Parental Perceptions of the Nutritional Quality of School Meals and Student Meal Participation: Before and After the Healthy Hunger-Free Kids Act.

ABSTRACT

OBJECTIVES: To examine (1) parental perceptions of school meals and (2) student meal participation before and after the implementation of the Healthy Hunger-Free Kids Act (HHFKA). DESIGN: Data were collected from telephone surveys of 2 independent cross-sectional panels in New Jersey (2009-2010 and 2016-2017). PARTICIPANTS: Households with children aged 7-18 years (pre-HHFKA n = 1,027; post-HHFKA n = 324). MAIN OUTCOME MEASURES: Parental perception of school meals and parental reports of student participation in school meals. ANALYSIS: Multivariable logistic regression models were developed to examine outcome variables. For school meal participation, nested models were analyzed first controlling for sociodemographic variables, followed by parental perception, and then the interaction between perception and time. RESULTS: Parental perceptions of school meals did not change significantly after the HHFKA. At both time points, school meal participation rates were significantly higher for children of parents who perceived school meals as healthy compared with children whose parents perceived meals to be unhealthy (pre-HHFKA 89.9% vs 75.1%, P < 0.001; post-HHFKA 87.3% vs 64.9%, P = 0.02). CONCLUSION AND IMPLICATIONS Because higher perception of school meal quality is associated with higher participation, it is important for school food programs to inform parents about the improved nutritional quality of school meals.