Putting Kids First: Evaluation of an intervention to improve the nutritional value of foods offered in public school

Unhealthy meal and snack options in public schools promote poor eating habits that contribute to childhood obesity. Policies must be established to ensure that healthy food options are available to the 30 million American children who eat lunch at school.1 Kids First, a non-profit organization, designed a district-wide middle-school nutrition intervention program to 1) ensure that school meals and snacks are highly nutritious and promote good health and 2) instill an appreciation for healthy dietary habits among students. At one pilot school, soda machines and unhealthy vending and a la carte options were replaced and/or removed, and the cafeteria increased the use of whole grains, fruit and vegetables in the meal program. As part of an evaluation to assess the program, students and staff were surveyed and participated in focus groups. Resistance to change was initially high, but at follow-up, the majority of students and staff were accepting of the changes and supported program continuation. Additionally, a small increase in the number of students expressing positive attitudes toward healthy foods was seen at follow-up.

Program implementation presented challenges including increased costs, a dip in sales, lost incentives from vending sales, and initial resistance to change. Barriers to program success were identified and feedback from the evaluation was used to inform and revise strategies for implementation. The program is currently expanding to other district schools. On-going evaluation activities will facilitate program improvement and development. This evaluation highlights the challenges of putting school nutrition policy into practice.