School staff, parent and student perceptions of a Breakfast in the Classroom model during initial implementation.

OBJECTIVE: To understand perspectives of stakeholders during initial district-wide implementation of a Breakfast in the Classroom (BIC) model of the School Breakfast Program. DESIGN: Qualitative data were collected from twenty-nine focus groups and twenty interviews with stakeholders in a school district early in the process of implementing a BIC model of the School Breakfast Program. SETTING: Ten elementary schools within a large, urban school district in the USA that served predominantly low-income, racial/ethnic minority students. SUBJECTS: Purposively selected stakeholders in elementary schools that had implemented BIC for 3-6 months: students (n 85), parents/guardians (n 86), classroom teachers (n 44), cafeteria managers (n 10) and principals (n 10). RESULTS: Four primary themes emerged, which were interpreted based on the Diffusion of Innovations model. School staff had changed their perceptions of both the relative disadvantages and costs related to time and effort of BIC over time; the majority of each stakeholder group expressed an appreciation for BIC; student breakfast consumption varied from day to day, related to compatibility of foods with child preferences; and stakeholders held mixed and various impressions of BIC's potential impacts. CONCLUSIONS: The study underscores the importance of engaging school staff and parents in discussions of BIC programming prior to its initiation to pre-emptively address concerns related to cost, relative disadvantages and compatibility with child preferences and school routines/workflow. Effectively communicating with stakeholders about positive impacts and nutritional value of the meals may improve support for BIC. These findings provide new information to policy makers, districts and practitioners that can be used to improve implementation efforts, model delivery and outcomes.

'It's just so much waste.' A qualitative investigation of food waste in a universal free School Breakfast Program.

OBJECTIVE: To understand stakeholders' perspectives on food waste in a universal free School Breakfast Program implementing a Breakfast in the Classroom model. DESIGN: Semi-structured focus groups and interviews were conducted with school district stakeholders. Inductive methods were used to code resulting transcripts, from which themes were identified. The analysis provides a thematic analysis of stakeholders' perspectives on food waste in the School Breakfast Program. SETTING: Ten elementary schools in a large urban school district implementing a universal free Breakfast in the Classroom model of the US national School Breakfast Program. SUBJECTS: Elementary-school students (n 85), parents (n 86), teachers (n 44), cafeteria managers (n 10) and school principals (n 10). RESULTS: Stakeholders perceived food waste as a problem and expressed concern regarding the amount of food wasted. Explanations reported for food waste included food-related (palatability and accessibility), child-related (taste preferences and satiation) and programme-related (duration, food service policies, and coordination) factors. Milk and fruit were perceived as foods particularly susceptible to waste. Several food waste mitigation strategies were identified by participants: saving food for later, actively encouraging children's consumption, assisting children with foods during mealtime, increasing staff support, serving smaller portion sizes, and composting and donating uneaten food. CONCLUSIONS: Stakeholders recognized food waste as a problem, reported myriad contributing factors, and have considered and employed multiple and diverse mitigation strategies. Changes to the menu and/or implementation logistics, as well as efforts to use leftover food productively, may be possible strategies of reducing waste and improving the School Breakfast Program's economic, environmental and nutritional impact.

Educational Video Intervention Improves Perceptions of Breakfast in the Classroom Among College Students in Elementary Education.

OBJECTIVE: Evaluate Elementary Education college students' familiarity and perceptions of Breakfast in the Classroom (BIC) before and after an educational video intervention. METHODS: A 5-minute educational video was developed as an intervention in a pilot study. Quantitative data were collected from Elementary Education students using preintervention and postintervention surveys and analyzed using paired sample t tests (P < 0.001). RESULTS: A total of 68 participants completed preintervention and postintervention surveys. Postintervention survey scores indicated that participants' perceptions of BIC improved after watching the video. Paired sample t tests also showed an increase in preference for BIC, familiarity with the 5 school breakfast service models, and confidence to implement BIC in future classrooms. CONCLUSIONS AND IMPLICATIONS: An educational video intervention effectively improves Elementary Education students' perceptions of BIC. Elementary Education students who gain a positive perception of BIC may influence the program's success and ability to benefit students.

Alternative School Breakfast Service Models and Associations with Breakfast Participation, Diet Quality, Body Mass Index, Attendance, Behavior, and Academic Performance: A Systematic Review.

The United States (US) School Breakfast Program provides Breakfast After The Bell (BATB) to alleviate hunger, provide nutrition, and ensure students have a healthy start to the day. This study aims to review the evidence regarding the impact of BATB on students' diet and academic outcomes, including participation, diet quality and consumption, body mass index (BMI) and weight status, attendance, classroom behavior, and academic performance. The articles were extracted from three electronic databases and published since the start of the literature through December 2022. Studies were peer-reviewed; quantitative research articles or government reports; and conducted in public or private elementary, middle, and high schools. Quality was assessed using the Newcastle-Ottawa Scale. Thirty-seven studies were included in this review. This review found BATB increased school breakfast participation, improved diet quality, and improved classroom behavior particularly among students from racial and ethnic minority backgrounds and students eligible for free or reduced-price meals. The impact of BATB on BMI and weight status, academic achievement and attendance was mixed. This review is particularly timely given free school meals and updated school nutrition standards are being prioritized over the next decade in the US. Thus, it is important to evaluate the nutritional and educational outcomes of BATB. (PROSPERO registration: CRD42021289719).

Alternative Service Methods Associated With Increased Participation in the School Breakfast Program.

BACKGROUND: School breakfast programs (SBP) play an important role in reducing food insecurity and helping provide children with adequate nutrition. Using alternative service methods such as breakfast in the classroom, grab and go, and second chance breakfast may increase student participation. METHODS: We compared the SBP participation of students in 194 Pennsylvania schools that received a mini-grant to support the implementation of an alternative service method to participation in the academic year prior to implementation. In addition, we examined SBP participation in 90 schools that did not receive such a mini-grant to determine the change in participation in these schools over the 2-year period and compared this to the change in participation in schools that did receive a mini-grant. RESULTS: Overall, SBP participation in schools that received the mini-grant increased over the 2-year study period, a change that was not seen in schools that did not receive the mini-grant. The largest increases were seen in schools that implemented the breakfast in the classroom model. CONCLUSIONS: Alternative service methods, particularly breakfast in the classroom, are associated with increased participation in the SBP and therefore increase access to adequate nutrition and food security for school children.

Breakfast in the Classroom Initiative Does Not Improve Attendance or Standardized Test Scores among Urban Students: A Cluster Randomized Trial.

BACKGROUND: The Breakfast in the Classroom (BIC) initiative, a common approach to implementing the federal School Breakfast Program, is advocated as a method to improve students' academic performance. However, the influences of BIC on academic outcomes are unclear. OBJECTIVE: To examine the effect of a BIC initiative which provided free, universal BIC on attendance and standardized test performance over 2.5 years, vs free universal breakfast served in the cafeteria before school, among students in an urban school district serving a low-income population. DESIGN: Secondary analysis of data from a cluster randomized controlled trial conducted between 2013 and 2016; 16 kindergarten through eighth-grade public schools in Philadelphia, PA, were enrolled and randomized to condition. Baseline data for 1,362 fourth- through sixth-grade students were provided by the school district. Midpoint data were collected after 1.5 years and endpoint data after 2.5 years. PARTICIPANTS/SETTING: Schools were eligible in the case that ≥50% of students qualified for free or reduced-priced meals, did not offer BIC, and received programming as part of the US Department of Agriculture Supplemental Nutrition Assistance Program. Parents consented for their children to participate. INTERVENTION: Intervention schools provided BIC and breakfast-related nutrition-promotion activities. Control schools provided breakfast in the cafeteria before the school day. MAIN OUTCOME MEASURES: Student attendance and standardized exam scores. STATISTICAL ANALYSES PERFORMED: Weighted generalized estimating equations were used to evaluate differences in outcomes between conditions at midpoint and endpoint. RESULTS: The BIC initiative did not influence attendance (ß ± standard error = .004 ± .06; P = 0.94) or standardized reading exam scores (ß ± standard error = .02 ± .06; P = 0.79) after 2.5 years. Students in BIC initiative schools had lower standardized math exam scores than those in control schools, although this difference was small (ß ± standard error = -.20 ± .07; P = 0.005). CONCLUSIONS: BIC did not improve academic outcomes among students attending low-income, urban schools.

Teachers' Perceptions and Attitudes Toward Breakfast in the Classroom: The Importance of Health.

BACKGROUND: Teacher resistance is sometimes cited as a barrier to implementing Breakfast in the Classroom (BIC), an approach to school breakfast in which students eat at their desks after the school day has begun. Given their role in serving breakfast with BIC, teacher perceptions may be critical in implementing an effective BIC program. METHODS: K-5 teachers (N = 249) in an urban, low-income school district completed an online survey that assessed their expectations of BIC (retrospectively), perceptions of its benefits and challenges, and current program satisfaction. Descriptive statistics, Pearson's correlation tests, and multiple regression analyses were performed. RESULTS: Most teachers (64%) whose students were currently receiving BIC were satisfied with the program overall, and 81% of teachers agreed that (1) BIC should continue and (2) is worth the effort. The most commonly identified problem was lack of breakfast variety and healthfulness. Retrospective positive expectations were positively correlated with current program satisfaction (r = .61, p < .001), although overall post-implementation perceptions are much more positive. Additionally, the perception that BIC improves students' health is related to higher satisfaction with BIC. CONCLUSIONS: Focusing on the health implications of BIC may be important to implementing new BIC programs.

Impact of Breakfast in the Classroom on Participation and Food Waste.

OBJECTIVE: To investigate differences in school breakfast participation and food waste in 1 school district before and after the adoption of Breakfast in the Classroom. METHODS: Using a pretest-posttest design, participation and food waste were measured from 7 elementary schools in a rural area of southwest Virginia during the 2014-2015 school year. Participation and waste were measured on 4 days in each school (twice before and twice after Breakfast in the Classroom implementation) using the quarter-waste method. RESULTS: Across all schools, food waste decreased from 43.0% to 38.5% with Breakfast in the Classroom, with significant decreases for entrée items, juice, and savory snack foods (P < .01). Fruit and cheese items generated the greatest amount of food waste at 58.2% and 49.0%, respectively. CONCLUSIONS AND IMPLICATIONS: Breakfast in the Classroom may be an effective tool to decrease food waste while improving dietary intake. Future research is needed among more diverse populations.

Teachers' Experience and Perspectives of Traditional Breakfast and Breakfast in the Classroom.

OBJECTIVE: To understand teachers' perceptions about Breakfast in the Classroom and traditional breakfast. DESIGN: An electronic survey was sent to teachers across the state of Utah. Teachers responded to an open-ended question exploring what they liked and/or disliked about Breakfast in the Classroom and traditional breakfast. SETTING: Schools across the state of Utah. PARTICIPANTS: Kindergarten through grade 12 teachers who were members of the Utah Education Association. PHENOMENON OF INTEREST: Teachers' opinions regarding Breakfast in the Classroom and traditional school breakfast ANALYSIS: Researchers independently coded all responses and then grouped codes into themes. Themes were reviewed recursively over time. RESULTS: The 3 overarching themes were food and nutrition, administration of school breakfast, and student outcomes. Aspects most commonly disliked were the nutrition or quality of food, the mess created, the time required, coordination and logistical issues, behavioral issues, and waste. Aspects most commonly liked were breakfast being available to all students, students being fed or not hungry, coordination and logistics, and student learning and academics. CONCLUSIONS AND IMPLICATIONS: Teachers liked and disliked aspects of Breakfast in the Classroom and traditional breakfast. Schools could potentially increase efforts to garner support and feedback from teachers to create buy-in and identify best practices. Future research could focus on identifying the effect that the School Breakfast Program model has on teachers' perceptions as well as confirming results with a larger and more diverse population.

Teacher Perceptions and Preferences for 5 School Breakfast Program Models.

OBJECTIVE: Identify differences in teacher perceptions of benefits, challenges, and preferences to different School Breakfast Program (SBP) service models. DESIGN: A cross-sectional study design was used and an electronic survey was distributed to teachers throughout the state of Utah. SETTING: Kindergarten through 12th-grade schools throughout Utah. PARTICIPANTS: A convenience sample of 369 kindergarten through 12th-grade teachers in Utah. VARIABLES MEASURED: Demographics, benefits and challenges, and teacher preference for SBP models in Utah. ANALYSIS: Frequencies and multiple comparison analysis tests were performed. A level of significance of <.001 was chosen to protect for multiple comparisons. RESULTS: Traditional breakfast was the most preferred model, with a mean score of 2.8; Breakfast in the Classroom was the least preferred model by teachers, with a mean of -1.3 (scale used = -5 to 0 to 5). Children not going hungry was the greatest benefit (95.4%; n = 352) to SBP and food waste was the greatest challenge (45.8%; n = 168). CONCLUSIONS AND IMPLICATIONS: Teachers prefer traditional SBP model over BIC and other nontraditional models. Increased awareness and education regarding benefits and challenges of SBP models may increase teacher preference for nontraditional SBP models, especially BIC.