Emerging evidence suggests a link between young people’s interest in alternative food production practices and dietary quality. The primary purpose of this study was to examine the impact of a student-driven sustainable food systems education and promotion intervention on adolescent school lunch selection, consumption, and waste behaviors. Sixth grade science teachers at two middle schools (n = 268 students) implemented a standards-based curriculum on sustainable food systems, addressing the environmental impacts of food choices and food waste. The cumulating curriculum activity required the 6th grade students to share their food systems knowledge with their 7th and 8th grade counterparts (n = 426) through a cafeteria promotional campaign to discourage food waste. School-wide monthly plate waste assessments were used to evaluate changes in vegetable consumption and overall plate waste using a previously validated digital photography method. At baseline, the intervention students consumed significantly less vegetables relative to the control group (47.1% and 71.8% of vegetables selected, respectively (p = 0.006). This disparity was eliminated after the intervention with the intervention group consuming 69.4% and the control consuming 68.1% of selected vegetables (p = 0.848). At five months follow up, the intervention group wasted significantly less salad bar vegetables compared to the control group (24.2 g and 50.1 g respectively (p = 0.029). These findings suggest that food systems education can be used to promote improved dietary behaviors among adolescent youth.
Background: School meal programs have a large reach and thus are ideal environments in which to implement interventions targeting improved youth eating behaviors and reduced food waste. This systematic review summarizes the evidence on the effectiveness of school meal nudge interventions on influencing children's eating and waste behaviors. Methods: Inclusion criteria required studies have participants in primary or secondary school (grades K-12) with interventions that occurred during school lunch or breakfast in the cafeteria and included at least one of the following outcomes: selection, consumption, waste, or school meal participation. Analyses of intervention outcomes were restricted to studies of strong and moderate quality. Results: Twenty-nine studies were included in the quality assessment. Included interventions fell into three categories: 1) placement/convenience, 2) marketing/promotion, or 3) variety/portions. The 20 strong and moderate quality studies included in outcome analyses generally used strong data collection methods and study designs, but were limited by an overall lack of intervention fidelity checks. Multi-component interventions often did not use methods that allowed for separate analyses of outcomes for different intervention components. Conclusions: School meal nudge interventions were positively associated with food selection, and had an inconsistent relationship with food consumption. There were few studies evaluating the impact of nudge interventions on meal participation or food waste. The limited evidence available links nudges to improved meal participation, as well as undesirable increases in food waste. Future research in this area should use methods that incorporate implementation metrics, attend to systems factors, and allow the outcomes of individual intervention components to be isolated.
Farm to school programs (F2SPs) operate in 42% of school districts and are supported in part through federal and state policies as well as philanthropic funding. Although research evaluating the effects of farm to school–related activities on student outcomes is growing, a systematic review of the results and thus a synthesis of implications for future programming have not occurred. The primary objective of this systematic literature review is to summarize and evaluate studies on student outcomes associated with farm to school–related activities up to 1 September, 2017. Four databases spanning 4 research disciplines were used to identify full-text, English-language studies. Twenty-one studies were reviewed: 7 explicitly investigated F2SPs, and 14 evaluated the impact of school-based interventions that were relevant to activities reported in the 2013 and/or 2015 Farm to School Census. All of the F2SP studies (n = 7) and 85.7% of farm to school–related activity studies (n = 12) were multicomponent, and there was a wide variety of implemented intervention components across the reviewed studies. Results from F2SP and farm to school–related activity studies consistently show positive impacts on food and nutrition-related knowledge; most studies also suggest a positive relation between farm to school–related activities and healthy food selection during school meals, nutrition self-efficacy, and willingness to try fruits and vegetables. The impact of farm to school activities on fruit and vegetable consumption and preferences is unclear. The most common F2SP study limitations were study designs that preclude causal inference, outcome measurement with no reported or limited psychometric testing, lack of long-term outcome evaluation, and challenges related to quantifying intervention implementation. These findings underscore the need for more conclusive evidence on the relation between farm to school–related activities and changes in fruit and vegetable consumption.
Nudge interventions are widely used to promote health in schools, yet implementation metrics are seldom used to understand intervention outcomes. A multi-component intervention consisting of cafeteria decorations, creative names, social norming taste tests, and flavor station components was implemented in three rural elementary school cafeterias by school nutrition services (SNS) and extension staff. Selection and consumption of fruits and vegetables at lunch were measured through monthly plate waste assessments over eight months (n = 1255 trays). Interviews were conducted with SNS staff (n = 3) upon completion of the intervention to assess implementation outcomes using validated acceptability and feasibility metrics. Consumption findings were generally inconsistent across schools and time points, yet fruit consumption increased at School 1 (p < 0.05) during the taste test and flavor station intervention months and School 2 (p < 0.001) during the creative names intervention months compared to baseline. Odds of selecting a vegetable at School 3 were three times higher than baseline during the taste test intervention months (odds ratio (OR), 3.0; 95% confidence interval (CI), 1.3–6.5). Cafeteria decorations and taste tests had higher reported implementation metrics for acceptability and feasibility than other interventions. Thematic analysis underscored the facilitating role of extension support, as well as systems factors, which served as facilitators and barriers across schools and interventions. These findings suggest that nudge interventions are a promising strategy to improve vegetable selection and fruit consumption in school meal programs.
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