High School Student and Caregiver Preferred Communication Method Regarding School Meals: A Qualitative Approach.

BACKGROUND: This study examined student and caregiver preference for school communication and explored the feasibility and acceptability of a digital tool to assist with communication about school meal program between schools and families. METHODS: The study used qualitative methodology through youth focus groups and caregiver semi-structured phone interviews. The study was conducted in 4 high schools in a large, urban city. The phenomenon of interest included the exploration of preferences regarding communication around school meal programs and feasibility and acceptability of a digital tool for communication and promoting the ordering of healthful foods in the school environment. Interviews were transcribed, coded, and analyzed through NVivo qualitative software using thematic analysis approach to examine themes. RESULTS: Forty-seven students (ages 14-21, grades 9-12) participated in 7 focus groups and 24 caregivers participated in semi-structured phone interviews. Three themes emerged around (1) communication preferences, (2) accessibility, and (3) extrinsic motivational factors for engagement in healthy eating behaviors. CONCLUSION: Results indicated that communication methods could potentially influence motivation and engagement in youth school meal participation.

Barriers and Facilitators to High School Meal Program Participation: A Qualitative Study of Students and Their Caregivers.

BACKGROUND: The school food environment is a critically important area to target the health of millions of students, especially those experiencing food insecurity. However, both students and caregivers have noted significant barriers to participation in the school meal program, including taste, lunchroom experience, and limited availability of fresh, healthy foods. There is a lack of qualitative research which considers both caregiver and adolescent perspectives, particularly among youth of color. METHODS: Forty-seven students (77% Black) and 24 caregivers across 4 midwestern high schools participated in focus groups and key informant interviews assessing barriers and facilitators to school meal participation. We conducted thematic analysis of the data using matrix intersection queries and reviewing frequencies of relevant nodes to identify themes. RESULTS: Themes about the importance of freshness and quality of the foods served in the lunchroom emerged from both students and caregivers. CONCLUSIONS: Future research may explore differences in meal participation depending on types of vender, farm to school program status, and other local variations in public schools and determine whether they increase participation, reduce food insecurity, and increase diet quality.

A pilot study of a school lunchroom intervention in a predominantly Latinx sample.

OBJECTIVE: The purpose of the study was to assess the feasibility of an environmental school lunchroom intervention ('Smarter Lunchrooms') and test initial efficacy within a predominantly Latinx population. DESIGN: We collected baseline and intervention lunchroom food consumption and waste data in a pre-post, single group design. Meal consumption data was analyzed using Nutrition Data System for Research software to obtain estimates of nutritional content. MAIN OUTCOME MEASURES: Feasibility. SECONDARY MEASURES: Plate Waste, Nutrient Intake. RESULTS: Participants were 88 1st-4th graders (51% female; 77% Latinx). Our recruitment rate was 45%, we were able to implement 8 Smarter Lunchroom strategies, and we were able to collect 82 baseline plate photos (93%) and 80 intervention photos (90%) of school lunches. On average, students threw away more than half of their meals on both days. Fruit consumption and fiber per 1000 kcal were significantly poorer at intervention compared to baseline. CONCLUSIONS: Our findings highlight challenges in collecting consumption data in a real-world setting. We describe directions for future research taking into consideration our "lessons learned" from this formative work.