Process Evaluation Results of a Smarter Lunchrooms Study in New York State Middle Schools Presented by Alisha Gaines, PhD, Cornell University Division of Nutritional Sciences Welcome, thank you for joining! To connect to audio, please click “Quick Start” towards the top left hand corner and then “Connect to Audio.” Then select one of the 3 connection options and follow the instructions. During the last 10 minutes of this presentation Alisha will address as many questions as time allows. To ask a question please use the Q & A feature. If you are interested in joining the Healthy Food Choices in Schools Community of Practice or have any questions, please contact us at: healthy_food_choices_in_schools@cornell.edu
Pres esentation on Ou Outline • Introduction • Study • Purpose • Design overview • Process evaluation • Purpose • Design and methods • Process evaluation results • Real-world takeaways • Big-picture takeaways
The S e Smar arter er L Lunchroom ooms AFRI The Smarter Lunchrooms Movement (SLM) • Easy no- or low-cost changes to encourage students to select and consume healthier foods in school without eliminating their choices Food and Nutrition Education in Communities group (FNEC) • Research and nutrition education programming with low-income families • Strong ties with Cornell Cooperative Extension (CE) Agriculture and Food Research Initiative (AFRI) • BEN-FNEC-CE study funded 2012-2017
Study P Purpose se Test Test Test Year Year Year Year Year selected, Disseminate Plan single combined 1 2 3 4 combined 5 results changes changes changes Overall objective: • Examine effectiveness of SLM strategies in increasing students’ selection and consumption of fruit, vegetables, and unsweetened milk. • Used a series of randomized controlled trials in New York State middle schools. Year 4 objective : • Examine effectiveness of changes in schools that self-selected intervention protocol, compared with matched schools that were assigned protocols.
Role ole of of CE CE 1. Recruit schools 2. Attend training from campus staff 3. Train food service staff 4. Provide weekly, in-person support to food service staff during intervention
Year 4 4 Over ervi view Control schools Self-selection schools Matched, assigned schools (n=5) (n= 4) (n=3)
Year 4 4 Over ervi view Control schools Self-selection schools Matched, assigned schools (n=5) (n= 4) (n=3) Select intervention components
Year 4 4 Over ervi view Control schools Self-selection schools Matched, assigned schools (n=5) (n= 4) (n=3) Select intervention components Plate waste measures Plate waste measures Plate waste measures
Year 4 4 Over ervi view Control schools Self-selection schools Matched, assigned schools (n=5) (n= 4) (n=3) Select intervention components Plate waste measures Plate waste measures Plate waste measures Unrelated training from CE Training from CE Training from CE
Year 4 4 Over ervi view Control schools Self-selection schools Matched, assigned schools (n=5) (n= 4) (n=3) Select intervention components Plate waste measures Plate waste measures Plate waste measures Unrelated training from CE Training from CE Training from CE No lunchroom changes, no 6 wk lunchroom changes 6 wk lunchroom changes CE support with CE support with CE support
Year 4 4 Over ervi view Control schools Self-selection schools Matched, assigned schools (n=5) (n= 4) (n=3) Select intervention components Plate waste measures Plate waste measures Plate waste measures Unrelated training from CE Training from CE Training from CE No lunchroom changes, no 6 wk lunchroom changes 6 wk lunchroom changes CE support with CE support with CE support Plate waste measures Plate waste measures Plate waste measures Changes offered later with CE support
Int ntervent ntion Proto tocol I Ite tems Schools selected or were assigned 2 fruit, 2 vegetable, & 2 milk protocol items.
Proc ocess E Eval aluation ? ? ? Pre- Post- intervention intervention plate waste plate waste data data What is process evaluation? • What happened? How? Why? • Informs outcome results
Proc ocess E Eval aluation Process evaluation objectives for this study: • Monitor protocol fidelity • Determine maintenance post-intervention • Identify facilitators and barriers to implementation
Proce cess E Evaluation T Timeline and M Measures 6-week intervention Pre-Intervention Post-Intervention Weekly site visits Lunchroom Lunchroom Recruit and 3 lunchroom audits audit audit Lunchroom randomize (2 weeks post) (6 weeks post) audit schools CE and food CE and food service service interviews interviews School training CE training Process data: Recruitment notes • School environmental Training records • assessments School environmental assessments • Contact logs • Lunchroom audits with fidelity checklists for • scoring, photos, and field notes Post-intervention interviews •
RE RE-AIM F Framework rk & & Proc ocess E Eval aluation M Meas easures Environmental Lunchroom Recruitment Training records Contact logs Interviews assessments audits notes Nutrition • CE & food Weekly logs used Conducted pre-, Interviews with School education, food service to communicate during, & post- CE & food service • enrollment advertising, etc. evaluations challenges, intervention & to assess • free & not with the concerns, & included: barriers, • Training reduced lunch study requests facilitators delivery • field notes participation records • fidelity • students' checklists family income • photographs status
RE RE-AIM F Framework rk & & Proc ocess E Eval aluation M Meas easures Reach Description of students exposed to intervention Environmental Lunchroom Recruitment Training records Contact logs Interviews assessments audits notes Nutrition • CE & food Weekly logs used Conducted pre-, Interviews with School education, food service to communicate during, & post- CE & food service • enrollment advertising, etc. evaluations challenges, intervention & to assess • free & not with the concerns, & included: barriers, • Training reduced lunch study requests facilitators delivery • field notes participation records • fidelity • students' checklists family income • photographs status
RE RE-AIM F Framework rk & & Proc ocess E Eval aluation M Meas easures Reach Effectiveness Description of External students influences exposed to (contamination) intervention Environmental Lunchroom Recruitment Training records Contact logs Interviews assessments audits notes Nutrition • CE & food Weekly logs used Conducted pre-, Interviews with School education, food service to communicate during, & post- CE & food service • enrollment advertising, etc. evaluations challenges, intervention & to assess • free & not with the concerns, & included: barriers, • Training reduced lunch study requests facilitators delivery • field notes participation records • fidelity • students' checklists family income • photographs status
RE RE-AIM F Framework rk & & Proc ocess E Eval aluation M Meas easures Reach Effectiveness Adoption Description of External Number of schools students influences participating, exposed to (contamination) number of staff intervention trained & their preparedness Environmental Lunchroom Recruitment Training records Contact logs Interviews assessments audits notes Nutrition • CE & food Weekly logs used Conducted pre-, Interviews with School education, food service to communicate during, & post- CE & food service • enrollment advertising, etc. evaluations challenges, intervention & to assess • free & not with the concerns, & included: barriers, • Training reduced lunch study requests facilitators delivery • field notes participation records • fidelity • students' checklists family income • photographs status
RE RE-AIM F Framework rk & & Proc ocess E Eval aluation M Meas easures Reach Effectiveness Adoption Implementation Fidelity to the Description of External Number of schools intervention students influences participating, protocol exposed to (contamination) number of staff intervention trained & their preparedness Environmental Lunchroom Recruitment Training records Contact logs Interviews assessments notes audits Nutrition • CE & food Weekly logs used Conducted pre-, Interviews with School education, food service to communicate during, & post- CE & food service • enrollment advertising, etc. evaluations challenges, intervention & to assess • free & not with the concerns, & included: barriers, • Training reduced lunch study requests facilitators delivery • field notes participation records • fidelity • students' checklists family income • photographs status
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