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School Transformation after Redesign of 3 Cafeterias (STARCafé)

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Objective: Creating healthy food environments in schools is a national strategy to reduce child-hood obesity. In this study, we explore the impact of major changes to school cafeterias on students. Method: We conducted a natural experiment of redesigns in 3 cafeterias within New York City (NYC) public high schools. All received an intervention, STARCafé, that changed the cafeteria serving line, dining area, aesthetics, and signage and menu. Student outcomes were school lunch consumption, participation, and attitudes measured at pre-redesign, 3-month, and one-year post-redesign. Additional outcomes were fidelity to the Healthy Eating Design Guidelines and ripple effect on health-related programming. Results: STARCafé had a statistically significant and positive change on 4 of the 5 students' attitude scales (serving line, dining/seating space, aesthetics, and general) from pre-redesign to one-year post-redesign (all ps < .05), and a positive impact on school lunch participation (p = .04). There were no positive changes in school lunch consumption or on a ripple effect on additional health-related programming. Conclusions: Our results show that school cafeteria redesigns may promote long-term increases in participation and students' attitudes toward school lunch. Future studies are needed to understand how various redesigns and menu changes influence healthy eating behaviors such as increasing fruit and vegetable consumption.
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Keywords: ADOLESCENT HEALTH; HEALTHY EATING DESIGN GUIDELINES; SCHOOL FOOD SERVICES; SCHOOL LUNCH

Document Type: Research Article

Publication date: July 1, 2020

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  • Health Behavior and Policy Review is a rigorously peer-reviewed scholarly bi-monthly publication that seeks manuscripts on health behavior or policy topics that represent original research, including papers that examine the development, advocacy, implementation, or evaluation of policies around specific health issues. The Review especially welcomes papers that tie together health behavior and policy recommendations. Articles are available through subscription or can be ordered individually from the Health Behavior and Policy Review site.
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