Reducingstress 47. Stayingawayfromalcohol,drugs,tobacco 48. Reducingtheamountofpoporsugarydrinks 49. Eatingmorefruitsandvegetables

50.Doyouhaveanyfurtherthoughtsorideasaboutimprovingschoolmealsatyourmiddleschoolchild’sschool

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57

Appendix25ParentSurveyPre-Results

Schoolmealparticipation Yes No nIsyourmiddleschoolchildinthefreeorreducedlunchprogramattheirschool?

7813.5%

49986.5%

577

0days

aweek

1dayaweek

2daysaweek

3daysaweek

4daysa

week

5days

aweek

Mean(St

Dev) n

Lastweek,howmanydaysdidyourmiddleschoolchildeatschoolbreakfast?

48884.7%

264.5%

101.7%

142.4%

122.1%

264.5%

5.54(1.24)

576

Lastweek,howmanydaysdidyourmiddleschoolchildeatschoollunch?

7112.3%

244.2%

274.2%

356.1%

468.0%

37464.7%

3.88(1.80)

577

ReasonswhytheirchildrendonotbringfoodfromhometoeatatschoolReason n(%)Thereisnotimetopackalunchfromhome 163

(28.2%)Wedonothavemoneytopackalunchfromhome 39

(6.8%)Mychildreceivedfreeorreducedcostlunch 53

(9.2%)Mychildlikesschoollunch 266

(46.1%)Mychild’sfriendseatschoollunch 198

(34.3%)Schoollunchisahealthymeal 75

(13.0%)Schoollunchisagoodvalueformymoney 127

(22.0%)Schoollunchisbetterformychildthanwhatwecouldmakeathome 32

(5.5%)Mychilddoesnotlikethefoodpackedinalunchfromhome 21

(3.6%)Mychilddoesnoteatschoolfood 78

(13.5%)

Appendix 25: Parent Survey Pre-Results

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58

ReasonswhytheirchildrenbringfoodfromhometoeatatschoolReason n(%)Mychildsometimesdoesn’tlikewhatisbeingservedatschoollunch 273

(47.3%)Mychilddoesnotlikeschoollunch 69

(12.0%)Lunchfromhomeischeaperthanschoollunch 77

(13.3%)Lunchfromhomeismadewithlove 39

(6.8%)Lunchfromhomeisahealthymeal 91

(15.8%)MakinglunchfromhomemeansIknowwhatmychildiseating 95

(16.5%)Bringingalunchfromhomegivesmychildmoretimetoeat 79

(13.7%)Mychild’sfriendsbringlunchfromhome 16

(2.8%)Mychildneedsmorefoodthanschoollunchprovides 91

(15.8%)Mychildwillnoteatthefruitsandvegetablestheschoollunchprovides 35

(6.1%)Mychilddoesnotbringfoodfromhometoeatatschool 145

(25.1%)Schoollunchdoesnotmeetmychild’sspecificdietaryrestrictionsand/orallergies 11

(1.9%)ParentKnowledge

Parents’opiniononthepurposeofschoolmealsprogram

Question Yes No nHasyourmiddleschoolchildsaidanythingtoyouaboutchangestoschoolmealsthatoccurredduringthecurrentschoolyear?

20836.75%

35863.25%

566

Statement n(%)Toprovideschoolchildrenwithhealthyfood 383(66.4%)Tomakesureschoolchildrenhavesomethingtoeatduringtheday 465(80.6%)Tohelpfamilieswhoarestrugglingtofeedtheirchildrenbecausetheydonothaveenoughmoney

214(37.1%)

Tohelpfamilieswhoarestrugglingtofeedtheirchildrenbecausetheydonothaveenoughtime

94(16.3%)

Tosetanexampleforwhatahealthymeallookslike 179(31.0%)Touseupsurplusfoodproducedbyfarmers 27(4.7%)Togiveschoolchildrenabreakfromtheirlessons 55(9.5%)

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59

Howschoolmealshavechangedsinceparentswereinschool

Importanceofspecificlunchcomponentstoparents

Statement

Not

impo

rtan

tat

all

(1)

Very

im

port

ant(

7)

Mean(St

Dev)n

Freshfruitsandvegetablesareavailableforyourmiddleschoolchild’sschoollunch

20.4%

20.4%

101.9%

315.9%

8516.0%

11521.7%

28553.8%

6.20(1.12)

530

Proteinrichfoods(liketurkey,fish,beans,cheese,nuts)areavailableforyourmiddleschoolchild’sschoollunch

81.5%

61.1%

112.1%

366.8%

6111.5%

13725.9%

27151.1%

6.01(1.28)

530

Wholegrainbreadproductsareavailableforyourmiddleschoolchild’sschoolmeal

163.1%

254.9%

479.2%

12825.0%

10019.5%

6312.3%

13426.1%

4.94(1.65)

513

Foodsinyourmiddleschoolchild’sschoolmealsarepreparedfromscratchbyschoolfoodservicestaff

224.3%

214.1%

489.3%

8817.0%

10921.0%

8616.6%

14427.8%

5.08(1.69)

518

Statement n(%)SchoolsmealsareprettymuchthesameaswhenIwenttoschool 79(13.7%)SchoolsmealshavegottenalothealthiercomparedtowhenIwenttoschool 170(29.5%)SchoolsmealslookmoreappealingsinceIwenttoschool 88(15.3%)SchoolmealsarenotashealthyastheyusedtobewhenIwasinschool 66(11.4%)SchoolmealslooklessappealingsinceIwenttoschool 220(38.1%)IwouldbelesslikelytoeatschoolmealsnowthanwhenIwasinschool 221(38.3%)IwouldbemorelikelytoeatschoolmealsnowthanwhenIwasinschool 75(13.0%)PortionsizesinschoolmealsarelargerinsizethanwhenIwenttoschool 16(2.8%)PortionsizesinschoolmealsaresmallerthanwhenIwenttoschool 249(43.2%)IneverateschoolmealswhenIwasinschool/myschooldidnotprovideschoollunch

29(5.0%)

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60

Yourmiddleschoolchildthinksschoolmealstastegood

173.2%

152.9%

203.8%

479.0%

6312.0%

12123.1%

24146.0%

5.77(1.58)

524

Parentopinionsofschoolmeals

StatementStronglydisagree

(1)

Somewhatdisagree

Neitheragreenor

disagree

Somewhatagree

Stronglyagree

(5)

Mean(StDev) n

Schoolmealsarehealthy

346.3%

9718.1%

7614.2%

27350.7%

5610.5%

3.41(1.09) 537

Eatinghealthyschoolmealswillmakemymiddleschoolchildhealthier

397.3%

8115.1%

12022.3%

18334.0%

11421.2%

3.47(1.19) 537

Healthyschoolmealswillhelpimprovemymiddleschoolchild’sschoolperformance

142.6%

539.9%

10018.7%

20438.1%

16530.8%

3.85(1.05) 536

Mymiddleschoolchildgetsenoughtoeatatschoolmeals

10920.4%

14927.9%

8816.5%

12623.6%

6211.6%

2.78(1.32) 534

Icantellifthefoodmymiddleschoolchildeatsatschoolishealthy

275.1%

9117.1%

21841.0%

13625.6%

6011.3%

3.21(1.02) 532

Thefoodservicestaffatmychild’sschoolseemswellinformedaboutschoolmealnutrition

112.1%

458.6%

30057.1%

11822.5%

519.7%

3.29(0.84) 525

QuestionNo,doesnottastegoodat

all

No,tastesbad

Doesnottaste

goodbutdoesnottastebad

Yes,tastesgood

Yes,verytasty

Idonot

know

Mychilddoesnot

eatschoolmeals

n

Doesyourmiddleschoolchildthinkschoolmealstastegood?

397.3%

6512.2%

15829.8%

19737.1%

264.9%

173.2%

295.5% 531

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61

Question Definitelynot

Probablynot

Mightor

mightnot

Probablyyes

Definitelyyes

Idonot

know

Mychilddoesnot

eatschoolmeals

n

Doesyourmiddleschoolchildthinkthatfoodintheschoollunchlinelooksgood?

397.3%

6512.17%

16029.96%

17632.96%

397.3%

366.74%

193.56% 534

Question School Home Both

Mymiddleschoolchild

doesnotusuallyeatschoolmeals

n

Sincethestartofthecurrentschoolyear,onatypicaldaydoesyourmiddleschoolchildgetamorenutritiousmealathomeoratschool?

336.23%

24746.60%

19737.17%

5310.0% 530

Howwouldyouratethecostofschoolmealsatyourmiddleschoolchild’sschool?

VeryExpensive 326.03%

Expensive 9918.64%

Reasonable 27050.85%

VeryReasonable 539.98%

Bestvalueformydollar 71.32%

Noopinion 142.64%

Notsurewhatthecostofaschoolmealis

142.64%

Mychildparticipatesinthefree&reducedmealprogram

427.91%

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62

n 531Parentperceptionsofschoollunchroomandstaff

Statement Stronglydisagree

Somewhatdisagree

Neitheragreenordisagree

Somewhatagree

Stronglyagree

Idon'tknow

Mean(StDev) n

Theschoollunchroomstaffisfriendly

102.0%

234.5%

8316.2%

9117.8%

14127.5%

16432.0%

3.95(1.08) 512

IknowthatIcanoffersuggestionstoschoollunchroomstaff

428.3%

489.5%

15931.3%

346.7%

285.5%

19738.8%

2.86(1.07) 508

Theschoollunchroomstaffofferssuggestionstomychildaboutwhichfoodtotry

5110.0%

418.1%

13927.4%

326.3%

112.2%

23446.1%

2.68(1.03) 508

Mychildusuallylikesthefoodservedintheschoollunchroom

5410.7%

8817.4%

6312.4%

20039.5%

8516.8%

1173.4%

3.35(1.27) 507

Theschoollunchroomstaffknowmychild’sname

285.5%

367.1%

9117.9%

6312.4%

8115.9%

20941.0%

3.44(1.26) 508

Ithinktheschoollunchroomstaffcareaboutthestudentsinmychild’sschool

112.2%

214.2%

9919.6%

10019.8%

12625.0%

14829.3%

3.87(1.06) 505

Ifmychildhadaproblemshe/hecouldgotooneoftheschoollunchstaffforhelp

285.6%

326.4%

9218.3%

9318.5%

8116.1%

19635.1%

3.51(1.21) 502

Schoollunchroomstaffregularlyspeaktomychildinthelunchline

112.2%

265.2%

9819.6%

7715.4%

6112.2%

22845.5%

3.55(1.06) 501

Theschoollunchroomservesagoodvarietyoffood

305.9%

6312.5%

7715.3%

20340.2%

8516.8%

479.3%

3.54(1.14) 505

Whenmychildpurchasesaschoollunch,she/hehasplentyoftimetobuyandeatfood

9017.9%

13627.0%

5911.7%

10721.2%

499.7%

6312.5%

2.75(1.32) 504

Thelinesintheschoollunchroomaretoolong

173.4%

397.7%

11322.3%

10621.0%

7514.8%

915630.8%

3.52(1.09) 506

Theschoollunchroomrunsoutpopularfoodsbeforeeveryoneisserved

255.0%

5110.2%

9919.8%

7615.2%

489.6%

20140.2%

3.24(1.16) 500

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63

Whenmychildpurchasesaschoollunch,she/hefeelsforcedtotakehealthyfoods

6412.8%

7314.5%

11923.7%

6212.4%

5711.4%

12725.3%

2.93(1.29) 502

Parentalvaluesregardingchildren’shealth

Statement Not

im

port

anta

tal

l(1)

2 3 4 5 Mean(StDev) n

Stayingcurrentonimmunizations/shots

81.6%

71.4%

306.0%

8216.5%

37174.5%

4.61(0.80) 498

Goingtothedoctorforcheckups

51.0%

81.6%

438.6%

11723.4%

32765.4%

4.51(0.80) 500

Gettingenoughsleep 00.0%

10.3%

51.0%

8516.8%

41682.1%

4.81(0.42) 507

Healthyeating 00.0%

20.4%

183.6%

12324.3%

36471.8%

4.67(0.56) 507

Drinkingenoughwater 10.2%

51.0%

193.8%

11222.1%

36972.9%

4.67(0.62) 506

Washinghandsregularly

20.4%

51.0%

356.9%

11522.8%

34868.9%

4.59(0.70) 505

Brushingteeth 00.0%

10.2%

132.6%

7214.2%

42183.0%

4.80(0.47) 507

Reducingstress 20.4%

71.4%

5711.3%

14428.5%

29558.4%

4.43(0.78) 505

Stayingawayfromalcohol,drugs,tobacco

10.2%

00%

10.2%

224.4%

48095.2%

4.94(0.28) 504

Reducingtheamountofpoporsugarydrinks

20.4%

102.0%

418.1%

13927.6%

31261.9%

4.49(0.76) 504

Eatingmorefruitsandvegetables

10.2%

30.6%

234.6%

13126.0%

34568.6%

4.62(0.62) 503

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64

Appendix26

ParentSurveyPost-Results

Schoolmealparticipation Yes No nIsyourmiddleschoolchildinthefreeorreducedlunchprogramattheirschool?

3911.1%

31388.9%

352

0days

aweek

1daya

week

2daysa

week

3daysa

week

4daysa

week

5daysa

week

Mean(St

Dev)n

Lastweek,howmanydaysdidyourmiddleschoolchildeatschoolbreakfast?

30586.4%

154.2%

61.7%

61.7%

51.4%

164.5%

.41(1.21)

353

Lastweek,howmanydaysdidyourmiddleschoolchildeatschoollunch?

3810.8%

113.1%

123.4%

246.8%

318.8%

23767.1%

4.01(1.70)

353

ReasonswhytheirchildrendonotbringfoodfromhometoeatatschoolReason n(%)Thereisnotimetopackalunchfromhome 99(28%)Wedonothavemoneytopackalunchfromhome 14(4.0%)Mychildreceivedfreeorreducedcostlunch 30(8.5%)Mychildlikesschoollunch 149(42.2%)Mychild’sfriendseatschoollunch 123(34.8%)Schoollunchisahealthymeal 43(12.2%)Schoollunchisagoodvalueformymoney 85(24.1%)Schoollunchisbetterformychildthanwhatwecouldmakeathome 21(5.9%)Mychilddoesnotlikethefoodpackedinalunchfromhome 23(6.5%)Mychilddoesnoteatschoolfood 43(12.2%)

Appendix 26: Parent Survey Post-Results

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65

ReasonswhytheirchildrenbringfoodfromhometoeatatschoolReason nMychildsometimesdoesn’tlikewhatisbeingservedatschoollunch 153(43.3%)Mychilddoesnotlikeschoollunch 49(13.9%)Lunchfromhomeischeaperthanschoollunch 34(9.6%)Lunchfromhomeismadewithlove 17(4.8%)Lunchfromhomeisahealthymeal 48(13.6%)MakinglunchfromhomemeansIknowwhatmychildiseating 50(14.2%)Bringingalunchfromhomegivesmychildmoretimetoeat 33(9.3%)Mychild’sfriendsbringlunchfromhome 11(3.1%)Mychildneedsmorefoodthanschoollunchprovides 52(14.7%)Mychildwillnoteatthefruitsandvegetablestheschoollunchprovides 18(5.1%)Mychilddoesnotbringfoodfromhometoeatatschool 97(27.5%)Schoollunchdoesnotmeetmychild’sspecificdietaryrestrictionsand/orallergies 7(2.0%)

ParentKnowledge

Parents’opiniononthepurposeofschoolmealsprogram

Question Yes No nHasyourmiddleschoolchildsaidanythingtoyouaboutchangestoschoolmealsthatoccurredduringthecurrentschoolyear?

10229.7%

24270.3% 344

Statement n(%)Toprovideschoolchildrenwithhealthyfood 246(69.7%)Tomakesureschoolchildrenhavesomethingtoeatduringtheday 282(79.9%)Tohelpfamilieswhoarestrugglingtofeedtheirchildrenbecausetheydonothaveenoughmoney

143(40.5%)

Tohelpfamilieswhoarestrugglingtofeedtheirchildrenbecausetheydonothaveenoughtime

63(17.8%)

Tosetanexampleforwhatahealthymeallookslike 126(35.7%)Touseupsurplusfoodproducedbyfarmers 11(3.1%)Togiveschoolchildrenabreakfromtheirlessons 38(10.8%)

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66

HowschoolmealshavechangedsinceparentswereinschoolStatement n(%)SchoolsmealsareprettymuchthesameaswhenIwenttoschool 38(10.8%)SchoolsmealshavegottenalothealthiercomparedtowhenIwenttoschool 120(34.0%)SchoolsmealslookmoreappealingsinceIwenttoschool 56(15.9%)SchoolmealsarenotashealthyastheyusedtobewhenIwasinschool 36(10.2%)SchoolmealslooklessappealingsinceIwenttoschool 121(34.3%)IwouldbelesslikelytoeatschoolmealsnowthanwhenIwasinschool 125(35.4%)IwouldbemorelikelytoeatschoolmealsnowthanwhenIwasinschool 44(12.5%)PortionsizesinschoolmealsarelargerinsizethanwhenIwenttoschool 12(3.4%)PortionsizesinschoolmealsaresmallerthanwhenIwenttoschool 142(40.2%)IneverateschoolmealswhenIwasinschool/myschooldidnotprovideschoollunch 15(4.2%)

Importanceofspecificlunchcomponentstoparents

Statement

Not

impo

rtan

tat

all

(1)

Very

impo

rtan

t(7

)

Mean(St

Dev)n

Freshfruitsandvegetablesareavailableforyourmiddleschoolchild’sschoollunch

10.3%

61.8%

51.5%

257.7%

4814.7%

6319.3%

17854.6%

6.11(1.23) 326

Proteinrichfoods(liketurkey,fish,beans,cheese,nuts)areavailableforyourmiddleschoolchild’sschoollunch

41.2%

61.8%

61.8%

3510.7%

4614.1%

5918.1%

17052.1%

5.98(1.37) 326

Wholegrainbreadproductsareavailableforyourmiddleschoolchild’sschoolmeal

82.5%

226.9%

3310.4%

7523.6%

5717.9%

3611.3%

8727.4%

4.91(1.70) 318

Foodsinyourmiddleschoolchild’sschoolmealsarepreparedfromscratchbyschoolfoodservicestaff

134.1%

226.9%

226.9%

6821.4%

7323.0%

5316.7%

6721.1%

4.86(1.66) 318

Yourmiddleschoolchildthinksschoolmealstastegood

82.5%

113.5%

92.8%

3711.7%

4413.9%

6921.8%

13843.7%

5.71(1.55)

316

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67

Parentopinionsofschoolmeals

Statement

Stro

ngly

di

sagr

ee

(1)

Som

ewha

tdi

sagr

ee

Nei

ther

ag

ree

nor

disa

gree

Som

ewha

tag

ree

Stro

ngly

ag

ree

(5) Mean

(StDev) n

Schoolmealsarehealthy

154.6%

4112.7%

5115.8%

18757.9%

299.0%

3.54(.98)

323

Eatinghealthyschoolmealswillmakemymiddleschoolchildhealthier

206.2%

3711.5%

8426.1%

11736.3%

6419.9%

3.2(1.12)

322

Healthyschoolmealswillhelpimprovemymiddleschoolchild’sschoolperformance

154.7%

226.8%

6720.8%

12137.6%

9730.1%

3.82(1.08)

322

Mymiddleschoolchildgetsenoughtoeatatschoolmeals

6119.0%

9730.2%

6419.9%

7724.0%

226.9%

2.69(1.22)

321

Icantellifthefoodmymiddleschoolchildeatsatschoolishealthy

195.9%

5015.5%

13241.0%

9429.2%

278.4%

3.19(.99)

322

Thefoodservicestaffatmychild’sschoolseemswell-informedaboutschoolmealnutrition

134.0%

175.3%

18256.7%

8024.9%

299.0%

3.30(0.86)

321

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68

Question

No,doesnottastegoodatall(1)

No,tastesbad(2)

Doesnottastegoodbutdoesnottastebad(3)

Yes,tastes

good(4)

Yes,verytasty(5)

Idonot

know

Mychilddoes

noteatschoolmeals

Mean(St

Dev)n

Doesyourmiddleschoolchildthinkschoolmealstastegood?

268.2%

3611.4%

9830.9%

12539.4%

113.5%

92.8%

123.8%

3.20(1.00) 317

Question Definitelynot(1)

Probablynot(2)

Mightor

mightnot(3)

Probablyyes(4)

Definitelyyes(5)

Idonot

know

Mychilddoesnot

eatschoolmeals

Mean(St

Dev)n

Doesyourmiddleschoolchildthinkthatfoodintheschoollunchlinelooksgood?

278.4%

5617.5%

8426.3%

10231.9%

257.8%

185.6%

82.5%

3.14(1.11) 320

Question School Home Both

Mymiddleschoolchilddoesnot

usuallyeatschoolmeals

n

Sincethestartofthecurrentschoolyear,onatypicaldaydoesyourmiddleschoolchildgetamorenutritiousmealathomeoratschool?

134.1%

16150.3%

12539.1%

216.6% 320

Howwouldyouratethecostofschoolmealsatyourmiddleschoolchild’sschool?

VeryExpensive 144.4%

Expensive 6119.1%

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69

Reasonable 16350.9%

VeryReasonable 4313.4%

Bestvalueformydollar 82.5%

Noopinion 72.2%

Notsurewhatthecostofaschoolmealis

41.3%

Mychildparticipatesinthefree&reducedmealprogram

206.3%

Mean(StDev) 2.97(.93)n 320

Parentperceptionsofschoollunchroomandstaff

Statement

Stro

ngly

di

sagr

ee

Som

ewha

tdi

sagr

ee

Nei

ther

agr

ee

nord

isag

ree

Som

ewha

tag

ree

Stro

ngly

agr

ee

Idon

'tkn

ow

Mea

n(S

tDev

)

n

Theschoollunchroomstaffisfriendly 31.0%

134.2%

5116.6%

6521.4%

8126.3%

9530.8%

3.98(1.00) 308

IknowthatIcanoffersuggestionstoschoollunchroomstaff

227.1%

3310.7%

10634.4%

289.1%

134.2%

10634.4%

2.89(.99) 308

Theschoollunchroomstaffofferssuggestionstomychildaboutwhichfoodtotry

247.8%

309.8%

7323.9%

278.8%

82.6%

14447.1%

2.78(1.05) 306

Mychildusuallylikesthefoodservedintheschoollunchroom

3812.4%

6220.3%

4113.4%

11437.3%

4013.1%

113.6%

3.19(1.30) 306

Theschoollunchroomstaffknowmychild’sname

196.3%

289.2%

4414.5%

309.9%

5518.2%

12741.9%

3.42(1.36) 303

Ithinktheschoollunchroomstaffcareaboutthestudentsinmychild’sschool 8

2.6%185.9%

5217.1%

7524.7%

6722.0%

8427.6%

3.80(1.10) 304

Ifmychildhadaproblemshe/hecouldgotooneoftheschoollunchstaffforhelp

196.2%

196.2%

6019.6%

6721.9%

4514.7%

9631.4%

3.48(1.19) 306

Schoollunchroomstaffregularlyspeaktomychildinthelunchline

134.2%

216.9%

4916.0%

4815.7%

3511.4%

14045.8%

3.43(1.18) 306

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70

Theschoollunchroomservesagoodvarietyoffood

154.9%

4013.0%

4013.0%

13744.6%

4815.6%

278.8%

3.58(1.10) 307

Whenmychildpurchasesaschoollunch,she/hehasplentyoftimetobuyandeatfood

4715.3%

8527.6%

3511.4%

6822.1%

309.7%

4314.0%

2.81(1.31) 308

Thelinesintheschoollunchroomaretoolong

82.6%

247.8%

6019.6%

7323.9%

4615.0%

9531.0%

3.59(1.10) 306

Theschoollunchroomrunsoutpopularfoodsbeforeeveryoneisserved 19

6.2%216.8%

5718.6%

6220.2%

3611.7%

11235.5%

3.38(1.12) 307

Whenmychildpurchasesaschoollunch,she/hefeelsforcedtotakehealthyfoods 27

8.8%46

15.0%89

29.0%43

14.0%258.1%

7725.1%

2.97(1.14) 307

Parentalvaluesregardingchildren’shealth

Statement Not

im

port

anta

tal

l(1

) 2 3 4

Very

Impo

rtan

t

(5

) Mean(StDev) n

Stayingcurrentonimmunizations/shots 4

1.3%2

0.7%185.9%

4314.0%

24078.2%

4.67(0.73) 307

Goingtothedoctorforcheckups

10.3%

82.6%

258.1%

6822.1%

20566.8%

4.52(0.78) 307

Gettingenoughsleep 10.3%

00%

72.3%

4916.0%

25081.4%

4.78(0.51) 307

Healthyeating 10.3%

10.3%

123.9%

7624.8%

21770.7%

4.65(0.60) 307

Drinkingenoughwater 10.3%

00%

134.2%

7825.4%

21570.0%

4.65(0.59) 307

Washinghandsregularly 10.3%

20.7%

206.5%

7624.8%

20767.6%

4.59(0.67) 306

Brushingteeth 10.3%

00%

72.3%

5417.6%

24479.7%

4.76(0.52) 306

Reducingstress 10.3%

72.3%

3210.5%

8828.8%

17858.2%

4.42(0.80) 306

Stayingawayfromalcohol,drugs,tobacco 1

0.3%00%

10.3%

154.9%

28994.4%

4.93(0.33) 306

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71

Reducingtheamountofpoporsugarydrinks 2

0.7%7

2.3%

3511.4%

6621.6%

19664.1%

4.46(0.83) 306

Eatingmorefruitsandvegetables

10.3%

10.3%

258.3%

6722.1%

20969.0%

4.59(0.68) 303

Return to TOC

72

Appendix27

FoodServiceStaffPre-Survey

WeinviteyoutoparticipateinaresearchstudybeingconductedbyinvestigatorsfromtheUniversityofIowa.Thepurposeofthestudyistobetterunderstandfoodservicestaff'sattitudestowardstheirjobandschoolmealsattheschoolwhereyouareemployed.Weareinvitingyoutobeinthisstudybecauseyouareafoodservicestaffmemberataschoolparticipatinginaschoollunchroomintervention.Thissurveyasksyourattitudesandthoughtsaboutyourjob.ThesurveyisconductedfortheIowaDepartmentofEducationbytheUniversityofIowaPublicPolicyCenterandCollegeofPublicHealth.Theinformationgatheredfromthesurveywillbeusedtohelpschoolsimprovetheirmeals.Ifyouagreetoparticipate,wewouldlikeyoutocompleteabriefonlinesurvey.Itwilltake5-10minutestocomplete.Youarefreetoskipanyquestionsthatyouprefernottoanswer.Ifyoudonotwanttodothissurvey,youmaystoptakingitatanytime.Wewillkeeptheinformationyouprovideconfidential,howeverfederalregulatoryagenciesandtheUniversityofIowaInstitutionalReviewBoard(acommitteethatreviewsandapprovesresearchstudies)mayinspectandcopyrecordspertainingtothisresearch.Wewillnotcollectyournameoranyidentifyinginformationaboutyou.Ifwewriteareportaboutthisstudywewilldosoinsuchawaythatyoucannotbeidentified.Therearenoknownrisksfrombeinginthisstudy,andyouwillnotbenefitpersonally.Howeverwehopethatothersmaybenefitinthefuturefromwhatwelearnasaresultofthisstudy.Youwillnothaveanycostsforbeinginthisresearchstudy.Youwillnotbepaidforbeinginthisresearchstudy.Takingpartinthisresearchstudyiscompletelyvoluntary.Ifyoudecidenottobeinthisstudy,orifyoustopparticipatingatanytime,youwon’tbepenalizedorloseanybenefitsforwhichyouotherwisequalify.Ifyouhaveanyquestionsabouttheresearchstudyitself,pleasecontactNatoshiaAskelson,(319)335-6867,Email:Natoshia-Askelson@uiowa.edu.Ifyouexperiencearesearch-relatedinjury,pleasecontact:NatoshiaAskelson,(319)335-6867,Email:Natoshia-Askelson@uiowa.eduIfyouhavequestionsabouttherightsofresearchsubjects,pleasecontacttheHumanSubjectsOffice,105HardinLibraryfortheHealthSciences,600NewtonRd,TheUniversityofIowa,IowaCity,IA52242-1098,(319)335-6564,ore-mailirb@uiowa.edu.Toofferinputaboutyourexperiencesasaresearchsubjectortospeaktosomeoneotherthantheresearchstaff,calltheHumanSubjectsOfficeatthenumberabove.Thankyouverymuchforyourconsideration.Ifyouwouldliketoparticipateinthisstudypleaseclickonthearrowboxbelow.

Appendix 27: Food Service Staff Pre-Survey

Return to TOC

73

IfyouchoosenottoparticipateyoumaycloseyourInternetbrowser.1. Whichschooldoyouworkat?

Not

Im

port

ant

ata

ll

Very

Im

port

ant

2. Itisimportantformetoencouragestudentstobuyandeatfruitsandvegetables

3. Itisimportanttomethateverystudentbuysandeatsfruitandvegetables

Pleaseselecttheanswerthatbestfitsforyou

St

rong

ly

Disa

gree

Stro

ngly

Ag

ree

Do

esn

ot

appl

y

4.

Mysupervisorwantsmetoencouragestudentstobuyandeatfruitsandvegetables

5. IhavetheskillsIneedtoencouragestudentstobuyandeatfruitsandvegetables

6. IfIwantedmoretraininginencouragingstudentstobuyandeatfruitsandvegetables,Iwouldbeabletogetit

Oneofmyresponsibilitiesisto7. Make/servefoodtostudents Yes No8. Haveapositivecommunicationwithstudentsonadailybasis 9. Makeastudent’sdaybetter 10. Makesurestudentshavethefueltheyneedtolearn 11. Makesurethathungrystudentsgetameal 12. Helpstudentsselecthealthyfoodoptions 13. Encouragestudentstoeatfruitsandvegetables 14. Encouragestudentstochoosefruitsandvegetablesoverlesshealthyitems(chips,

cookies,etc.)atlunch

Return to TOC

74

Thefollowingarealistofsomeissuesrelatedtofruitsandvegetablesthatschoolsmayface.Pleaseselecttheanswerthatbestfitswithyouropinionofifthatissueispresentatyourschool.

Not

a

prob

lem

Am

ajor

pr

oble

m

Don

ot

know

15. Thereisn’tenoughtimetosuggeststudentstakefruitorvegetableswhenstudentscomethroughthelunchline

16. Thereisnotenoughofavarietyoffruitsandvegetablesavailabletostudents

17. Fruitsandvegetablesrequiremoretimetoprepare 18. Studentsdon’tlikefruitsandvegetablesasmuchasotherfoods 19. Parentsofstudentsatourschooldonotencouragefruitand

vegetableconsumption

20. Classroomteachersdonotencouragefruitandvegetableconsumption

21. Principals/Administratorsdonotencouragefruitandvegetableconsumption

22. Thereisnotenoughfinancialsupportatthedistrictleveltoofferavarietyoffruitsandvegetables

23. Wedonothaveenoughtrainingonhowtopreparefruitsandvegetables

24. Wedonothaveenoughtrainingonhowtoencouragestudentstotakefruitsandvegetables

25. Fruitsandvegetablesareexpensive

St

rong

ly

Disa

gree

Stro

ngly

Ag

ree

Do

esn

ot

appl

y26.

Studentswhoeatfruitsandvegetablesatschoolaregenerallyhealthierthanstudentswhodonoteatfruitsandvegetablesatschool

27. Whatstudentseatatschoolishealthierthanwhattheyeatathome

28. Iameasilyabletoencouragestudentstochoosefruitsandvegetableswhentheycomethroughthelunchline

Return to TOC

75

Appendix28FoodServiceStaffPre-SurveyResults

StronglyDisagree

(1)

SomewhatDisagree(2)

SomewhatAgree(3)

StronglyAgree(4)

DoesnotApply

Mean(StDev) n

Mysupervisorwantsmetoencouragestudentstobuyandeatfruitsandvegetables.

13.4%

00.0%

724.1%

1655.2%

517.2%

3.58(.72) 29

IhavetheskillsIneedtoencouragestudentstobuyandeatfruitsandvegetables.

13.4%

00.0%

1448.3%

1448.3%

00.0%

3.41(.68) 29

IfIwantedmoretraininginencouragingstudentstobuyandeatfruitsandvegetables,Iwouldbeabletogetit.

310.3%

620.7%

724.1%

1137.9%

26.9%

2.96(1.10)

29

Studentswhoeatfruitsandvegetablesatschoolaregenerallyhealthierthanstudentswhodonoteatfruitsandvegetablesatschool.

14.2%

00.0%

1041.7%

1250.0%

14.2%

3.43(.73)

24

Whatstudentseatatschoolishealthierthanwhattheyeatathome.

00.0%

28.3%

1145.8%

416.7%

729.2%

3.12(.60) 24

Iameasilyabletoencouragestudentstochoosefruitsandvegetableswhentheycomethroughthelunchline.

00.0%

728.0%

936.0%

728.0%

25.7%

3.00(.80)

25

Extremely

Unlikely(1)

UnlikelyNeither

LikelynorUnlikely

LikelyExtremely

Likely(5)

Mean(St

Dev)n

Iwillencouragestudentstobuyandeatfruitsandvegetablesthisweek.

00.0%

00.0%

724.1%

1241.4%

1034.5%

4.10(.77)

29

Appendix 28: Food Service Staff Pre-Survey Results

Return to TOC

76

Oneofmyresponsibilitiesisto:

Yes No n

Make/servefoodtostudents

1557.7%

1142.3% 29

Havepositivecommunicationwithstudentsonadailybasis

2596.2%

13.8% 26

Makeastudent'sdaybetter

2596.2%

13.8% 26

Makesurestudentshavethefueltheyneedtolearn

2076.9%

623.1% 26

Makesurethathungrystudentsgetameal

2673.1%

726.9% 26

Helpstudentsselecthealthyfoodoptions

1976.0%

624.0% 25

Encouragestudentstoeatfruitsandvegetables

2284.6%

415.4% 26

Encouragestudentstochoosefruitsandvegetablesoverlesshealthyitems(chips,cookies,etc.)atlunch

1973.1%

726.9% 26

Question

Not

Impo

rtan

tata

ll(1

) 2 3 4 5 6

Very

Impo

rtan

t(7)

Mean(St

Dev)n

Itisimportantformetoencouragestudentstobuyandeatfruitsandvegetables.

00.0%

00.0%

13.3%

13.3%

310.0%

930.0%

1653.3%

6.27(1.02) 30

Itisimportanttomethateverystudentbuysandeatsfruitsandvegetables.

00.0%

00.0%

00.0%

414.3%

310.7%

1035.7%

1139.3%

6.00(1.05)

28

Return to TOC

77

Notaproblem

(1)

Aminorproblem

Somewhatofaproblem

Amajorproblem

(4)

Don’tknow

Mean(St

Dev)n

Thereisn’tenoughtimetosuggeststudentstakefruitorvegetableswhenstudentscomethroughthelunchline.

622.2%

518.5%

1037.0%

311.1%

311.1%

2.42(1.02) 27

Thereisnotenoughofavarietyoffruitsandvegetablesavailabletostudents.

1973.1%

623.1%

00.0%

12.9%

00.0%

1.35(.69) 26

Fruitsandvegetablesareexpensive.

520.0%

416.0%

832.0%

28.0%

624.0%

2.37(1.01) 25

Fruitsandvegetablesrequiremoretimetoprepare.

1352.0%

312.0%

416.0%

00%

514.3%

1.55(.83) 25

Studentsdon’tlikefruitsandvegetablesasmuchasotherfoods.

312.0%

832.0%

1352.0%

14.0%

00.0%

2.48(.77) 25

Parentsofstudentsatourschooldonotencouragefruitandvegetableconsumption.

14.0%

14.0%

728.0%

14.0%

1560.0%

2.80(.79) 25

Classroomteachersdonotencouragefruitandvegetableconsumption.

312.0%

00.0%

312.0%

00.0%

1976.0%

2.00(1.10) 25

Principals/Administratorsdonotencouragefruitandvegetableconsumption.

520.0%

28.0%

14.0%

00%

1768.0%

1.50(.76) 25

Thereisnotenoughfinancialsupportatthedistrictleveltoofferavarietyoffruitsandvegetables.

728.0%

28.0%

28.0%

14..0%

1352.0%

1.75(1.10) 25

Wedonothaveenoughtrainingonhowtopreparefruitsandvegetables.

1560.0%

14.0%

14.0%

00.0%

832.0%

1.18(.53) 25

Wedonothaveenoughtrainingonhowtoencouragestudentstotakefruitsandvegetables

1038.5%

415.4%

519.2%

00.0%

726.9%

1.74(.87) 26

Return to TOC

78

Appendix29

School1LunchroomAssessmentPreandPostreport

Appendix 29: School 1 Lunchroom Assessment Pre- and Post-Report

Return to TOC

79

Appendix30School2LunchroomAssessmentPreandPostreport


Return to TOC

80



Return to TOC

81



Return to TOC

82



Return to TOC

83



Return to TOC

84

Appendix35

IowaLunchroomFoodProductionRecordTemplate

Appendix 35: Iowa Lunchroom Food Production Record Template

Return to TOC

85

Appendix36ProductionRecordsResultsSchool1

WeeklyProduction TotalVeg TotalFruit TotalMilk

Fall 1617 1569 1946Spring–April* 3876.75 2302.5 1581Spring–May 2265 1846 1357

*Weightedavgfora5dayweek

0200400600800

10001200140016001800

DarkGreen Red&Orange Beans,Peas,&Legumes

Starchy Others

#of

serv

ings

VegetableSubgroupsFallSpring- April

Appendix 36: Production Records Results School 1

Return to TOC

86


*Nodataprovidedbyschoolsfor1%Whitemilkinthespring


Fall* 835 936 837

Spring* 953 1134 1139

*Disclaimer:onlyfourdaysreportedinbothfallandspring

0

100

200

300

400

500

600

700


Starchy Other

#of

serv

ings

VegetableSubgroups Fall Spring

0100200300400500600700800900

1000

1%White SkimWhite SkimChocolate

#of

serv

ings

MilkSubgroupsFall Spring


Return to TOC

87



Fall 696 240 372

Spring 298 107 238

0

50

100

150

200

250


Starchy Other

#of

serv

ings


020406080

100120140160180200


#of

serv

ings

MilkSubgroups Fall Spring


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88



Fall 2256.65 4523.5 2882Spring 2514.1 4068.5 3183

0

100

200

300

400

500

600

700

800


Starchy Other

#of

serv

ings


0200400600800

100012001400160018002000


#of

serv

ings

MilkSubgroupsFall Spring


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89


WeeklyProduction

TotalVeg TotalFruit TotalMilkFall 1666 1531 2046

Spring* 1452.5 1390 2258.75

*Weightedavg.fora5dayweek

0

500

1000

1500

2000

2500

3000


#of

serv

ings

MilkSubgroups Fall Spring

0100200300400500600700800900


Starchy Other

#of

serv

ings



Return to TOC

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Appendix41FoodServiceDirector/OtherAdult:PhoneInterviewGuide

Purpose:Toassesssuccessesandchallenges.Toidentifywhatcanbedonebetter.Hi,mynameisXandIamcallingfromtheUniversityofIowaPublicPolicyCenter.WeareconductinganevaluationoftheCommunicationandBehavioralEconomicsproject.Ifyouagreetoparticipateinthisstudywewouldlikeyoutocompleteaphoneinterviewthatwilllast20minutes.Wewillbeaskingyoutoshareyourperceptionsoftheprojectandsuggestionsonhowtoimprovetheprojectinthefuture.Ifyouagreetoparticipateinthisstudy,yourparticipationisvoluntaryandyoucanchoosetoendtheinterviewatanytime.Additionally,youmayskipanyquestionsyouprefernottoanswer.Thephoneinterviewwillberecorded,butwewillnotbecollectinganyidentifyinginformationaboutyou.Itwillnotbepossibletolinkyoutoyourresponses.Ifyouhaveanyquestionsabouttherightsofresearchsubjects,pleasecontacttheHumanSubjectsOffice,105HardinLibraryfortheHealthSciences,600NewtonRd.,TheUniversityofIowa,IowaCity,IA52242,(319)335-6564oremailirb@uiowa.edu.Areyouwillingtoparticipateinthisstudy?Anyquestionsbeforewebegin?Iamnowturningontherecordingdevice.Introduction:FirstIwouldliketoknowalittleaboutyouandyourpositionwithintheschool.Howlonghaveyouworkedfortheschoolyouarecurrentlyemployedat?Whatisthenameofyourcurrentposition?Inordertogetabetterideaofyourroleasa<<insertnameofpositionhere>>>,tellmealittlebitaboutwhatyourjobentails?Whatdoesanaveragedaylooklikeforyou?Tellmeaboutyourexperienceswiththeproject.Whatdoyouthinkworked?Whatdidyouenjoy?Whatdidn’twork?Whatwerethebiggestchallenges?Didyoulearnanythingnew?(Probeforspecificexamples) Whatdidyouthinkaboutthewebinars?Whatwasyourfavoritewaytogetthetraining?In-person,throughwebinars,orconferencecalls?WouldyourecommendthesetrainingtoFSSatotherschools?NowIwouldliketoaskyouquestionsaboutyourexperiencesandperceptionsfromyourparticipationintheproject.

Appendix 41: Food Service Director/Other Adult: Phone Interview Guide

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?Inyouropinion,wasthisprojectsuccessful?Hasanythingimprovedinthelunchroom?What? Probe:Noticeanychangesinpurchasingbehavior,anychangesinstudentstaffinteractionsIwouldliketoknowmoreaboutyourthoughtsaboutworkingwiththestudentsduringthisproject.Whatwasitlikeworkingwiththestudents?Isthissomethingyouusuallydo?Explain.Didanythingthatthestudentssaidordidwhenworkingwithyousurpriseyou?Doyouthinkthestudentsyouworkedwithunderstandfoodservicemoreaccuratelyafterparticipatingintheprogram?Priortoworkingonthisproject,describeyourlevelofengagementwithstudentsattheschool.Willyoucontinuetoworkwithstudentsafterthisprojectisover?Howmuchinfluencedoyouthinkyourschoolcanhaveonstudentselectionofhealthierfooditemsduringschoollunch?Howmuchinfluencedoyouthinkyoucanhaveonstudentselectionofhealthierfooditemsduringschoollunch?FutureIdeas:TheremainingquestionsIhaveforyouaskaboutideasyoumighthaveforotherschoolsthatwoulddoasimilarprojectinthefuture.Ifweweregoingtoimplementthisprojectinanothermiddleschool’snextyear,whatadvicewouldyougiveplanners?(Probefortipsandideasforwhattheythoughtwouldimprovefutureprojects)AnythingelseyouwouldliketosharewithmebeforeIturnofftherecordingdevice?

Thankyouforparticipating!

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