Serving the Nutritional Needs of Pre-Kindergarten Children in the Public School Setting: Best Practices

Transcription

1 Serving the Nutritional Needs of Pre-Kindergarten Children in the Public School Setting: Best Practices National Food Service Management Institute The University of Mississippi

2 This publication has been produced by the National Food Service Management Institute Applied Research Division, located at The University of Southern Mississippi with headquarters at The University of Mississippi. Funding for the Institute has been provided with federal funds from the U.S. Department of Agriculture, Food and Nutrition Service, to The University of Mississippi. The contents of this publication do not necessarily reflect the views or policies of The University of Mississippi or the U.S. Department of Agriculture, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. The information provided in this publication is the result of independent research produced by NFSMI and is not necessarily in accordance with U.S. Department of Agriculture Food and Nutrition Service (FNS) policy. FNS is the federal agency responsible for all federal domestic child nutrition programs including the National School Lunch Program, the Child and Adult Care Food Program, and the Summer Food Service Program. Individuals are encouraged to contact their local child nutrition program sponsor and/or their Child Nutrition State Agency should there appear to be a conflict with the information contained herein, and any state or federal policy that governs the associated Child Nutrition Program. For more information on the federal Child Nutrition Programs please visit

3 National Food Service Management Institute The University of Mississippi Building the Future Through Child Nutrition The National Food Service Management Institute (NFSMI) was authorized by Congress in 1989 and established in 1990 at The University of Mississippi in Oxford. The Institute operates under a grant agreement with the United States Department of Agriculture, Food and Nutrition Service. PURPOSE The purpose of NFSMI is to improve the operation of Child Nutrition Programs through research, education and training, and information dissemination. The Administrative Offices and Divisions of Technology Transfer and Education and Training are located in Oxford. The Division of Applied Research is located at The University of Southern Mississippi in Hattiesburg. MISSION The mission of the NFSMI is to provide information and services that promote the continuous improvement of Child Nutrition Programs. VISION The vision of the NFSMI is to be the leader in providing education, research, and resources to promote excellence in Child Nutrition Programs. CONTACT INFORMATION Headquarters The University of Mississippi Phone: Fax: Education and Training Division Information Services Division The University of Mississippi 6 Jeanette Phillips Drive P.O. Drawer 188 University, MS Applied Research Division The University of Southern Mississippi 118 College Drive #10077 Hattiesburg, MS Phone: Fax:

4 Acknowledgments WRITTEN AND DEVELOPED BY Kristi L. Lofton, PhD, RD Research Scientist Mary Frances Nettles, PhD, RD Research Scientist EXECUTIVE DIRECTOR Charlotte B. Oakley, PhD, RD, FADA

5 TABLE OF CONTENTS EXECUTIVE SUMMARY...8 INTRODUCTION...11 Research Objectives METHOD...15 Research Plan Informed Consent Phase I Development of Best Practice Goals and Statements Expert Panel Expert Panel Work Group Session Post Session Review Draft PreK Best Practice Guide Phase II Review Panel Data Analysis RESULTS AND DISCUSSION...25 Phase I Phase II CONCLUSIONS AND RECOMMENDATIONS...47

6 REFERENCES...49 APPENDIX A: State Agency APPENDIX B: Invitation to Participate in Expert Panel Work Group Session...53 APPENDIX C: Confirmation and Travel Letter...55 APPENDIX D: Draft PreK Goals for Practice Categories...59 APPENDIX E: Draft Best Practice Statements...64 APPENDIX F: PreK Expert Panel Work Group Agenda...75 APPENDIX G: Goal Summary Form...77 APPENDIX H: Best Practice Statements Summary Form...82 APPENDIX I: Expert Panel Post-Meeting Draft Summary Questionnaire...95 APPENDIX J: Questionnaire of Unconfirmed Best Practice Statements, Goals and Practice Categories APPENDIX K: Goals as Best Practice Statements APPENDIX L: PreK Best Practices with Instructions APPENDIX M: Review Panel Invitations APPENDIX N: PreK Best Practice Guide Evaluation and Demographic Survey APPENDIX O: NFSMI Best Practice Guide for School Nutrition Professionals Serving the Nutritional Needs of Pre-Kindergarten Children...154

7 LIST OF TABLES Table 1: Best Practice Consensus List by Practice Categories, Goals and Best Practice Statements...27 Table 2: Table 3: Personal and Program Characteristics of Review Panel Members...29 Mean Agreement and Standard Deviations of the Review Panel s Evaluation of Goals and Best Practice Statements...33 Table 4: NFSMI PreK Best Practice Guide by Practice Category, Goals, and Best Practice Statements...36 Table 5: Table 6: Goals and Best Practice Statements for Communication and Training...37 Goals and Best Practice Statements for Administrative Support...40 Table 7: Goals and Best Practice Statements for Encouragement...41 Table 8: Goals and Best Practice Statements for Mealtime Opportunities...42 Table 9: Goals and Best Practice Statements for Dining Environment...43 Table 10: Goals and Best Practice Statements for Nutritious Menus and Meal Experiences...44 Table 11: Goals and Best Practice Statements for Healthy Wellness Practices...45

8 SERVING THE NUTRITIONAL NEEDS OF PRE-KINDERGARTEN CHILDREN IN THE PUBLIC SCHOOL SETTING: BEST PRACTICES EXECUTIVE SUMMARY Decision makers in public education are increasingly recognizing the benefits of positive early educational experiences for young children and are moving toward providing education programs for the Pre-Kindergarten (PreK) child in the public school setting. During the school year, 38 states funded PreK initiatives across the U.S. The PreK programs offered in these school districts varied in the ages of children served, the length of the school day, and whether meal service was provided (Barnett, Hustedt, Hawkinson, & Robin, 2006). Many PreK programs seeking to improve school readiness include comprehensive services that provide at least one meal; vision, hearing, health screening and/or referrals; and additional parental involvement opportunities and support services. By including these services, PreK programs preparing young children for success in school promote their cognitive, physical, social, and emotional development (Shonkoff & Phillips, 2000). School nutrition programs (SNP) serve as one of the comprehensive services that provide food and nutrition services in PreK programs in public schools. High quality PreK programs include school nutrition (SN) as a comprehensive service that not only provides meals necessary to meet the nutritional needs of young children, but also provides an opportunity to promote healthy eating, lifestyle behaviors, and attitudes essential for growth and development in young children (Lord, Wade, & Daugherty, 2005; Shonkoff & Phillips, 2000). SN directors understand the need for program assessment to measure the effectiveness of efforts that affect PreK 8

9 children s learning and development. However, there are no assessment resources for SN directors to evaluate PreK programs and assist in elevating their overall standards. Previous research conducted by the National Food Service Management Institute Applied Research Division (NFSMI, ARD) assessed the perceptions, practices, and perceived barriers faced by SN directors, SN managers, and other school professionals (principals, classroom teachers, and early education directors) serving the nutritional needs of PreK children in the public school setting. Findings from this research indicated that practices to meet the nutritional needs of PreK children statistically factored into seven categories: Communication and Training, Nutritious Menus and Meal Experiences, Administrative Support, Encouragement, Mealtime Opportunities, Dining Environment, and Healthy Wellness Practices (Nettles, Carr, & Johnson, 2006). The purpose of this research project was to identify the best practices or quality indicators for SN professionals serving the nutritional needs of PreK children in the public school setting. The researchers used a best practices research model described by Mold and Gregory (2003) to identify best practices related to the seven practice categories from previous research for SN professionals in school districts offering PreK programs. The research project was conducted in two phases. In phase I, an expert panel of key stakeholders (SN directors, PreK teachers, principals, and early education directors) from four USDA regions convened to identify goals and best practices under the seven practice categories. The researcher provided a draft of goals and best practice statements to expert panel members for feedback on content, scope, and wording of quality indicators, organization, and formatting of the final guide. In phase II, comments and suggestions from the expert panel were used to revise the best practice guide for pilot testing by a review panel in phase II of the research project. The review panel consisted of 9

10 SN directors, SN managers, PreK teachers, principals and early education directors with professional expertise in PreK programs in public schools. The revised best practice guide was sent to the review panel to pilot and complete a directed review of the guide in order to validate and evaluate its usefulness. Based on review panel results, the best practice guide was revised and formatted as a Web-based, self-assessment tool for use by SN professionals. The final version of the NFSMI Best Practice Guide for School Nutrition Professionals Serving the Nutritional Needs of Pre-Kindergarten Children consists of seven practice categories, 17 goals, and 97 best practice statements. The guide could be used as a self-assessment tool to evaluate and monitor the quality of nutrition services within existing PreK programs or as a resource to plan new PreK programs. 10

11 INTRODUCTION Pre-Kindergarten (PreK) programs offer young children and their families educational experiences to better prepare children to succeed in school. There is growing evidence that highquality PreK programs and services improve children s educational success and well-being. Research indicates that young children participating in high-quality PreK programs are more prepared academically and socially for Kindergarten and first grade, have a higher level of academic achievement, are less likely to be referred for special education services, and are less likely to repeat a grade or drop out of primary and secondary school (Denton, 2001; Gormley, Gayer, Philips, & Dawson, 2005). Policy makers recognize the benefits of positive early educational experiences for young children and support state-funded PreK program initiatives in public schools. During the school year, 38 states had at least one state-funded PreK program. State-funded PreK programs in these school districts varied by the age of children served, length of the school day, and whether meal service was being provided (Barnett, et al., 2006). Due to the complexities and variations in PreK programs in public schools, policymakers demand for evidence of high-quality Pre-K program effectiveness continues to be a primary issue associated with continuous funding and support. Growing evidence suggests that PreK programs committed to goals to improve children s readiness for school have shown significant short-term and long-term effects on children s cognitive growth and development (Gormley et al., 2005; Southern Rural Education Board, 2001; Temple, Reynolds, & Miedel, 2000). Essential characteristics of high-quality PreK programs evaluated include provisions and standards to protect children s health and safety; low student-to-teacher ratios and small classes; qualified, well-compensated teachers; appropriate 11

12 learning curricula, and parent and community involvement (Denton, 2001; Scott-Little, Kagan, & Frelow, 2003). Health and safety standards are the most basic requirements for children in any living and learning environment (Denton, 2001). Many PreK programs that seek to improve school readiness beyond basic health and safety standards include comprehensive services that provide at least one meal; vision, hearing, health screening and/or referrals; and additional parental involvement opportunities and support services. By including these services, PreK programs preparing young children for success in school involve not only their cognitive development but their physical, social and emotional well-being (Shonkoff & Phillips, 2000). School nutrition (SN) programs are an important part of PreK programs in public schools and make the following important contributions: provide food and services essential for optimal growth; promote healthy eating practices; and promote healthy physical, social and emotional development of young children. High quality PreK programs include SN programs as a comprehensive service that not only provide meals necessary to meet the nutritional needs of young children but also opportunities to promote healthy eating and lifestyle behaviors and attitudes essential for growth and development in young children. Therefore, establishing quality standards or best practices for SN services is an essential part of meeting overall PreK program standards (Lord, et al., 2005; Shonkoff & Phillips, 2000). Research conducted by the National Food Service Management Institute Applied Research Division (NFSMI, ARD) assessed the perceptions, practices, and perceived barriers faced by SN directors, SN managers, and other school professionals (principals, classroom teachers, and early education directors) serving the nutritional needs of PreK children in the public school setting. Research findings suggest that serving the nutritional and developmental 12

13 needs of PreK children is a more wide-ranged, complex undertaking than just serving meals. The practices in serving the nutritional needs of Pre-K children statistically factored into seven categories: Communication and Training, Nutritious Menus and Meal Experiences, Administrative Support, Encouragement, Mealtime Opportunities, Dining Environment, and Healthy Wellness Practices. Findings indicate that a team-centered approach, effective communication, and the seven practice categories are components necessary to implement the provisions for quality nutrition services for PreK children (Nettles, Carr, & Johnson, 2006). The NFSMI research also identified the need to ascertain the quality indicators or best practices that programs implement when serving the nutritional needs of PreK children by focusing on the seven practice categories. Mold and Gregory (2003) described the best practice approach as a systematic process used to identify, describe, and disseminate effective and efficient strategies developed and refined by practicing professionals. Best practices are utilized by professionals as a guide to achieve a desired outcome and reduce the risk for complications in operations (Mold & Gregory, 2003). The best practices research model (BPRM) proposed by Mold and Gregory (2003) consists of five steps for developing best practices and management approaches in real-life practice settings. These steps include the development of a best practices conceptual model, defining the best method based on program and practices, identification and evaluation of the draft best practice guide, combining or revising best practice guide components, and evaluating the final guide. The BPRM has been used to develop best practices for program success by experts and professionals working in actual practice settings. 13

14 Research Objectives Serving the Nutritional Needs of Pre-Kindergarten Children Determine the best practices or quality indicators related to Communication and Training, Administrative Support, Encouragement, Mealtime Opportunities, Dining Environment, Nutritious Menus and Meal Experiences, and Healthy Wellness Practices in PreK programs. Compile a best practice guide that can be used as an implementation resource or assessment tool for SN programs. Validate and evaluate the usefulness of the best practice guide. 14

15 METHOD Research Plan To accomplish the research objectives, the project was conducted following the BPRM described by Mold and Gregory (2003). The research project was conducted in two phases using an expert panel and review panel to identify, reach consensus, and evaluate goals and best practice statements for serving the nutritional needs of PreK children. Phase I utilized an expert panel consisting of SN directors, school administrators, and early education directors to assist with the development of best practice goals and statements. Information from Phase I was used to revise and format the draft best practice guide that was then sent to the Phase II review panel of state agency personnel, school administrators, and SN directors to evaluate. Informed Consent The researcher followed consent procedures established by the Human Subjects Protection Review Committee at the University of Southern Mississippi for this research project. There were no identifying codes used to identify either participants in the expert panel or the review panel participants in Phase I and Phase II of the research project. Agreement to participate in research activities associated with this project served as consent. Phase I Development of Best Practices Goals and Statements To accomplish the research objectives, the BPRM described by Mold and Gregory (2003) was used to guide the research process for this project. NFSMI, ARD research described seven practice categories for serving the nutritional needs of PreK children in the public school setting that will provide the framework for these best practice statements: Communication and Training, 15

16 Nutritious Menus and Meal Experiences, Administrative Support, Encouragement, Mealtime Opportunities, Dining Environment, and Healthy Wellness Practices. Serving the Nutritional Needs of Pre-Kindergarten Children The researchers reviewed previous research from various sources related to PreK children prior to drafting best practice goals and statements. In addition to drafting statements from published regulations and standards for young children served through the National School Lunch Program (NSLP), educational resources and standards for the Child and Adult Care Food Program (CACFP) were also used to capture quality indicators that meet the developmental and age-appropriate needs of PreK children. These resources included the following: Building for the Future: Nutrition Guidance for the Child Nutrition Programs (FNS-279, p. 94). (1992). Washington, DC: United States Department of Agriculture, Food and Nutrition Services. Copple, C. & Bredekamp, S. (2006). Basics of Developmentally Appropriate Practice - Introduction for Teachers of Children 3-6. Washington, DC: National Association for the Education of Young Children. Martin, J. & Conklin, M. (Eds.). (1999). Managing Child Nutrition Programs: Leadership for Excellence. Gaithersburg, MD: Aspen Publishers. National Association for the Education of Young Children Academy for Early Childhood Program Accreditation and Standards. Retrieved February 2007 from National Food Service Management Institute. (2003). Happy Mealtimes for Healthy Kids. University, MS: Author. Oakley, C., & Carr, D. (2003). Steps to Nutrition Success Checklist Child Care Centers: A program self-assessment resource. Retrieved February 2007 from 16

17 Oakley, C. & Carr, D. (2003). Steps to Nutrition Success Checklist Family Day Care Homes: A program self-assessment resource. Retrieved February 2007 from The initial draft of the PreK best practice document consisted of 30 goals and 140 statements/quality indicators focusing on the seven practice categories. Expert Panel State agency child nutrition directors were asked to recommend SN directors from public school districts with exemplary PreK programs to participate in the research project (Appendix A). The SN directors were ed details of the project and invited to attend a day and a half work group session. Since effective communication and a collaborative team approach with other school personnel is critical, the SN directors were also asked to provide contact information for PreK teachers, principals, administrators, and early education directors who could also serve on the expert panel. All potential participants were ed an invitation explaining the research project and the purpose of the work group session (Appendix B). Seven SN professionals and school administrators representing four USDA regions were selected to participate on the expert panel. After panel members agreed to participate, confirmation letters were mailed with additional information on the work group session and travel arrangements (Appendix C). Expert Panel Work Group Session In preparation for the work group session, a packet was mailed to expert panel members that included a cover letter, instructions, and two pre-meeting documents containing the practice categories, draft goals, and draft best practice statements. An NFSMI Insight which presented an overview of previous research was also included in the packet. As panel members reviewed the 17

18 first pre-meeting document containing the draft goals, they were instructed to assess the context of each goal while considering the following three questions: 1) Could this be a goal related to serving the nutritional needs of PreK children in my school district? 2) Could this be a goal related to serving the nutritional needs of PreK children that SN professionals support in other school districts throughout the country? 3) Is this an attainable goal in serving the nutritional needs of PreK children? Expert panel members were also asked to indicate which practice category (or categories) each goal could be classified (Appendix D). The second pre-meeting document contained a draft of 140 best practice/quality indicator statements (Appendix E). Panel members were asked to review each statement for specificity while considering the following questions: Does the best practice statement represent a best practice for serving the nutritional needs of PreK children in my school district? Does the best practice statement represent a best practice for serving the nutritional needs of PreK children in school districts throughout the U.S.? Is this statement a best practice for serving the nutritional needs of PreK children? Can this best practice statement be assessed? Space was provided on both documents for panel members to provide comments on organization, content, clarity, and wording of goals and best practice statements. Additional space was provided on the draft documents to make revisions of goals and best practice statements or to write additional goals and statements not included in the draft. 18

19 Seven expert panel members attended the work group session. The work group session was facilitated by three NFSMI, ARD researchers. Panel members were purposefully divided into two work groups based on their professional role in PreK programs. Each group consisted of a PreK administrator and two to three SN professionals to capture panel members perspectives on their professional roles and experiences in diverse PreK programs. Both subgroups participated in work group discussions and consensus building activities (Appendix F) to accomplish the following objectives: Review the wording of each draft goal and take action, Sort goals into practice categories and identify additional goals, if necessary, Review the wording of each draft best practice statement and take action, Sort best practice statements under the appropriate goals and practice categories, Identify additional best practice statements needed to achieve goals under each practice category, and Discuss appropriate format and design for the Web-based best practice guide for use by SN professionals. The first activity for panel members was to evaluate the draft goals. Each subgroup was asked to be mindful that goals were broad statements and provide the context for what is to be accomplished under the practice categories, not only in their schools, but in other PreK programs across the U.S. Each subgroup discussed three options for each goal and reached consensus for their group s recommendations. The options were to: Accept each goal as stated with no changes, Modify the wording of the goal, or Delete the goal. 19

20 Once the wording was agreed upon, the subgroup placed each goal under the appropriate practice category. They were also asked to identify any missing goal(s), write the new goal(s), and place it into one of the practice categories. Each subgroup used the goal summary form (Appendix G) to verify that they had not overlooked any goals and to capture the revised wording. The researchers used consensus building steps to reach agreement with all panel members on a course of action for the wording of goals and placement of goals under the practice categories. As each practice category was discussed, an NFSMI, ARD researcher summarized the dialogue concerning the course of action for each goal. The second work group activity focused on the best practice statements. Panel members were asked to be mindful that best practice statements were more specific than goals and should be reviewed as measurable or achievable objectives necessary to reach or attain goals under the practice categories. For this activity, each subgroup was instructed to use the same process as was used for the goal statements. Once the subgroup members reached agreement on the wording of the best practice statements, they placed the statements under the appropriate goal and practice category. Each subgroup s agreement on best practice statement wording, and placement of each statement under goals and practice categories were recorded on a best practice summary form (Appendix H). The researchers used consensus building steps to reach agreement with all panel members on a course of action for the wording of best practice statements and placement of best practice statements under goals and practice categories. Due to time constraints, the expert panel did not reach agreement for placement of all best practice statements under the goals and practice categories during the work group session. NFSMI researchers determined that a post-work group session review was necessary to confirm the recommendations of the expert panel. 20

21 The last work group activity required the panel members to discuss various Web-based formats that could be used for the PreK best practice guide and to review examples of selfassessment forms and checklists. Panel members recommended a checklist format that would include the practice category as the primary heading, the goal as a secondary heading, and the appropriate best practice statements to follow after each goal. Post Session Review Following the expert panel work group session, the researcher used the subgroups goal and best practice statement summary forms and the researchers discussion notes to formulate three post-expert panel review questionnaires. The first post-session questionnaire summarized the goals and best practice statements for the practice categories that were agreed upon at the work group session (Appendix I). The second questionnaire contained the list of unconfirmed goals and best practice statements (Appendix J). The third questionnaire contained goals that each work group decided should be best practice statements (Appendix K). The researcher ed the three post-session questionnaires with instructions to complete the review process to the expert panel members. The objectives of the post session review were as follows: Review the draft summary of best practice statements, goals and practice categories confirmed during the expert panel work group session and confirm the best practice statements and goals; Determine if the unconfirmed list of best practice statements grouped by the expert panel support the achievement of each goal and practice category; and Sort goals that the subgroups considered to be best practice statements under the appropriate goal and practice category. 21

22 Five of the seven (71%) expert panel members returned the post session review questionnaires. The researcher used their responses to formulate the draft best practice guide and the evaluation questionnaire for the national review panel in the next phase of the project. Draft PreK Best Practice Guide The draft PreK best practice guide contained the seven practice categories, 23 goals and 142 best practice statements (Appendix L). Following the expert panel recommendation, the draft guide was designed into a checklist format. Each practice category contained a description of the category, one or more goals, and the related best practice statements. A 4-point scale was used that would allow the SN professional to assess the degree to which their SN program was achieving each best practice statement. The categories in the 4-point scale were 1 (unsatisfactory), 2 (needs improvement), 3 (area of strength), and 4 (demonstrates excellence). An additional column (not applicable) was provided for responses to best practice statements that do not apply to SN professional s school and/or SN program. Phase II Review Panel In Phase I of the research project, state agency directors were asked to submit names of SN professionals to participate in both the expert panel and the review panel. SN professionals were selected from this pool of names and asked to participate on the Phase II review panel. In addition to this list of names, expert panel members were also asked to participate. The researcher ed potential review panel members outlining the details of the research project and inviting them to participate in the review (Appendix M). Seventeen SN professionals, representing ten states and the District of Columbia in six USDA regions agreed to serve on the review panel. Participants consisted of SN directors, nutrition and child care consultants, and 22

23 state agency representatives. The main objectives of the review were to evaluate the usefulness of the guide by assessing the efficacy of the PreK best practice guide as a self-assessment tool, and confirming the placement of best practice statements under related goals and practice categories. Each review panel participant received a review packet that included a cover letter, instructions, a draft PreK best practice guide, an evaluation questionnaire, and a demographic survey. Review panel members were asked to assess best practices at their school and SN program. After completion of the draft PreK best practice self-assessment, reviewers were asked to then complete an evaluation form to assess their level of agreement with the goals and best practice statements in the seven practice areas. For each practice category, review panel participants were asked to indicate their agreement with five questions using a scale ranging from 1 (strongly disagree) to 4 (strongly agree). The evaluation questions were as follows: The goals and best practices under this practice category are clearly stated. All of the best practices under the goals and practice category are measurable. The best practices listed under the goals identify performance standards needed to serve PreK children. The best practices will help achieve the goals under this practice category. All of the best practices listed are applicable to meet the needs of PreK children in public schools. Open-ended questions and space for input were also provided on the evaluation form for expert panel members to offer comments and suggestions on the wording and scope of the goals and best practice statements. The comment questions were as follows: Are there additional best practices needed to fulfill these goals? 23

24 Are there best practices that do not fit under the goals and practice category? Are there best practices that need to be modified to fit under these goals and practice category? The demographic survey asked review panel members to provide additional information about themselves, their school district and SN operation. They responded to questions related to their highest education level, certification/credentialed status, and information about their PreK and SN programs (Appendix N). The draft PreK best practice guide with instructions, evaluation form, demographic survey, cover letter, and a self-addressed, postage-paid return envelope were mailed to the 17 review panel participants. The cover letter informed review panel participants of the purpose of the project, asked for their participation, assured them confidentiality of their responses, and provided researchers contact information for questions and concerns. No identifying codes were placed on the guide, evaluation form or demographic survey, thus preserving the anonymity of the review panel. The review panel participants were instructed to return the completed PreK best practice guide, evaluation form, and demographic survey in the self-addressed, postage-paid return envelope within two weeks of receipt of the review packet. A follow-up was sent to all review panel participants encouraging them to complete and return all requested documents. Data Analysis The evaluation questionnaire and demographic survey were analyzed using the statistical package SPSS Version 15.0 for Windows. Descriptive statistics included means, standard deviations, and frequencies of total responses. 24

25 RESULTS AND DISCUSSION The purpose of this research project was to determine the best practices/quality indicators to assist SN professionals who provide food and nutrition services to PreK children in public schools. Seven practice categories identified in previous NFSMI research and 30 goals and 140 statements/quality indicators identified from previously cited regulations and standards were drafted as practices and/or strategies essential for meeting the nutritional needs of PreK children. SN directors, school administrators, and PreK directors participated in an expert panel (Phase I) and review panel (Phase II) to reach consensus on quality indicators and best practices regarded as essential elements for exemplary PreK programs in public schools. Phase I An expert panel was convened to review draft goals and best practice statements for the seven practice categories as outlined by the Best Practice Research Model (Mold & Gregory, 2003). Of the seven school professionals invited to participate in the expert panel session, all seven completed the pre-meeting assignments and attended the expert panel session (100% participation rate). Five of the expert panel members were SN directors (71.4%), one (14.3%) a school administrator, and one (14.3%) a PreK director. All were recommended because of their major role with the PreK programs in their school districts. During the work group session, expert panel members were asked to evaluate the draft goals and then take action to keep, modify, combine, or delete. Expert panel members were then asked to place goals under the appropriate practice categories. The same process was used in the evaluation of the draft best practice statements. Throughout the process, the researcher asked the expert panel members to remember that the goals identified for each practice category should be attainable and the best practice statements should support the achievement of the goal and be 25

26 measurable. The work group session time expired before reaching consensus on all best practice statements. Work group session results were summarized and final consensus on the placement and formatting of practice categories, goals, and best practice statements occurred via correspondence. Six of the seven (86%) expert panel members completed all the steps required for the initial evaluation phase of the BPRM. The draft list of categories, goals, and best practices before the expert panel review and after expert panel consensus is described in Table 1. The revision from the expert panel resulted in 23 goals and 141 best practice statements. The revised draft list of practice categories, goals, and best practices were formatted based on suggestions from the expert panel into a self-assessment checklist to be used by SN professionals. 26

27 Table 1 Best Practice Consensus List by Practice Categories, Goals and Best Practice Statements Consensus Before Consensus After Consensus Communication and Training Goals Best Practice Statements Administrative Support Goals Best Practice Statements Encouragement Goals Best Practice Statements Mealtime Opportunities Goals Best Practice Statements Dining Environment Goals Best Practice Statements Nutritious Meals and Meal Experiences Goals Best Practice Statements Healthy Wellness Practices Goals Best Practice Statements

28 Phase II Of the seventeen professionals invited to participate in the review panel evaluation process, fourteen (82%) completed the self-assessment checklist, evaluation form, and demographic survey. Demographic information for the review panel members is presented in Table 2. Review panel members represented six of the seven USDA regions. Eight (57%) of the review panel participants described their job title as SN director, and two (14%) as state agency staff. The four panel members (29%) who indicated their title as other PreK personnel worked as consultants/monitors for Head Start and PreK in public schools. Eight of the panel members (57%) have worked with SN programs for eleven years or more and 86% had at least one certification or credential associated with nutrition, education or other certification in medicine. Seven review panel members (57%) indicated that their schools served PreK through 12 th grade. The majority of review panel members indicated that 86% of their school districts have PreK programs in three or more schools, and 64% of these school districts serve more than 100 PreK children who are ages three and four (79%). Nine members (64%) of the review panel reported serving two meals and a snack under the NSLP to PreK children. 28

29 Table 2 Personal and Program Characteristics of Review Panel Members Question Frequency a % What best describes your job title? School Nutrition Director Other State Agency Personnel How long have you worked in school nutrition programs? More than 20 years to 15 years to 10 years to 5 years to 20 years What is your certification/credentialed status? b SNA certification State Department of Education certification SNS credentials Registered Dietitian Other Licensed Dietitian/Nutritionist Not certified a Total N varies based on responses for each question b Total exceed 100% since respondents could select more than one response (table continues) 29

30 Table 2 (continued) Personal and Program Characteristics of Review Panel Members Question Frequency a % What is your highest level of education? Baccalaureate degree Doctorate degree Graduate credits beyond Master s degree Master s degree Some graduate credits Associate degree Which of the following categories best describes the grade levels serviced at your schools? Other PreK to Lower Elementary PreK to Upper Elementary How many elementary schools in your district offer PreK programs/services? Five or more Three Four Two One a Total N varies based on responses for each question b Total exceed 100% since respondents could select more than one response (table continues) 30

31 Table 2 (continued) Personal and Program Characteristics of Review Panel Members Question Frequency a % Which of the following categories best describes the PreK ages serviced at your schools? Ages 3 and Age 4 only How many schools in your district offer nutrition services to the PreK program? Five or more Three Two One How many PreK students are served in your school district? More than 400 PreK students to to Which best describes the food program you follow for your PreK program? Food served under NSLP guidelines Food served under CACFP guidelines a Total N varies based on responses for each question b Total exceed 100% since respondents could select more than one response (table continues) 31

32 Table 2 (continued) Personal and Program Characteristics of Review Panel Members Question Frequency a % Which of the following describes the meals served to PreK children? 2 meals + 1 snack Depends on length of PreK program day In what USDA Region do you work? Southeast Mid-Atlantic Mountain Plains Southwest Western Northeast a Total N varies based on responses for each question b Total exceed 100% since respondents could select more than one response Review panel participants were instructed to use the PreK best practice guide to assess their school and SN program and complete an evaluation form on the goals and best practice statements in the seven practice categories. For each practice category, review panel participants indicated their agreement with five evaluation questions using a scale ranging from 1 (strongly disagree) to 4 (strongly agree). The review panels mean agreement ratings on the evaluation questions are displayed in Table 3. All seven practice categories had mean agreement ratings of 3.0 or greater for the evaluation questions. These ratings indicated a high level of agreement that 32

33 the goals and best practices were stated clearly, were measurable and achievable, and the goals and best practice statements were similar to performance standards necessary for PreK children. Table 3 Mean Agreement Ratings and Standard Deviations of the Review Panels Evaluation of Goals and Best Practice Statements Level of Agreement a Mean (Standard Deviation) Evaluation Statement Communication and Training Administrative Support Encouragement Mealtime Opportunities Dining Environment Nutritious Meals and Meal Experiences Healthy Wellness Practices Goals and best practices under this practice category are clearly stated. 3.4 (0.5) 3.3 (0.9) 3.4 (0.5) 3.5 (0.5) 3.4 (0.5) 3.3 (0.9) 3.4 (0.5) All of the best practices under the goals and practice category are measurable. 3.1 (0.5) 3.1 (0.3) 3.0 (0.0) 3.1 (0.5) 3.1 (0.5) 3.1 (0.5) 3.0 (0.0) The best practices listed under the goals identify performance standards needed to serve PreK children. 3.1 (0.5) 3.2 (0.4) 3.1 (0.5) 3.1 (0.3) 3.1 (0.3) 3.1 (0.5) 3.1 (0.5) The best practices listed will help achieve the goals under this practice category. 3.3 (0.5) 3.1 (0.5) 3.4 (0.5) 3.3 (0.5) 3.1 (0.5) 3.2 (0.4) 3.1 (0.5) All of the best practices listed are applicable to meet the needs of PreK children in public schools. 3.1 (0.3) 3.1 (0.4) 3.3 (0.9) 3.0 (0.0) 3.2 (0.4) 3.2 (0.4) 3.1 (0.5) a Scale = 1 (strongly disagree) to 4 (strongly agree) Additional space on the evaluation form was provided for review panel members to offer comments and suggestions for deleting, modifying, or combining goals and best practice statements. All review panel members recorded comments about deleting duplicate best practice 33

34 statements and offered suggestions for placement of best practice statements and goals under practice categories to improve the best practices guide. Researchers reviewed the comments and incorporated suggestions from the review panel when finalizing the best practice guide. The final version of the best practice guide consisted of seven practice categories, 17 goals, and 97 best practice statements (Table 4). 34

35 Table 4 NFSMI PreK Best Practice Guide by Practice Category, Goals, and Best Practice Statements Best Practice Categories Before Review Panel Evaluation After Consensus Communication and Training Goals Best Practice Statements Administrative Support Goals Best Practice Statements Encouragement Goals Best Practice Statements Mealtime Opportunities Goals 1 11 Best Practice Statements Dining Environment Goals 2 12 Best Practice Statements Healthy Wellness Practices Goals Best Practice Statements Nutritious Meals and Meal Experiences Goals Best Practice Statements

36 Previous NFSMI, ARD research suggested a team approach and effective communication between school staff is essential in meeting the nutritional needs of PreK children. The practice category, Communication and Training, contains six goals and 41 best practice/quality indicator statements (Table 5). Best practices/quality indicators in this category relate to communication and training issues associated with child development, nutrition education, and collaboration as necessary elements for serving the educational and social needs of PreK children. Goals and best practices under Communication and Training also reflect specific roles and duties of school nutrition staff, as team members, who collaborate with PreK teachers, principals, and early education directors to provide comprehensive services to PreK children. Table 5 Goals and Best Practice Statements for Communication and Training Goal 1. School staff is trained in the area of child development to meet the needs of Pre- Kindergarten (PreK) children. 1. The school nutrition staff receives training on appropriate ways to communicate, interact, and be sensitive and responsive to differing abilities and temperaments of PreK children. 2. School nutrition staff receives training on social, cognitive, and other development issues in PreK children. 3. The school nutrition director provides training/information to the school nutrition staff on menu and nutrition needs of PreK children. 4. The school nutrition staff is trained in customer service strategies appropriate for PreK children. 5. Nutrition concerns about PreK children with special needs are addressed in a timely manner. 6. The PreK teachers and/or members of the school nutrition staff receive training in nutrition education activities to promote healthy eating habits. 7. PreK teachers and school nutrition staff are trained in the importance of good nutrition to educational preparedness of PreK children. (table continues) 36

37 Table 5 (continued) Goals and Best Practice Statements for Communication and Training Goal 2. School professionals work together as a child-centered cohesive team to better serve PreK children. 8. School nutrition staff, PreK teachers, and other school staff communicate with parents to identify PreK children s needs during the enrollment process. 9. School nutrition staff and PreK teachers work as a team to disseminate information to parents to meet the nutritional needs of PreK children. 10. The school nutrition program has a plan to review and implement program improvements regarding PreK services. 11. At least one school staff member in the dining area has received training and certification in CPR and first-aid. 12. Menus are available and distributed to administrators, teachers, and the school community. 13. Parents of PreK children who are unable to pay for meals and/or snacks are provided information regarding free/reduced eligibility and applications. 14. School administrators adjust meal schedules to meet the developmental needs of PreK children. 15. PreK teachers partner with the school nutrition staff to use the cafeteria as a learning lab for PreK children. 16. School nutrition staff works with PreK teachers to integrate nutrition-related activities into the PreK learning curriculum. Goal 3. School staff, administrators, and parents are familiar with food and nutrition procedures appropriate for PreK children. 17. The school nutrition program collects and analyzes data to monitor and evaluate services provided by the School Nutrition Program to PreK children. 18. The school nutrition staff follows the USDA meal pattern to meet the nutritional needs of PreK children. 19. All food and nutrition procedures are consistent with the federal, state and local guidelines and the local wellness policy. 20. Selected food items for PreK children are evaluated regularly for nutritional content and appropriate portion size. (table continues) 37

38 Table 5 (continued) Goals and Best Practice Statements for Communication and Training Goal 4. School staff is trained in food and nutrition policies and procedures. 21. PreK teachers and school nutrition staff are trained on health, safety, and emergency guidelines to protect PreK children. 22. The school nutrition staff is trained on the USDA meal pattern to meet the nutritional needs of PreK children. 23. School staff is trained on food safety and sanitation guidelines. 24. The school staff is trained on food and nutrition procedures for feeding children with allergies and special needs. 25. The school nutrition program has developed and implemented policies and procedures to inform parents about nutrition-related issues. 26. A plan or procedure is in place to feed PreK children who come to school hungry or have missed an opportunity for meals. 27. School nutrition staff receives training on policies and procedures associated with feeding PreK children. 28. School nutrition staff receives training on policies and procedures to feed PreK children who arrive to school hungry. Goal 5. School nutrition directors, school staff and parents maintain an on-going line of communication to serve the needs of PreK children. 29. Nutrition information encouraging healthful eating and active living practices is disseminated to parents via menus, website, newsletter and other means, as appropriate. 30. The school staff communicates to parents in their preferred language or through translation. 31. The school district and school nutrition program documents and addresses parental concerns through ongoing communication. 32. PreK teachers and school nutrition staff work with parents to address special diet needs of PreK children. 33. School staff communicates with parents about policies and procedures to feed PreK children who arrive to school hungry. (table continues) 38