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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
6,873
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.
meals prepared by a professional chef with enhanced palatability
Change in the selection of meal components (Selection of entrees, milk, fruits, and vegetables)
Selection of entrees, milk, fruits, and vegetables
Time frame: baseline, up to 3 months post-implementation, and up to 7 months post-implementation
Change in the consumption of meal components (consumption of entrees, milk, fruits, and vegetables)
consumption of entrees, milk, fruits, and vegetables
Time frame: baseline, up to 3 months post-implementation, and up to 7 months post-implementation
Time to eat (Estimated amount of time spent eating foods)
Estimated amount of time spent eating foods
Time frame: up to 24 months
Hunger (Self-reported hunger at the end of the meal)
Self-reported hunger at the end of the meal
Time frame: up to 12 months
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