Perceived vs. observed implementation of local school wellness policies in the cafeteria Erin Biehl, MSPH; Susan Gross, PhD, MPH, RD; Beth Marshall, DrPH; David Paige, MD, MPH; Kristin Mmari, DrPH, MA

Presenter Disclosures Erin Biehl (1) The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: No relationships to disclose

Background Local School Wellness Policy: “…a written document that guides a local educational agency or school district’s efforts to create supportive school nutrition and physical activity environments.” Applies to Schools participating in National School Lunch or School Breakfast Program 30.3 million children in 2014 Mandated by Child Nutrition and WIC Reauthorization Act of 2004 Healthy, Hunger-Free Kids Act of 2010

Background Nutrition Environment Policies Eating Environment Healthy Food Promotion Healthy Role Modeling Food Service Staff Involvement in Nutrition Education

Objectives To examine administrator perceptions of school wellness policies and their implementation as observed in cafeterias Identify school wellness policies that may not be effectively implemented in cafeterias Discuss possible barriers to implementing and enforcing school wellness policies

Methods: CookShop Evaluation Study Food Bank For NYC CookShop Program: Classroom- based cooking & nutrition education program Longitudinal study evaluating impact of CookShop on changing nutrition attitudes and behaviors among elementary students 2013 Baseline: 26 public NYC elementary schools

Methods: School Environment Survey Sample: Principal or vice principal from 26 NYC schools Measured: Perceived implementation of 25 nutrition/wellness policies 0 = Not in Place, Not Considered 1 = Not in Place, Being Considered 2 = Partially in Place 3 = Fully in Place Analysis: Total score & individual policies

Methods: Cafeteria Workers Survey 78 cafeteria workers from 26 schools Measured food service staff involvement in nutrition education

Methods: Cafeteria Workers Survey

Methods: Cafeteria Observation 10 schools, one lunch period Measured Cafeteria Environment Factors Noise Level Seating Capacity Supervision Lunch Period Length Healthy Food Promotion

Results – All Schools (N=26) Wellness Policy Score Mean 55.4 ± 10.3, Range 34-75 Policies most in place Pleasant eating environment 20 minutes+ for lunch 10 minutes+ for breakfast Policies least in place Offer healthy eating/weight management programs to staff and encourage participation Offer “healthy” snack options in vending machines, school stores, concession stands and a la carte lines

Results: Food Service Staff Involvement in Nutrition (26 schools)

Results: Food Service Staff Involvement in Nutrition (26 schools) Food Service Staff Perceptions: 84.6% of cafeteria staff thought the cafeteria should be involved in nutrition education Greatest barriers to including the cafeteria No staff (41.0%) No time (32.1%) No administrative support (20.5%) No money (17.9%)

Results: Observation Schools (n=10) School Characteristic Mean (SD) Range Wellness Policy Score 52.9 (5.7) 47.0-66.0 % Ethnic Minority (Black, Hispanic, Asian, or Other) 96.8 (6.0) 80.0-100.0 No. of Years Principal at the School 5.8 (3.4) 1.0-10.0 % Students Eligible for Free Lunch 80.7 (9.7) 63.9-92.8

Results: Provide a Pleasant Eating Environment

Results: Lunch Period Length

Results: Healthy Food Promotion

Results: Modeling Healthy Eating Habits

Conclusions Administrators & cafeteria workers perceive nutrition policy implementation differently Cafeteria workers need administrative, financial support for nutrition education Despite administrator beliefs, nutrition policies may not be implemented in the cafeteria Pleasant eating environment Healthy food/nutrition marketing Some recommended policies not in place Teachers modeling healthy eating habits

Acknowledgements Johns Hopkins Bloomberg School of Public Health, Baltimore, MD Amanda Belknap Jenna Fahle Food Bank of New York City, New York City, NY Jeannie Fournier Gail Quets, M.Phil. New York City Public Schools Contact: Erin Biehl, ebiehl1@jhu.edu