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.
Identifer | oai:union.ndltd.org:VTETD/oai:vtechworks.lib.vt.edu:10919/98470 |
Date | 18 May 2020 |
Creators | Nelson, Rachel A. |
Contributors | Human Nutrition, Foods and Exercise, Misyak, Sarah A., Hedrick, Valisa E., Porter, Kathleen J., Serrano, Elena L. |
Publisher | Virginia Tech |
Source Sets | Virginia Tech Theses and Dissertation |
Detected Language | English |
Type | Thesis |
Format | ETD, application/pdf |
Rights | In Copyright, http://rightsstatements.org/vocab/InC/1.0/ |
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