Improving student school lunch choices using a web and text based pre-ordering system

Background: Although interventions aimed at changing food available to students in school settings have shown some success in increasing healthy food consumption, it is also important to encourage students to choose these healthier options. One potential approach to improving decision-making is the use of strategies based on behavioral economics, such as having students "pre-commit" to lunch choices and make decisions in less chaotic environments than the lunch line, which have demonstrated efficacy in improving food choices. Objective: To determine the efficacy of a web/text based pre-ordering system to encourage students to choose healthier school lunches. Methods: A web/text based system will be developed that allows students to pre-order from a limited menu of healthy lunch choices. Measures of intervention effectiveness will include self-report fruit and vegetable intake, sales data, and assessment of participant attitudes toward the intervention. Results: The proposed intervention format will be based on previously conducted formative work, which indicated that students in the target school have high cell phone ownership rates (88%) and prefer texting to other forms of electronic communication (73%). In addition, taste, appearance and convenience were reported as important lunch decision-making factors. Results will be used to examine participation, economic impact, attitudes, and changes in fruit and vegetable intake. Implications: Results from this study will shed light on the efficacy and cost effectiveness of an intervention designed to improve nutrition among high school students. Given the health and economic costs of poor child nutrition, this intervention has significant potential to improve public health.