How Environmental Interventions Influence Behavior in School Lunchrooms

NCT ID: NCT02091154

Last Updated: 2022-02-07

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 43 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2012-03-31
• Study Completion Date: 2012-05-31

Brief Summary

The investigators hypothesize that the new United States Department of Agriculture (USDA) regulations for lunches served as part of the National School Lunch Program will decrease the percentage of enrolled students purchasing lunch, increase the percentage of children taking fruit and vegetables, decrease the percentage of fruit and vegetable servings being thrown away, and increase the total number of fruit and vegetable servings eaten.

The investigators also hypothesize that when the regulations are in force, simple behavioral interventions can counteract the potentially negative impact on lunch sales and consumption. In other words, implementing the regulations and behavioral interventions together, the percentage of enrolled students taking a school lunch will increase at least back to baseline levels, the percentage of children taking fruits and vegetables will increase, the percentage of fruit and vegetable servings wasted will decrease, and the total number of fruit and vegetable servings eaten will increase.

Detailed Description

This study was conducted in 43 schools in the New York City (NYC) School district in the spring of 2012. The new regulations for school lunches were scheduled to roll out nationally in the fall of the same year, so this study was designed to provide an indication of the impact the new regulations would have.

In addition to the regulations, the investigators also tested additional behavioral interventions, in conjunction with the regulations, to determine how the behavioral interventions might offset, or magnify, the impacts of the regulations.

Conditions

Child Behavior; Adolescent Behavior; Health Behavior

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: FACTORIAL
• Primary Study Purpose: OTHER
• Blinding Strategy: DOUBLE

Study Groups

USDA Regulations Only

Implement USDA Regulations in assigned school cafeterias during the intervention period.

Group Type: EXPERIMENTAL

USDA Regulations

Intervention Type: BEHAVIORAL

Implement new USDA regulations assigned school cafeterias.

1. Fruit or vegetable on every tray

2. Meet requirements for vegetable varieties

3. 50% of all grains must be whole grain

4. Milk must be 1% or skim; flavored milk must be skim

USDA Regulations and Marketing Kit

Implement new USDA regulations in assigned schools along with the Marketing Kit during the intervention period.

Group Type: EXPERIMENTAL

USDA Regulations

Intervention Type: BEHAVIORAL

Implement new USDA regulations assigned school cafeterias.

1. Fruit or vegetable on every tray

2. Meet requirements for vegetable varieties

3. 50% of all grains must be whole grain

4. Milk must be 1% or skim; flavored milk must be skim

Marketing Kit

Intervention Type: BEHAVIORAL

This marketing tool kit is designed to encourage purchasing of school lunches. The marketing tool kit included the following components:

1. 56''x72'' vinyl sign with the words "[school mascot] Cafe"

2. 8.5''x11'' signs describing the foods offered on a specific day

3. 2''x4'' signs used to name all foods. These were to be placed in a visible location near the corresponding food.

4. Magnetic board displaying a tray onto which magnets shaped as food can be placed to show what foods were being offered during a specific lunch shift.

USDA Regulations and SLM

Implement USDA Regulations and Smarter Lunchrooms Makeover in assigned schools during intervention period.

Group Type: EXPERIMENTAL

USDA Regulations

Intervention Type: BEHAVIORAL

Implement new USDA regulations assigned school cafeterias.

1. Fruit or vegetable on every tray

2. Meet requirements for vegetable varieties

3. 50% of all grains must be whole grain

4. Milk must be 1% or skim; flavored milk must be skim

Smarter Lunchrooms Makeover (SLM)

Intervention Type: BEHAVIORAL

Implement three basic Smarter Lunchrooms techniques. It consists of the following components:

1. Place fruit in an attractive bowl or serving dish and set on two places on the line. One of the places should be at or near the register.

2. Give all vegetables descriptive names and write or type them on a 2''x4'' card. These cards should be visible and placed near the corresponding food.

3. Make white milk the most prominent milk in the milk coolers by making it the most available milk and easiest to take.

Control

Schools assigned to this intervention made no changes to their lunchroom or menus.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

USDA Regulations

Implement new USDA regulations assigned school cafeterias.

1. Fruit or vegetable on every tray

2. Meet requirements for vegetable varieties

3. 50% of all grains must be whole grain

4. Milk must be 1% or skim; flavored milk must be skim

Intervention Type: BEHAVIORAL

Marketing Kit

This marketing tool kit is designed to encourage purchasing of school lunches. The marketing tool kit included the following components:

1. 56''x72'' vinyl sign with the words "[school mascot] Cafe"

2. 8.5''x11'' signs describing the foods offered on a specific day

3. 2''x4'' signs used to name all foods. These were to be placed in a visible location near the corresponding food.

4. Magnetic board displaying a tray onto which magnets shaped as food can be placed to show what foods were being offered during a specific lunch shift.

Intervention Type: BEHAVIORAL

Smarter Lunchrooms Makeover (SLM)

Implement three basic Smarter Lunchrooms techniques. It consists of the following components:

1. Place fruit in an attractive bowl or serving dish and set on two places on the line. One of the places should be at or near the register.

2. Give all vegetables descriptive names and write or type them on a 2''x4'' card. These cards should be visible and placed near the corresponding food.

3. Make white milk the most prominent milk in the milk coolers by making it the most available milk and easiest to take.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• Public schools with any combination of grades K-12

Exclusion Criteria

• No point of sale system in school
• Satellite school
• Feeder school

• Minimum Eligible Age: 5 Years
• Maximum Eligible Age: 19 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

United States Department of Agriculture (USDA)

FED

Sponsor Role: collaborator

Cornell University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Adam Brumberg, BA

Role: PRINCIPAL_INVESTIGATOR

Cornell University

Kathryn Hoy, RD, MFN

Role: PRINCIPAL_INVESTIGATOR

Cornell University

David Just, PhD

Role: STUDY_CHAIR

Cornell University

Brian Wansink, PhD

Role: STUDY_DIRECTOR

Cornell University

Andrew Hanks, PhD

Role: PRINCIPAL_INVESTIGATOR

Cornell University

Locations

New York City School District

New York, New York, United States

Countries

United States

References

Hanks AS, Wansink B, Just DR. Reliability and accuracy of real-time visualization techniques for measuring school cafeteria tray waste: validating the quarter-waste method. J Acad Nutr Diet. 2014 Mar;114(3):470-474. doi: 10.1016/j.jand.2013.08.013. Epub 2013 Oct 14.

Reference Type: BACKGROUND

PMID: 24135053 (View on PubMed)

Hanks AS, Just DR, Wansink B. Smarter lunchrooms can address new school lunchroom guidelines and childhood obesity. J Pediatr. 2013 Apr;162(4):867-9. doi: 10.1016/j.jpeds.2012.12.031. Epub 2013 Feb 22.

Reference Type: BACKGROUND

PMID: 23434267 (View on PubMed)

Wansink B, Just DR, Hanks AS, Smith LE. Pre-sliced fruit in school cafeterias: children's selection and intake. Am J Prev Med. 2013 May;44(5):477-80. doi: 10.1016/j.amepre.2013.02.003.

Reference Type: BACKGROUND

PMID: 23597811 (View on PubMed)

Hanks AS, Just DR, Smith LE, Wansink B. Healthy convenience: nudging students toward healthier choices in the lunchroom. J Public Health (Oxf). 2012 Aug;34(3):370-6. doi: 10.1093/pubmed/fds003. Epub 2012 Jan 31.

Reference Type: BACKGROUND

PMID: 22294661 (View on PubMed)

Other Identifiers

1202002824

Identifier Type: -

Identifier Source: org_study_id