| This paper examines the impact of a nutrition education intervention on food choice and consumption in elementary cafeterias. After a school district changed 42 lunch and breakfast entrée recipes to include more whole grains, fresh produce and fresh meats, this study examined student food choice and food consumption in five schools with a nutrition education intervention and five schools without. The nutrition education intervention, focusing on a 3-level rating system to teach children about healthful food (Go, Slow, and Whoa), included an assembly, classroom instruction, point of sale cafeteria labeling, parent breakfast, and nutrition-related newsletter articles. Intervention schools were matched with comparison schools using propensity score matching. Student food choice and consumption was measured with digital plate waste methodology with a final sample size of 2223 lunch trays. Students enrolled in intervention schools showed significantly increased odds of choosing white milk (OR=2.17, p=0.05) over chocolate milk or no milk. None of the other healthy eating outcome models produced significant differences between intervention and comparison schools when controlling for gender, grade, and entrée items. Qualitative interviews with physical education teachers responsible for program implementation revealed low dose and fidelity of implementation for a variety of reasons. Additional teacher support, clarification of goals and program components, and technical assistance is advised to improve program implementation. |
