MultiLevel Systems Approach to Improving School Nutrition

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Multi-Level Systems Approach to Improving School
Nutrition Health

• Lynn James, M.S., R.D., L.D.N.
• Extension Educator
• Penn State Cooperative Extension

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Who Influences Elementary Students Food Habits?
Parents
Teachers
Media
Student
Peers
School Policies
School lunch
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School Food Service Director Program

• Goals
• Increase number and variety of fresh fruits
  vegetables on elementary school lunch menus
• Increase SFSD knowledge of child nutrition
  feeding issues
• Increase knowledge/ability for new ways to access
  local produce

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School Food Service Director Program

• Methods
• Pre-program survey-identify some barriers 12/02
• Program at state SFSD meeting 8/02
• Panel program for regional SFSD 2/03
• Regional SFS association presentation 3/03-
  healthy preparation, feeding
• Healthy School Nutrition Programs

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School Food Service Director Survey

• Key SFSD Survey Q A (N13)
• Q How often serve fresh fruits/veg?
• A Rarely 1
• 1-2x/month 2
• 2-3 /week 7

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School Food Service Director Survey

• Q Greatest challenges in serving fruit/veg to
  students?
• A Cost8 Time/Labor 1
• Plate Waste7
• Ordering Constraints1
• Other Kids eat fruit vegs are
• plate waste

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School Food Service Director Survey

• Q How often do you purchase from Central
  Susquehanna Valley farmers?
• A 1-3x/year 4-9x/yr
• Potatoes- 3 1
• Apples- 4
• Melons 2 2

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School Food Service Director Survey

• Q Limitations from buying local?
• A Red tape-2
• Low Selection- 2
• Delivery issues- 5
• Need more ordering
• info/resources- 3

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School Food Service Director Survey

• Q Offer salad bar or self-serve?
• A Yes 7 No6
• Cut tomatoes, broccoli, cauliflower, Spinach,
  peppers, carrots, fruits

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School Food Service Director Survey

• Other issues
• Commodities
• Competitive foods
• SFSD offering nutrition education7

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SFSD Panel Program

• Cooperative Extension Educator-
• Child Nutrition/Chronic Disease Prevention
  Child Feeding Issues
• PSU Ag Map
• Central PA Regional Grower Map

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SFSD Panel Program

• Local Farmer- product availability
• Local Produce Auctioneer- PA Veg Growers
  Association
• Local Fresh-Cut Produce Processor
• Cooperative Extension Specialist- national
  resources

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SFSD Panel Program

• Impacts- post program
• 100 (N9) increased knowledge child
  nutrition/feeding issues and planned to improve
  menus
• 6/9 planned to increase variety fruits/veg on
  menus

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SFSD Panel Program

• Impacts- post program
• 8/9 planned to utilize 1 new ways to local
  produce
• 7/9 wanted more quantity fruit/veg recipes that
  appealed to children

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SFSD Panel Program

• Impacts- 3 month follow-up post program (N8)
• 6 had increased variety of fruits/veg on menus
• 3 had increased purchase of local produce, 4 had
  still planned to yet this year
• 5 had used new resources to increase access to
  local growers
• Reached 11,000-15,000 students

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Healthy School Nutrition Program

• Overview
• 4 school districts in rural, central PA
  (Midd-West, Shamokin, Shikellamy, Williamsport)
• 16 elementary schools- K-5
• Secured USDA, ACS, local grant funding
• Purchased curriculum, promotional supplies
• Trained 392 teachers at 2 in-services/school,
  361 taught nutrition education (N-returned evals)
• 2972 students, 681 parents, 22 administrators, 3
  school nurses, 4 school food service returned
  evaluations

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Major Objectives
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Target Audience Program Goals

• Teachers increase knowledge of child nutrition,
  relationship of diet chronic disease, teaching
  nutrition ed in classroom
• Students increase fruit, vegetable, dairy,
  minutes physical activity, knowledge FGP
• Parents increase fruit, vegetable, fiber
  servings, physical activity, decrease sat. fat
• School food service- increase fruit/veg variety,
  promotion
• Admin-policy review- school health advisory team

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School Program Process

• Secure Funding
• Find Key Contact-
• Meet principal/curriculum coordinator, review
  program goals, curriculum matrix, get letter of
  support
• 2 teacher inservices/school for K, 1-2, 3-5,
  include P.E. teacher, School Nurse, SFS Director
  (Act 48 credits) PTA meetings

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How School Meals Can Help

• Increase the variety of fruits vegetables
  offered
• An elementary focus group in Snyder County
  revealed they wanted fruits vegetables served
  most often fresh
• Offer your menus/ala carte selections as a role
  model

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How Schools Can Help

• Offer taste-testing of new produce, in classroom,
  promote on menu in cafeteria
• Teach nutrition education in elementary grades
  yearly, at least 1x/month
• Teach with variety of physical activity methods

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How Schools Can Help

• Develop school lunch/ health advisory committees
  with teachers, parents, students, administration,
  community-establish healthy policies
• Engage parents- via newsletters, send learn at
  home materials, PTA
• Work with Administrators to have lunch after
  recess for improved consumption

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Healthy School Nutrition Program

• Methods/Results
• Healthy School Advisory Committees for policy
  review established- ¾ districts
• School food service- training menus
• Significant increases- Knowledge FGP/health,
  teaching nutrition, increases fruit/veg, physical
  activity
• Reached approx. 3625 students

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Teacher Survey Results (N361)

• All t-test
• results
• significant
• to p.00
• n361

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Teacher Survey (N361)
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Student Results

• K-2, N1731
• 3-5, N1241
• All
• Statistically
• Significant,
• p.00
• (t-test, Mean
• Differences)

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School Nutrition Health Fair
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Student Results- Diet

• Grades K-2 number fruits, vegetables increased
  38.8 post program on matched surveys
• Grades 3-5 increased consumption 39 post
  program, dairy 30.

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Student Results- Physical Activity

• Grades K-2 number Physical Activity minutes
  increased significantly after program plt.02
• Grades 3-5 increased minutes P.A. 37 post
  program (N30)

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Parent Survey Results

• All t-test
• results
• significant
• to p.00
• N681

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School Food Service Results

• Increased purchase and variety of fresh fruits
  and vegetables on elementary school menus
• Increased purchase from local farmers
• Increased promotion of vegetables, fruits, dairy
  on lunch menus, and cafeterias

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School Food Service Results

• New opportunity for teachers/SFS collaborate
• Taste-testing fruit/vegetable in classrooms
• Purchased SFS educational materials
• Offered in-service and learn-at home materials to
  staff

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Healthy School Advisory Results

• 2 school districts reviewed- CDC Elementary
  Healthy School Index
• One districts new goal- initiate breakfast
  program
• Another district had several policy
  recommendations
• Overall program found to be sustainable
• Current future plans- training another district
  now. Already in-serviced PSU Extension educators.

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Multi-Level Systems Approach to Improving School
Nutrition Health

• Lynn James, M.S., R.D., L.D.N.
• Extension Educator
• Penn State Cooperative Extension
• Ljames_at_psu.edu
• Penn State is committed to affirmative action,
  equal opportunity, and the diversity of its
  workforce.