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The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework was used to evaluate the impact of the Virginia Department of Education's (VDOE) implementation of the USDA's Team Nutrition training program on Virginia elementary schools from 2017-2020. The VDOE provided training for school nutrition directors (SNDs) at workshops in June 2018 and September 2019 and continued technical assistance to help SNDs improve the school food environment within their divisions. SNDs' perceived support, self-efficacy, and intention to implement changes to the school food environment was measured through pre- and post-training surveys and quarterly check-ins. Implementation was measured using lunchroom environment observations and strategic plans created at the workshops. SNDs representing 83.9% of Virginia elementary students (512,953 students) in 111 divisions attended at least one of the workshops. Within effectiveness, perceived support from cafeteria staff was highest among all stakeholders for both the 2018 and 2019 trainings, though it significantly decreased from before to after the training for both workshops. Average perceived support did not significantly change over time. Self-efficacy was significantly higher following the 2018 training workshop only. The intervention was adopted by 84% of divisions and both intention to implement and actual implementation were highest for strategies related to Farm to School, a VDOE priority. Effectiveness and implementation are expected to improve as it takes up to years for changes to occur in schools. Despite RE-AIM not being part of the initial evaluation plan, 62% of indicators were assessed. With some adaptations to improve effectiveness, the intervention should continue and be expanded. / Master of Science / Interventions to improve the dietary habits of children are often conducted in schools, as most children attend school and children consume up to two meals while at school. USDA's Team Nutrition initiative trains school nutrition staff to serve healthy school meals and provides materials to implement nutrition education for students. The Virginia Department of Education implemented the Team Nutrition program statewide through two training workshops for school nutrition directors (SNDs), June 2018 and September 2019, and technical assistance between the trainings. This study examined the process of implementing the intervention, as well as the outcomes. Overall, 84% of Virginia elementary students were represented by SNDs at the training workshops. SNDs were most likely to intend to implement and implement changes in their divisions related to Farm to School programs and least likely change their culinary skills trainings for staff. It can take up to two years after a training for changes to be implemented in schools, therefore it may be too early to know the full effect of the training. The results showed that the intervention was widely adopted, with 84.1% of divisions in Virginia attending at least one of the training workshops. Although participation was high in-person, less SNDs participated in the intervention activities outside of the trainings. Overall, the intervention was successful in reaching many students and had a small positive effect. With some adaptations to improve the effectiveness, the intervention should continue to be implemented and expanded to the rest of the state.

The National School Lunch Program (NSLP) and the School Breakfast Program (SSP) operate daily in the nation's schools providing nutritious meals to children. These federally sponsored programs operate with the goal of providing nutritious meals for children so as to safeguard their health and well-being. Although participation rates in the school nutrition programs vary according to locality it has been shown that as students progressed in grade level and age participation in the school nutrition programs declined. This study identified the attitudes and practices of teenage students toward the school nutrition programs and evaluated if these attitudes had an affect on participation. Teenagers from a Fredericksburg, Virginia school were questioned using a survey format as the research tool. Students believed (77%) that the SBP and the NSLP should continue and they responded that these programs insured that they ate meals. Teenagers receiving free or reduced priced meals showed attitudes more favorable toward the programs while students paying a full price were more inclined to express dissatisfaction. Respondents did not view the school menu as "healthy" (58%). Eating at school provided an opportunity to socialize with friends which was an important aspect of eating at school for these students. Teenagers expressed an avid interest in learning about nutrition (70%) yet, they did not choose food according to nutritional content (70%). Teens found eating breakfast and lunch meals made them feel better physically and helped them concentrate on their school work (55%). / Master of Science

In this thesis, I study the effects of the National School Nutrition Programme (NSNP) on the rural areas of Western Cape, South Africa. More precisely I try to find out how the NSNP has affected the families in this rural area and what attitudes that can be found among the two generations of people living and working on wine farms. The reason for this investigation is that NSNP was set up to increase school attendance among children living in an exposed socioeconomic environment, and I wanted to see how much the NSNP affect people’s daily life, with focus on the ones living on/near wine farms in the more rural areas in Western Cape since these areas holds socioeconomic groups that are exposed in the society.  To answer the research questions, I conducted several interviews with both wine farm workers and pupils living on/near a wine farm. But oral history is more than a method! I wanted to look upon the history from a grassroots perspective with a special focus on the working class, ethnic minorities and women´s part in the history.  My theory is based upon the terms Welfare and Social inequality. These two perspectives describe access to labor market, poverty, education and income support. These aspects highlight different forms of social exclusion which wine farm workers and pupils living on/near wine farm lives in.  With these methods I found out that the NSNP plays a crucial part in the lives of those who lives in the rural areas of Western Cape. Many pupils go to school just because their parents want it due to lack of food at home. The government’s purpose of the NSNP, to increase the school attendance can be seen in the answers giving to me during interviews with wine farm workers.

School-aged children's nutritional needs have changed from a 1946 underweight and undernourished population to rapidly increasing numbers of overweight and obese children with associated health complications. The purpose of this quantitative study was to explore leadership practices of state and system school nutrition professionals. By obtaining information regarding the past and present practices of school nutrition professionals, this researcher strove to provide insight into best practices for future leaders. Electronic mail messages linked to Kouzes and Posner's (1995) self-reporting leadership practices survey were sent to 194 Tennessee school nutrition professionals (53 state directors and 141 system supervisors). The survey had a response rate of 40.7%. Descriptive statistics and content analysis were used to analyze responses from the survey's participants. Findings of the study provided a reflection of current school nutrition professionals' leadership practices and a demographic profile of school nutrition professionals. School nutrition professionals tend to have exemplary leadership skills as measured by the LPI compared to Kouzes-Posner mean scores. Of the nutrition professionals, 68% reported plans to retire in 10 or fewer years. Current school nutrition professionals primarily come from the ranks of existing school instructional personnel. A majority of the school supervisors held associate or bachelor degrees. State directors tended to have degrees at masters or doctorate level. A small number had postsecondary professional training in nutrition and disease. Over half had some type of training in nutrition. The findings of the study resulted in several suggestions for the school nutrition professional of the future including creation of specialized degree programs and internships at the post secondary level to train future candidates for the job as school nutrition professionals. Today's school nutrition professionals' postsecondary curriculum content could be lacking essential nutrition content area and might not be reflective of the current school population's nutritional risks, needs, and best practices of preventions and/or treatments.

Purpose: To access long-term sustainability of Manitoba SBP by examining the beliefs, attitudes and values of the diverse stakeholders involved in ensuring that SBP run. Sample/ Setting: Eighteen participants from the public school system, government departments and private funders in Manitoba. Method: Semi structured interviews to explore the perceptions, attitudes, and experiences of participants. Results: The perceived impact of SBP varied between each group of stakeholders though all shared a common belief that SBPs were beneficial to students. Major barriers identified were related to funding and manpower. Conclusion: All stakeholders support SBP because they understand and value the positive health, educational and social benefits SBP have for students and the wider school community. Long-term sustainability of SBP depends on creating and maintaining a positive policy environment in which SBP are seen as a valuable tool in supporting child nutrition so that funding and resources are allocated appropriately. / October 2015

Doctor of Philosophy / Department of Hospitality Management and Dietetics / Elizabeth B. Barrett / Rebecca A. Gould / Equipment to store foods at proper temperatures is critical to serving safe and nutritious meals in schools yet little is known about the amount or the adequacy of refrigerated storage in school nutrition programs. The purposes of this study were to identify the types and capacity of refrigeration equipment used in schools, determine the perceived adequacy of refrigerated storage capacity to meet new meal pattern requirements, and examine differences in adequacy and capacity. A modified Delphi technique, site observations, pilot study, and electronic survey were used for data collection. School nutrition directors in the USDA/FNS Southwest Region (N=2392) served as the population. Respondents provided an inventory of refrigeration equipment for one of the schools in their district and information about perceived adequacy of refrigerated storage, barriers to purchasing refrigeration equipment, resources used to develop specifications, and practices to compensate for inadequate refrigerated storage in their program. Data analysis included descriptive statistics, independent sample t-tests, regression, and ANOVA. Over a third of directors indicated that refrigerated equipment was inadequate to meet new meal pattern requirements. Directors with more experience rated adequacy higher than directors with less experience. Milk coolers (n=212, 88.3%) and walk-in freezers (n=180, 75.0%) were the types of refrigeration equipment found most often in schools. Walk-in freezers and refrigerators provided over 95% of refrigerated storage space. The mean average cubic feet of refrigerated storage per school was 1423±1152. School enrollment is a significant predictor of refrigerated storage capacity. Refrigerated storage is a concern for school nutrition directors who reported practices to compensate for inadequate storage including maintaining low inventory and decreasing the number of items purchased. School nutrition professionals may use the results of this study to implement practices to compensate for inadequate refrigerated storage. Results cannot be generalized due to the regional nature of the survey and low response rate and possible non-response bias.

Thesis (M. Dev.) --University of Limpopo, 2016 / The purpose of this study was to investigate the challenges in implementing the Nutrition Programme at Khomela Primary School in Vhembe District, Limpopo Province. A qualitative research was conducted using case study research design method. The Non-probability sampling method was done through purposive sampling method to select Grade 6 and 7 learners and convenient sampling method for teachers and parents. Data collection was done using individual unstructured interviews. Data was analysed using qualitative data analysis method. Four groups of respondents participated in the study: learners group (n=10) giving information on the meal preference; teachers (n=8) managing and administering the Nutrition Programme at school level; parents and food handlers (food handlers n=2, parents n=5). The study focused on the following challenges: management, infrastructure, training, motivation, food safety, quality of food, delivery by suppliers and feeding time as the main challenges of the Nutrition Programme. The findings of the study concluded that there was poor involvement of teachers and parents in the Nutrition Programme. The study also concluded that the aim and principles of the Nutrition Programme were not well understood at Khomela Primary School. The participants also made suggestions on how the Nutrition Programme could be improved effectively. The study suggested that the school had to conduct awareness campaigns of learners, teachers and parents indicating the importance of the Nutrition Programme in schools. The study also concluded that the school had to be provided with modern a kitchen and a school dining hall. Despite the challenges, the Nutrition Programme had a positive impact on the school enrolment. To minimise the challenges of the Nutrition Programme, the study recommends that the principal and the School Governing Body draft a School Nutrition Policy which is in line with the Nutrition Programme guidelines. The Nutrition Policy should cover issues such as management and administration of the Nutrition Programme.

Purpose: The purpose of this study was to investigate challenges faced by high schools in rural Appalachia in implementing the Healthy, Hunger Free Kids Act of 2010 (HHFKA). Methodology: We used qualitative, secondary analysis to analyze a collection of thirteen focus groups and 22 interviews conducted in 2013-14 among parents, teachers, and high school students in six counties in rural Appalachian Tennessee (n=98). Results: Five basic themes were identified during the thematic analysis: poor food quality prior to implementation of the HHFKA school nutrition reforms; students’ preference for low-nutrient energy-dense foods; low acceptance of healthier options after implementation of the HHFKA school nutrition reforms; HHFKA school nutrition reforms not tailored to unique needs of under-resourced communities; and students opting out of the National School Lunch Program after implementation of the HHFKA school nutrition reforms. Rural communities face multiple and intersecting challenges in implementing the HHFKA school nutrition reforms. Conclusion: As a result, schools in rural Appalachia may be less likely to derive benefits from these reforms. The ability of rural schools to take advantage of school nutrition reforms to improve student health may depend largely on factors unique to each community or school.

With the passage of the Child Nutrition and WIC Reauthorization Act of 2004, all schools that participate in the National School Lunch Program are required to establish local wellness policies to address childhood obesity. In the state of Kentucky, Senate Bill 172 requires all elementary schools to adopt a local wellness policy addressing competitive foods, healthy choices, and daily physical activity. This study measured federal and state compliance among schools that responded to the 2008 Kentucky School Nutrition Survey. This study analyzed differences in the school nutrition environment among policies based on data from the 2002 and 2008 Kentucky School Nutrition surveys. The majority of school wellness policies were compliant with both federal and state guidelines. Significant differences in the school environment include a reduction in the availability of vending machines, decreased percentage of teachers using food as a reward, and increased use by teachers of non food items as a reward. Significant differences were not found among foods offered in vending machines, snack bars, and classroom parties. In 2008, elementary schools provided an average of 174 minutes of physical activity weekly, which is above the recommended guideline of 150 minutes per week.