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Over 50 million children attend public elementary and secondary schools in the United States each day. Children spend a substantial portion of their waking hours in school and consume one-third to one-half of their daily calories there, making schools a promising site to influence dietary quality and potentially the risk of childhood obesity. Important policy revisions have been implemented in the National School Lunch Program (NSLP) to improve the nutritional quality of school meals. In 2010, the Healthy, and Hunger-Free Kids Act updated the NSLP standards. The revised nutrition standards required schools to increase the availability of fruits, vegetables, whole grains, and fat-free and low-fat fluid milk in school meals; reduce the level of sodium, saturated fat and trans fat; and meet the nutritional needs of school children within their calorie requirements. About 60% of elementary children participate in the NSLP at least once per week, with the remaining 40% of children bringing a packed lunch from home. While school lunches are guided by national standards and regularly monitored to ensure standards are maintained, the remaining 40% are not guided by national standards. The ultimate purpose of this research was to assess the current school lunch environment and increase the overall nutritional quality of elementary lunches. Data collection procedures included school and packed lunch observations, elementary parent questionnaires, and a pilot intervention to assist elementary parents in providing healthier packed lunches. Results from these studies provide insight on the nutritional differences in school and packed lunches, provide knowledge concerning the parental motivations and barriers to participating in the NSLP or packing lunch for a child, and contribute to the limited research on effective modalities for assisting parents in providing healthier lunches. This research has significant implications public policy and provides valuable information for health professionals, researchers, food service directors, parents, and elementary school administrators to encourage NLSP participation and/or develop interventions which assist parents in packing healthier lunches. Interventions can take the form of marketing strategies to potentially influence NSLP participation, interventions to increase the nutritional value of packed lunches, and/or improvements in school wellness policies. / Ph. D.

Background: National School Lunch Program (NSLP) meals have been found to be of higher dietary quality than home-packed lunches. Objective: To explore the cost, including time, of NSLP versus different categories of home-packed lunches. Methods: Data from pre-kindergarten and kindergarten lunches from three schools in southwest Virginia were used for this study. Each lunch item was priced, and a direct cost was assigned based on the lunches contents. Time assessments were conducted to determine the amount of time to prepare each lunch, with a monetary value for time computed based on average salary of the respective county. A non-parametric Kruskal Wallis test was used to compare the direct cost, time, time cost, and the full cost of the meals. Medians were computed based on outlier data. Results: The lowest median direct cost was found for homemade packed lunches ($1.55), followed by homemade school lunches ($2.11), then convenience packed lunches ($2.12), and then NSLP lunches ($2.15). When incorporating preparation time, the NSLP lunch cost the least ($2.15), followed by convenience packed lunches ($2.56), then homemade packed lunches ($2.92), and then homemade school lunches ($11.32). Seventy-six percent (n=414) of home-packed lunches contained sugar-sweetened beverages and/or dessert food items, accounting for almost one-quarter (21.8%) of the cost of all home-packed lunches. Conclusion: When time is computed as part of the total cost of NSLP versus home-packed lunches, the NSLP is the least expensive option. In conjunction with the nutritional benefits of the NSLP, this time-cost data may help shift purchasing and consumption patterns. / Master of Science

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