1. 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

2. 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

3. 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

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

5. 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

6. 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

7. 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

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

9. Methods: Cafeteria Workers Survey

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

11. 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

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

13. 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%)

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

15. Results: Provide a Pleasant Eating Environment

16. Results: Lunch Period Length

17. Results: Healthy Food Promotion

18. Results: Modeling Healthy Eating Habits

19. 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

20. 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,