How do we actually put smarter snacks in schools? NOURISH (Nutrition Opportunities to Understand Reforms Involving Student Health) conversations with food-service directors

Abstract

Objective: In autumn 2012, Massachusetts schools implemented comprehensive competitive food and beverage standards similar to the US Department of Agriculture’s Smart Snacks in School standards. We explored major themes raised by food-service directors (FSD) regarding their school-district-wide implementation of the standards. Design: For this qualitative study, part of a larger mixed-methods study, compliance was measured via direct observation of foods and beverages during school site visits in spring 2013 and 2014, calculated to ascertain the percentage of compliant products available to students. Semi-structured interviews with school FSD conducted in each year were analysed for major implementation themes; those raised by more than two-thirds of participating school districts were explored in relationship to compliance. Setting: Massachusetts school districts (2013: n 26; 2014: n 21). Subjects: Data collected from FSD. Results: Seven major themes were raised by more than two-thirds of participating school districts (range 69–100 %): taking measures for successful transition; communicating with vendors/manufacturers; using tools to identify compliant foods and beverages; receiving support from leadership; grappling with issues not covered by the law; anticipating changes in sales of competitive foods and beverages; and anticipating changes in sales of school meals. Each theme was mentioned by the majority of more-compliant school districts (65–81 %), with themes being raised more frequently after the second year of implementation (range increase 4–14 %). Conclusions: FSD in more-compliant districts were more likely to talk about themes than those in less-compliant districts. Identified themes suggest best-practice recommendations likely useful for school districts implementing the final Smart Snacks in School standards, effective July 2016.

Business outcomes of healthy food service initiatives in schools: A systematic review

“…Sixteen papers were included in the review representing 15 separate initiatives. [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]…”

“…A summary of the sample characteristics, study design, and findings of included studies is shown in Table 4 (and Appendix S5). Five studies were conducted in the USA, 25,28,34,37,39 five studies in Australia, 24,26,27,35,38 one in Norway, 33 two studies in the Netherlands, 29,31 one in Korea, 32 and two in Canada. 30,36 Three initiatives were implemented exclusively in primary schools; 24,35,38 eight initiatives were implemented across a combination of primary, middle, and high schools; [25][26][27]30,32,33,36,37 and five initiatives were implemented exclusively in high schools.…”

Are Nutrition Standards for Beverages in Schools Associated with Healthier Beverage Intakes among Adolescents in the US?

“…Food service directors indicated that ensuring that competitive foods aligned with the multiple aspects of the updated standards (including calories, caffeine levels, and portion sizes that varied by grade level) could be challenging, especially without sufficient training, resources, and/or support from the school district. Food service directors reported that it was easier to comply with the standards when reference lists for compliant foods were used (e.g., John C. Stalker A-List), when the district had strong wellness policies, and when they were able to work with their district’s wellness committee to ensure compliant foods were sold [ 44 ].…”

The Impact of 1 Year of Healthier School Food Policies on Students’ Diets During and Outside of the School Day

“…The NOURISH (Nutrition Opportunities to Understand Reforms Involving Student Health) Study was developed to learn more about the impact of the Massachusetts competitive food law on school compliance, 10,11 barriers and strategies for successful implementation, 12 revenues, 13 and students’ diets. This observational cohort study was a collaboration among the Harvard T. H. Chan School of Public Health, Northeastern University, Brandeis University, and the Massachusetts Department of Public Health.…”