ObjectiveTo: (i) understand the nutrition attitudes, self-efficacy, knowledge and practices of school food-service personnel (SFP) in Nebraska and (ii) identify potential barriers that schools face in offering healthy school meals that meet the US Department of Agriculture (USDA) nutrition standards.DesignConvergent parallel mixed-methods study.SettingKindergarten–12th grade schools in Nebraska, USA.ParticipantsSFP (260 survey participants; fifteen focus group participants) working at schools that participate in the USDA National School Lunch Program.ResultsMixed-methods themes identified include: (i) ‘Mixed attitudes towards healthy meals’, which captured a variety of conflicting positive and negative attitudes depending on the situation; (ii) ‘Positive practices to promote healthy meals’, which captured offering, serving and promotion practices; (iii) ‘Mixed nutrition-related knowledge’, which captured the variations in knowledge depending on the nutrition concept; and (iv) ‘Complex barriers’, which captured challenges with time, support and communication.ConclusionsThe study produced relevant findings to address the barriers identified by SFP. Implementing multicomponent interventions and providing training to SFP may help reduce some of the identified barriers of SFP.

Programming level measured with Healthy School Progress Report (HSPR), 100-point scale. Analysis was hierarchical linear regression with FV consumption as student-level variable, square root transformed to account for skewed data due to many students eating no FV, and HSPR scores as school-level variable. Results: FV consumption (n¼2571 trays): 96% of students had FV on tray, mean amount on tray: 0.96AE0.49 cups, amount consumed (student who had F&V on tray): 0.45AE0.40 cups. HSPR: range 24 to 97, mean 55.0AE17.2. Overall HSPR not associated with consumption (p¼0.119). Score on nutrition education (25 point scale, range 5 to 25) was positively associated with FV consumption (p¼0.004). Students from school with score of 5 ate 0.18 cups and students from school with score of 25 ate 0.61 cups. Other HSPR sections were not significant. Conclusions and Implications: Nutrition education appears to be associated with FV consumption at school lunch. Pre-post outcomes evaluation to determine impacts of increased programming on FV consumption is recommended. Funding: FoodCorps Inc.

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