The Modifying Eating and Lifestyles at School Study

NCT ID: NCT02309840

Last Updated: 2024-01-26

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 6873 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2011-09-30
• Study Completion Date: 2014-06-30

Brief Summary

The purpose of this study is to examine the impact of introducing healthier, chef-enhanced foods and/or environmental modifications (choice architecture) on selection and consumption of school foods among elementary and middle school students.

Detailed Description

Project Modifying Eating and Lifestyles at School (MEALS) was a school-based study developed by the nonprofit organization Project Bread (www.ProjectBread.org) and the Harvard School of Public Health. Project Bread hired a professional chef to work with several schools in a low-income, urban school district in Massachusetts to enhance the palatability and nutrient profile of the school meals. Four schools were randomly assigned to receive the professional chef. Additionally, two schools in that district and four schools in a second school district were randomly assigned to receive a behavioral psychology intervention to influence the selection and consumption of the healthier foods offered. Selection and consumption were assessed at baseline, up to 3 months post-implementation (short-term implementation for chef-enhanced meals), up to 4 months post-implementation (long-term implementation for behavioral psychology) and/or up to 7 months post-implementation (long-term implementation for chef-enhanced meals).

Primary Aim 1: to examine the impact of introducing healthier, chef-enhanced foods with increased palatability on selection and consumption among elementary and middle school students. It is hypothesized that there will be an increase in the selection and consumption of entrees, fruits, and vegetables in schools where healthier, chef-enhanced foods are served.

Aim 2: to examine the impact of physical modifications to the placement and displays of foods in the cafeteria on selection/consumption among elementary and middle school students. It is hypothesized that there will be an increase in selection and consumption of entrees, milk, fruits, and vegetables when modifications are made.

Conditions

Meals; Food Habits

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: FACTORIAL
• Primary Study Purpose: OTHER
• Blinding Strategy: NONE

Study Groups

control

Students received standard meals in a standard cafeteria environment

Group Type: NO_INTERVENTION

No interventions assigned to this group

Chef

Students were exposed to chef-enhanced meals

Group Type: EXPERIMENTAL

Chef-enhanced meals

Intervention Type: OTHER

meals prepared by a professional chef with enhanced palatability

choice architecture

Students were exposed to modifications to the physical environment in the cafeteria to "nudge" students towards healthier choices

Group Type: EXPERIMENTAL

choice architecture

Intervention Type: BEHAVIORAL

1. Place vegetables at the beginning of the lunch line.

2. Place fruits in attractive bowls or trays lined with appealing fabric, and place other fruit options next to the cash registers.

3. Promote fruits and vegetables with prominently displayed signage and images.

4. Place white milk selection in front of sugar-sweetened milk (e.g. chocolate milk) or at eye-level.

Chef and choice architecture

Students were exposed to both chef-enhanced meals and modifications to the physical environment in the cafeteria to "nudge" students towards healthier choices

Group Type: EXPERIMENTAL

choice architecture

Intervention Type: BEHAVIORAL

1. Place vegetables at the beginning of the lunch line.

2. Place fruits in attractive bowls or trays lined with appealing fabric, and place other fruit options next to the cash registers.

3. Promote fruits and vegetables with prominently displayed signage and images.

4. Place white milk selection in front of sugar-sweetened milk (e.g. chocolate milk) or at eye-level.

Chef-enhanced meals

Intervention Type: OTHER

meals prepared by a professional chef with enhanced palatability

Interventions

choice architecture

1. Place vegetables at the beginning of the lunch line.

2. Place fruits in attractive bowls or trays lined with appealing fabric, and place other fruit options next to the cash registers.

3. Promote fruits and vegetables with prominently displayed signage and images.

4. Place white milk selection in front of sugar-sweetened milk (e.g. chocolate milk) or at eye-level.

Intervention Type: BEHAVIORAL

Chef-enhanced meals

meals prepared by a professional chef with enhanced palatability

Intervention Type: OTHER

Other Intervention Names

Smart Cafe

Eligibility Criteria

Inclusion Criteria

• Students in grades 1-8 attending a participating school and receiving a school meal on a study day

Exclusion Criteria

• Bringing a lunch from home on a study day or not eating lunch in the cafeteria on a study day

• Minimum Eligible Age: 5 Years
• Maximum Eligible Age: 16 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Harvard School of Public Health (HSPH)

OTHER

Sponsor Role: lead

Responsible Party

Eric B. Rimm

Professor of Epidemiology and Nutrition

Responsibility Role: PRINCIPAL_INVESTIGATOR

References

Cohen JF, Richardson SA, Cluggish SA, Parker E, Catalano PJ, Rimm EB. Effects of choice architecture and chef-enhanced meals on the selection and consumption of healthier school foods: a randomized clinical trial. JAMA Pediatr. 2015 May;169(5):431-7. doi: 10.1001/jamapediatrics.2014.3805.

Reference Type: DERIVED

PMID: 25798990 (View on PubMed)

Other Identifiers

21198-103

Identifier Type: -

Identifier Source: org_study_id