10/20/2015. School Health Connection. Lessons Learned from the Healthy School Food Collaborative Evaluation in New Orleans. Kelley McDonough, MPH

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1 ASHA 2015 Annual School Health Conference Orlando, FL October 15, 2015 Lessons Learned from the Healthy School Food Collaborative Evaluation in New Orleans Kelley McDonough, MPH School Health Connection Established in 2006 by the Louisiana Public Health Institute in partnership with school health providers To improve the health of students and school communities SHC works with schools to develop comprehensive school wellness programs SHC also provides support and technical assistance to schoolbased health centers 1

Institute in partnership with school health providers To improve the health of students and school communities SHC works with

2 Healthy School Food Collaborative [2011] Propeller: A Force for Social Innovation partnered with KIPP New Orleans Schools to launch the Healthy School Food Collaborative (HSFC) Propeller= a New Orleans-based nonprofit that supports social entrepreneurship Health School Food Collaborative= a social venture that addresses the need for systemic change in the Louisiana school food environment through innovative policy and practice Healthy School Food Collaborative Through the Healthy School Food Collaborative (HSFC): Participating schools were given monetary and administrative support to select a food service provider independently of their school district The goal: To have New Orleans public schoolchildren eating healthier, delicious, and affordable school lunches that meet strict nutritional standards In New Orleans, 82% of students qualify for free or reduced priced lunch, which provides an important opportunity to positively affect the food consumption patterns of children and adolescents in schools. 2

through innovative policy and practice Healthy School Food Collaborative Through the Healthy School Food Collaborative (HSFC): Participating schools were given monetary and administrative support to

3 New Orleans Public Schools The city of New Orleans provides a unique education context for the implementation and evaluation of the HSFC Approximately 90% of New Orleans public schools are now independent public charter schools The HSFC Evaluation The partnership: Propeller partnered with School Health Connection of the Louisiana Public Health Institute to evaluate adherence to HSFC contractual requirements and student consumption of school food The objectives: To assess differences in the nutritional content of school lunches between food service management companies To assess student consumption of school meals Evaluation Overview Phase I Evaluation Phase Phase II K-5 Participating Grades 4 th & 5 th 8 # of Participating Schools 1 # of Days of Data Collection (at each school) 2,081 Total Trays (across all schools) ,525 3

contractual requirements and student consumption of school food The objectives: To assess differences in the nutritional content of school lunches between food service management companies To assess

4 Evaluation Overview Plate Waste Fidelity Monitoring Student Surveys Environmental Scan Focus Groups Evaluation Overview Part 1: Menu Analysis (Measures Nutrition) Part 2: Plate Waste Study (Measures Consumption) Part 3: Other Fidelity Monitoring Student Satisfaction Surveys Environmental Scans Focus Groups Methodology Plate Waste Study Research Assistants were assigned in teams of 3 to each of the 8 participating schools 10 standardized lunches were weighed at each school (before the start of the lunch periods) and averaged to quantify the pre-lunch weights of each of menu offering Students were instructed not to dispose of their lunch trays but to instead return them to a designated site Research Assistants calculated post-lunch weights by removing and weighing uneaten food items left on trays Combining the pre-lunch weight average with the post-lunch weight average allowed us to calculate student lunch consumption 4

each of the 8 participating schools 10 standardized lunches were weighed at each school (before the start of the lunch periods) and averaged to quantify the pre-lunch weights of each of menu offering

5 Daily Protocol Pre-Lunch Number trays Collect pre-weights Record menu options Lunchtime Record student selections Post-Lunch Weigh leftovers Complete fidelity monitoring tool Findings revealed that on average, students are only consuming 297 calories which is only around half of the calories recommended by the USDA Consumption by Vendor Total Vendor A Vendor B Vendor C 65% 68% 67% a 54% 50% 45% 40% 41% 41% 35% 36% 13% 52% 34% 25% 15% Entrée Veggie Fruit Milk 5

consuming 297 calories which is only around half of the 500-600 calories recommended by the USDA Consumption by

6 % Consumed of USDA Standard Nutrient 10/20/2015 Consumption and Nutrition kcal % consumed of 600 sodium % consumed of 1230 Nutrients Consumed Vendor A Vendor B Vendor C Kcal Sodium (mg) Total Fat (g) Saturated Fat (g) All comparisons between vendors across nutrient types are significantly different at p<.05 Most Consumed Foods Vendor A HSFC Vendor B HSFC Vendor C Non-HSFC (78%) (99%) (96%) (66%) (91%) (94%) (100%) (93%) (91%) Student Satisfaction 80% 70% 60% 50% 40% 30% 20% 10% 0% Like the taste of Still hungry after Have enough food lunch time to eat Can name all foods served Vendor A Vendor B Vendor C 6

0 All comparisons between vendors across nutrient types are significantly different at p<.

7 Were students allowed to talk during lunch? Social Lunch Policy Silent Punitive 31% Silent 13% Social 56% Lunch kcal Silent Silent punitive Social When did recess occur? Recess Schedule After lunch 58% Before lunch 42% Recess kcal Before 329 After 283 Moving Forward Research indicates that various factors beyond the availability of certain foods and beverages influence what students consume at school. Some factors identified include: Scheduling recess before or after lunch The duration of the lunch period The presence of vending machines within the school Availability of competitive foods during the lunch period Food preparation methods Student satisfaction with variety of foods offered Sufficient table space Hygiene of cafeteria Friendliness of lunch staff 7

influence what students consume at school.

8 Moving Forward Phase III begins in less than 2 weeks! Multi-component intervention aimed at increasing consumption School-based and vendor-based interventions Student (nutrition education, student-informed menu planning) Staff (modeling eating behaviors) Parent (nutrition education and modeling eating behaviors) Cafeteria (daily menu posting, staff engagement training) Multi-component evaluation to measure the effectiveness Phase III 3 participating schools 20 days of data collection Intervention 1 school will switch recess from after lunch to before lunch 2 schools will implement the multi-component intervention 20 days of data collection Thank You! Interested in learning more about the Healthy School Food Collaborative (HSFC) Evaluation? Contact: Kelley McDonough, MPH Senior Program Coordinator School Health Connection, LPHI kmcdonough@lphi.org 8

behaviors) Parent (nutrition education and modeling eating behaviors) Cafeteria (daily menu posting, staff engagement training) Multi-component evaluation to measure the effectiveness Phase III 3

Inspired Teaching Demonstration PCS Local Wellness Policy SY 2015 2018

Inspired Teaching Demonstration PCS Local Wellness Policy SY 2015 2018 Background The U.S. Congress established a requirement in the Child Nutrition and Women, Infants and Children (WIC) Reauthorization Act of 2004, that all school districts with a federally funded school