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A Cafeteria Personnel Intervention to Improve the School Food Environment

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Objective: In this study, we examined the impact of an intervention targeting food service personnel on Smarter Lunchroom adherence in school cafeterias. Methods: This study used a quasi-experimental design, conducted in a Virginia school district serving predominantly African-American children, all eligible for free meals. In 2014-15, cafeteria managers (N = 38) from 43 schools were trained (and tasked with training their staff) on principles of behavioral economics and choice architecture designed to enhance students' food selections via modifications to the cafeteria environment. Booster trainings were conducted in 2015-16. Cafeteria personnel completed post-intervention surveys; trained raters conducted objective cafeteria environment ratings, assessing adherence with Smarter Lunchroom principles, at baseline, post-intervention, and one-year follow-up. Sales data also were examined. Results: Cafeteria personnel were satisfied (3.91 [of 5]±0.70) with the training and confident (4.18±0.52) in their ability to make changes. Overall adherence to Smarter Lunchroom principles increased 6.47% at post-intervention and 6.93% at follow-up (p = .001; partial eta2 = .21-.24), with a corresponding decrease in sugared-beverage sales at post-intervention (p = .001). Conclusions: This environmental-level intervention focused on training cafeteria personnel was associated with increased adherence to Smarter Lunchroom principles, sustained over 2 years. Future research should investigate the impact of this intervention on students' dietary behaviors in a rigorously designed trial.
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Keywords: COMMUNITY ELIGIBILITY PROVISION; NUTRITION; SCHOOL CAFETERIA; SCHOOL FOOD ENVIRONMENT; SCHOOL HEALTH; SMARTER LUNCHROOMS

Document Type: Research Article

Affiliations: 1: Associate Professor, Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA;, Email: [email protected] 2: Chronic Disease and Food Systems Specialist, Richmond City Health District, Richmond, VA 3: Farm to School Specialist, Virginia Department of Education, Office of School Nutrition Programs, Richmond, VA 4: CEO, Greater Richmond Fit4Kids, Richmond, VA 5: Associate Professor, Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA

Publication date: January 1, 2019

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  • The American Journal of Health Behavior seeks to improve the quality of life through multidisciplinary health efforts in fostering a better understanding of the multidimensional nature of both individuals and social systems as they relate to health behaviors.

    The Journal aims to provide a comprehensive understanding of the impact of personal attributes, personality characteristics, behavior patterns, social structure, and processes on health maintenance, health restoration, and health improvement; to disseminate knowledge of holistic, multidisciplinary approaches to designing and implementing effective health programs; and to showcase health behavior analysis skills that have been proven to affect health improvement and recovery.

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