The objectives of this study were to describe the extent, nature, and enforcement of school competitive food policies in Pennsylvania public high schools and to determine if there are differences between school foodservice directors' and principals' perceptions of the existence and enforcement of these policies. A survey was distributed to 271 school foodservice directors and 100 principals in a representative, random sample of high schools. Two hundred twenty-eight school foodservice directors (84%) and 79 principals (79%) returned surveys. Descriptive statistics, chi(2) analyses, and a proportions test were done using SPSS statistical software (SPSS base 11.5 for Windows, 2002, SPSS Inc, Chicago, IL). Few nutrition policies were reported related to setting nutritional standards for competitive foods (0.5% to 15.0%). Respondents' reporting of existence of policies not always enforced ranged from 0% to 12.8%. School foodservice directors reported uncertainty about existence of several policies outside their direct domain, but with potential effect on school meals participation. Differences were found between school foodservice directors' and principals' reporting of policies, with principals more often reporting policy existence and enforcement. These findings suggest the need for communication, both about existence of policies and chain of command in enforcement of policies. Given the local wellness policy provision of the Child Nutrition and WIC Reauthorization Act of 2004, opportunities exist for nutrition professionals to contribute to development of policies that influence the nutritional quality of school foods.

Objective The objective of this study was to identify factors that predict offering and sale of competitive foods, as well as factors that predict average daily participation in school lunch.Design Surveys were distributed to 271 school foodservice directors in a random sample of high schools in Pennsylvania that were selected to be representative of the entire population of high schools in Pennsylvania based on chosen demographic characteristics.Subjects Two hundred twenty-eight school foodservice directors (84%) returned surveys. Statistical analyses Descriptive and multiple regression analyses were done using SPSS version 11.5 (2002, SPSS Inc, Chicago, IL).Results Percentage of students eligible for free or reduced-price meals and timing of lunch were significant predictors of a la carte sales. Enrollment was negatively associated with number of vending machines per student. The number of less nutritious food items offered in vending machines and existence of soft drink machines owned by soft drink companies, for which the school receives a percent of sales, both predicted number of vending machines per student. Enrollment was inversely related to average daily participation in school lunch. The percentage of students eligible for free/reduced-price meals and enforcement of a policy prohibiting parents or students from bringing food into the cafeteria from local fast-food establishments positively predicted average daily participation in school lunch.Conclusions These findings may be useful to school wellness councils in developing wellness policies as mandated by the Child Nutrition and WIC Reauthorization Act of 2004, as well as in structuring school environments to promote more healthful food choices by students.

Les programmes d'alimentation scolaire jouent un role majeur en matiere de nutrition des enfants. aussi bien aux Etats-Unis qu'a l'echelle internationale. Soucieux ce faire face a l'evolution ces problemes dietetiques le Ministere de l'agriculture des Etats-Unis (USDA), cui est charge de la supervisior des programmes d'alimentation scolaire, a mis en œuvre en 1995 an projet d'alimentation axe sur la sante des enfants. School Meals Initrative for Healthy Children Dans le cadre de ce projet, les besoms en nutrimerts ont ete modifies, afin d'assurer que les repas scolaire respectent les directives concernant les graisses alimentaires et les graisses saturees, en plus des exigences qui prevalaient jusqu'a present en matiere d'apport energetique alimentaire, de proteme et d'oligo-elements. Le present article traite de la strategie de communication et d'education mise en œuvre en Pennsylvanie, Etat caracterise par sa grande superticie et sa diversite et presentant des defis specifiques, pour que les programmes de repas scolaires de cet Etat respectent'es nouvelles exigences du Ministere de l'agriculture americain. L'article souligne les efforts deployes par l'Etat de Pennsylvanie pour repondre aux besoins en formation des 3 954 ecoles publiques et privees participant au Programme national d'alimentation scolaire (NSLP). Cette strategre, qui fait appel a des techniques aussi bien rudimentaires que sophistiquees, integre des methodes et des theories pedagogiques susceptibles d'etre appliquees dans d'autres pays, ou des programmes d'alimentation scolaire sont en phase de lancement ou de renforcement. Trois grands programmes representatifs de la strategie de communication sont presentes: les teleconferences par satellite, le programme de formation de formateurs Master Instructor Program et le site Web Project PA.

Adolescents’ dietary intake often fails to meet national dietary guidelines, especially among low-income African-American youth. The dietary habits established in adolescence are likely to continue into adulthood, and a poor-quality diet increases the risk of developing obesity and chronic disease. Based on principles from ecological and social-cognitive behavior change health theories, perceptions of parental beliefs about healthy eating, perceptions of peer eating behaviors, and parental monitoring of what adolescents eat may positively influence adolescent diet quality.The purposes of this study were to determine whether perceived parental beliefs about nutrition, perceived peer eating behaviors, and reported parental monitoring of the adolescent diet were related to African-American adolescent diet quality and whether these relationships were moderated by adolescent age or sex.This secondary cross-sectional study used baseline data (2002 to 2004) from an urban community sample of low-income adolescents participating in a health promotion trial.Participants were 216 African-American adolescent-caregiver dyads in Baltimore, MD.The 2010 Healthy Eating Index was used to estimate adolescent diet quality.Analyses included correlations, t tests, age- and sex-by-perception regression interactions, and multivariate regressions adjusted for body mass index–for-age percentile, caregiver weight status, and caregiver depressive symptoms.Higher diet quality scores were related to higher levels of perceived parental and peer support for healthy eating behaviors among adolescents (β=.21; P<0.05; β=.15; P<0.05, respectively) and to caregiver reports of parental monitoring of adolescent dietary behavior (β=1.38, P<0.01). Findings were not moderated by age or sex.Consistent with ecological and social-cognitive theories, adolescents look to their friends and family in making healthy food choices. The relationships uncovered by this study describe some of the contextual, interpersonal influences associated with diet quality among low-income, urban African-American adolescents and warrant further exploration in future intervention studies.

The effect of parental participation in sports nutrition workshops on young swimmers’ food choices was investigated. Parents of 9-15-year-old swimmers were recruited from swimming clubs that had requested sports nutrition workshops in Finland and assigned to intervention (IG) and control groups (CG). The research employed a pretest/workshop intervention/delayed post-test (1-month) design. The IG participated in a 4-hour workshop on the nutritional requirements of young athletes. In both groups, changes in the swimmers’ food choices were assessed via pre- and post-test questionnaire administered with parental help. Instruments included a FFQ and specific open ended questions designed to investigate food consumption patterns of young athletes. IG swimmers (n=36) reported changes in food choices before competition: they ate fewer foods high in fat (p<0.05) or salt (p<0.01), fewer fried foods and less meat and fish (p<0.05). CG swimmers (n=36) did not report changes in their pre-competition meal. No changes were reported in either group in food and fluid choices during or after competition or in the timing of intake before performance. In both groups, everyday food choices were nutritionally sound and showed no change.

The curriculum, “Every Day, Lots of Ways,” focuses on the topics of “5-A-Day” for the k-lst grades and the Food Guide Pyramid for 2nd-6th grades. Quantitative evaluation methodology included distribution of a survey to 181 teachers before and after they had implemented the curriculum in their classrooms. Questions were designed to assess teachers’ nutrition knowledge, including their knowledge of food groups and serving sizes, their attitudes toward nutrition, and their perceptions of the curriculum. 52% of the teachers returned the pre-survey; 48% returned the post-survey. Teachers’ overall nutrition knowledge (p=.005) as well as subscales of knowledge about food groups and serving sizes (p=.0001 and p=.001, respectively), improved significantly after teaching the curriculum. A significant difference was found in overall knowledge (F=9.02, p=.0001), knowledge of food groups(F=4.79, p=.0045) and serving sizes (F=7.95, p=.0001), and general nutrition knowledge (F=3.32, p=.0255) between the number of college nutrition credits taken by teachers using the pre-test score as a covariate. A significant difference in attitude toward nutrition (F=6.16, p=.0010) was also found between the number of college nutrition credits taken by teachers, using the pre-test score as a covariate. Teachers’ perceptions of the curriculum were very favorable. Mean scores rating various aspects of the curriculum ranged from 7.52-8.21 on a 10 point scale, with 10 being “excellent.” Satisfaction with effectiveness of overall curriculum was strongly related to effectiveness of lesson objectives, teacher background information and lesson extensions, and degree of grade appropriateness (F=77.80, p<.001). The regression model explained 85% of the variance in satisfaction with effectiveness of overall curriculum. These results show that teachers’ nutrition knowledge and attitudes can improve after teaching an elementary level nutrition curriculum.

BACKGROUND:The Working Well Trial (WWT) emphasized employee participation in the planning and implementation of the health promotion intervention. These participatory strategies were intended to promote institutionalization of the health promotion program and thereby encourage maintenance of the intervention activities. We used data from 107 worksites in the WWT to test whether the nutrition intervention activities were maintained after the research program (i.e., durability) or were adopted by control sites (i.e., diffusion). METHODS:At baseline, upon the completion of the 2-year intervention, and 2 years later, we conducted organization surveys regarding worksite health promotion activities. A nutrition activity score from 0 to 3 was calculated based on availability of nutrition-related programs, self-help manuals or guides, and videos, tapes, brochures, or posters. RESULTS:From baseline to the end of the intervention, there was a significant increase in the nutrition activity score in intervention worksites compared with the controls (P < 0.001). However, 2 years later, there was no difference between intervention and control worksites. In addition, there was no significant increase in the nutrition activity score in control site 2 years after they received the intervention protocols and materials. CONCLUSIONS:Research is needed to develop and test worksite-based interventions to promote institutionalization, durability, and diffusion.

This paper provides an evaluation of teachers' implementation and perceptions of Mid-LINC, an interdisciplinary nutrition curriculum for middle school students. Evaluation methodology included both quantitative and qualitative procedures. Quantitative evaluation included distribution of a survey instrument to measure teacher attitudes toward the curriculum, their implementation of the curriculum, and factors related to attitude and implementation. Qualitative evaluation included classroom observation, depth interviews with teachers, and focus group interviews. On average, elementary and home economics teachers taught the highest number of lessons, and language arts teachers taught the fewest. The number of college nutrition courses taken by the teacher was the best predictor of implementation of the curriculum. Overall, the response to the curriculum was very favorable, with teachers rating it easy to use, flexible, and complete. The perceived importance of team teaching, the extent to which the teacher felt informed about nutrition, and the felt importance; of nutrition in the middle school curriculum were significant predictors of comfort with the curriculum. Important facilitators to successful implementation are a project manager, teacher interest, and common planning times. Barriers to implementation include scheduling constraints, teacher resistance, personnel changes, and lack of administrative support.

Introduction: This report examines whether variability in the type and amount of the nutrition intervention in a worksite-based intervention could explain dietary outcomes.Methods: Data are from 55 intervention worksites in the Working Well Trial, a randomized controlled trial of worksite-based health promotion. The components of the nutrition intervention were kickoff event, direct education, interactive activities (e.g., food sampling), contests, printed information picked up by employees, and materials distributed to employees. We measured delivery of the nutrition intervention (i.e., dose) by determining the amount of workforce participation in each intervention component. Diet outcomes were changes in intakes of fat, fiber, and servings of fruits and vegetables (reported on food frequency questionnaires). All variables were aggregated to the worksite level. We correlated the dose variables with indices of receipt of the intervention and with the dietary outcomes.Results: Contests were associated with employee awareness of and participation in the nutrition intervention (r = 0.49 and 0.28, respectively); and interactive activities were associated with intervention participation (r = 0.43). Contests were associated with increased fiber intake and fruit and vegetable consumption (r = 0.36 and 0.31, respectively), and direct education was associated with fruit and vegetable consumption (r = 0.38). All the above correlation coefficients were statistically significant (P < .05). Intervention dose was not associated with changes in fat intake.Conclusions: It appears that longer, interactive intervention efforts (contests and classes) resulted in more positive outcomes than did one-time activities (such as the kickoffs) or more passive efforts (use of printed materials). There is a need for studies designed to test worksite- and community-based nutrition intervention methods.Medical Subject Headings (MeSH): health promotion, diet, nutrition, randomized controlled trial, worksite (work place).

LEARNING OUTCOME: Participants will learn about School Food Service Directors' interest in computer training, barriers to computer use, how they use computers, and their feelings about computers.

LEARNING OUTCOME: To delineate changes that School Food Service Directors (SFSDs) in Pennsylvania have made in response to the USDA Nutrient Standards and Dietary Guidelines. Based on Federal regulations, SFSDs need to document whether their menus meet nutrient standards. In order to assess the status of changes in menus based on the regulations, a survey was administered to a group of 48 school food service employees who attended a training session on nutrient analysis software. The survey included questions about participant demographics, perception of reaching USDA nutrient standards for school meals, self-reported menu changes, and documentation practices. The majority of the participants in the session were School Food Service Directors (83.33%). Respondents were split in terms of educational level. Twenty had high school diplomas and twenty had Bachelors degrees. Most of the SFSDs reported that they had begun to make menu changes associated with USDA nutrient standards. Twenty-five percent reported they felt they met the standards, forty percent had started the process, and only four percent (two respondents) stated that they had not yet begun making changes. Almost 40% of SFSDs felt that their meals were not less than 30% fat. Seventeen percent felt that their meals averaged less than 30% fat. The remaining 43% felt that their meals were sometimes low in fat. Eighty-five percent of the SFSDs reported increasing the amount of fruits and vegetables in their menus as a result of the new USDA regulations, and sixty-two percent felt that their menus were high in fruits and vegetables. Fifty-two percent had not analyzed the nutrient content of their menus; 48% had done so either by computer or manually. Most SFSDs (81%) are currently collecting nutrient information on the foods they are serving and most (73%) are requesting low fat foods from vendors. Most SFSDs in this sample are making changes to meet the USDA standards, and additional data about these changes will be presented along with conclusions.

Worksite nutrition educators and researchers need not only nutrient composition data but also information on employees’ food choices to create intervention messages that are food-focused and tailored to specific target audiences. This paper describes a method of calculating measures of food choice behavior related to intervention messages and reports relationships between workers’ food choices and demographic characteristics. This work was conducted as part of the Working Well Trial, a 5-year worksite cancer prevention randomized, controlled prospective field experiment funded by the National Cancer Institute. It was implemented in 114 worksites employing 37,291 workers who were engaged in a variety of businesses. In the fall of 1990, 20,801 respondents completed and returned a self-administered baseline survey. A modified Block 88-item food frequency questionnaire (FFQ) with portion sizes was used for the quantitative assessment both of nutrient intake and workers’ food choices. The worksite mean response rate was 71.6%. Responses to behavioral items regarding meat were used to measure meat preparation behaviors not captured on the FFQ. We found that higher education, greater age, and female gender were associated with food choices closest to the recommendations to increase fiber, fruits, and vegetables and to reduce fat. An exception to this pattern was the recommendation to increase the consumption of beans and lentils, which was associated with lower education, greater age, and male gender. The relationship of job status to the food choice variables was inconsistent across foods and study centers and there were differences between study centers in the magnitude of associations between food choices and demographic characteristics.

OBJECTIVES. This paper presents the behavioral results of the Working Well Trial, the largest US work site cancer prevention and control trial to date. METHODS. The Working Well Trial used a randomized, matched-pair evaluation design, with the work site as the unit of assignment and analysis. The study was conducted in 111 work sites (n = 28,000 workers). The effects of the intervention were evaluated by comparing changes in intervention and control work sites, as measured in cross-sectional surveys at baseline and follow-up. The 2-year intervention targeted both individuals and the work-site environment. RESULTS. There occurred a net reduction in the percentage of energy obtained from fat consumption of 0.37 percentage points (P = .033), a net increase in fiber densities of 0.13 g/1000 kcal (P = .056), and an average increase in fruit and vegetable intake of 0.18 servings per day (P = .0001). Changes in tobacco use were in the desired direction but were not significant. CONCLUSIONS. Significant but small differences were observed for nutrition. Positive trends, but no significant results, were observed in trial-wide smoking outcomes. The observed net differences were small owing to the substantial secular changes in target behaviors.

BACKGROUND The National Cancer Institute's Working Well Trial was a randomized controlled trial of a two-year, comprehensive, worksite-based cancer control intervention. METHODS Data from 19,582 respondents to the baseline survey were analyzed to determine the relationships between grouped age (18-29, 30-49, 50-54, 55-59, and > 60 years), dietary and smoking behaviors, and attitudes related to participation in health promotion activities. RESULTS Workers over 50 had more positive health behaviors, stronger beliefs about the value of healthy behavior, and better self-assessed health; they were more likely to hold attitudes associated with participation in worksite health promotion, more positive about work conditions, attributed greater concern about worker health to management, and were more willing to believe that they would be allowed to attend worktime health promotion activities. CONCLUSIONS Age may be an useful variable in targeting worksite cancer control programming. Workers in their 50s could be supported in weight management, since rates of overweight and obesity are higher in this group. Other health behaviors might be addressed for older workers.