Technology and Design Innovation for School Lunch

Technology and Design Innovation to Support 21st Century School Nutrition

This study will evaluate an innovative school lunch intervention that is designed to increase school meal participation and improve dietary intake among middle and high school students.

Study Overview

• Status: Completed
• Conditions: Childhood Obesity
• Intervention / Treatment: Behavioral: SmartMeal application; Behavioral: Distributed points of sale; Behavioral: Staff wellness curriculum

Detailed Description

Improving dietary intake among low-income youth is critical to reducing obesity, and schools are arguably the most important system in which to intervene. In 2010, Congress passed the Healthy, Hunger-Free Kids Act to better align school meal standards with the Dietary Guidelines, making school meals a nutritious option for students. Increasing participation in the school meal program, therefore, especially among low-income youth, has the potential to improve dietary intake among students and ultimately reduce childhood obesity.

Over three school years, the University of California (Berkeley's School of Public Health and the Division of Agriculture and Natural Resources' Nutrition Policy Institute) will evaluate an innovative, student-centered school-lunch intervention to increase school lunch participation and improve dietary intake among low-income middle and high school students. The project will be conducted in the San Francisco Unified School District (SFUSD), a large and diverse urban district serving over 32,000 students (70% of total) eligible for free or reduced-price meals. The intervention, developed in partnership with the global design firm IDEO, aims to promote healthier habits by leveraging principals of behavior economics. The intervention involves the following three components: 1) a smartphone application (SmartMeal) that allows students to pre-order school lunches, receive nutrition information about school lunch options, and provide feedback about meals to food service staff, 2) distributed points of sale for school meals, achieved through the addition of mobile food carts and vending machines, and 3) a staff wellness curriculum that encourages staff to promote school meals and model healthful eating behaviors to students.

• Study Type: Interventional
• Enrollment (Actual): 27406
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • California
    • San Francisco, California, United States
      • Academy High School and Ruth Asawa School of the Arts
    • San Francisco, California, United States
      • AP Giannini Middle School
    • San Francisco, California, United States
      • Aptos Middle School
    • San Francisco, California, United States
      • Balboa High School
    • San Francisco, California, United States
      • Burton High School
    • San Francisco, California, United States
      • Everett Middle School
    • San Francisco, California, United States
      • Francisco Middle School
    • San Francisco, California, United States
      • Galileo High School
    • San Francisco, California, United States
      • Herbert Hoover Middle School
    • San Francisco, California, United States
      • James Denman Middle School
    • San Francisco, California, United States
      • James Lick Middle School
    • San Francisco, California, United States
      • John O'Connell High School
    • San Francisco, California, United States
      • June Jordan High School
    • San Francisco, California, United States
      • Lincoln High School
    • San Francisco, California, United States
      • Lowell High School
    • San Francisco, California, United States
      • Marina Middle School
    • San Francisco, California, United States
      • Marshall High School
    • San Francisco, California, United States
      • Martin Luther King Middle School
    • San Francisco, California, United States
      • Mission High School
    • San Francisco, California, United States
      • Presidio Middle School
    • San Francisco, California, United States
      • Roosevelt Middle School
    • San Francisco, California, United States
      • Visitacion Valley Middle School
    • San Francisco, California, United States
      • Wallenberg High School
    • San Francisco, California, United States
      • Washington High School

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• All 7th-10th grade students at participating schools are eligible to participate in the student survey
• All 6th-12th grade students who eat the school lunch are eligible to participate in plate waste data collection
• All 7th-10th grade teachers are eligible to participate in the teacher survey

Exclusion Criteria:

• There are no exclusion criteria

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: School lunch intervention; Intervention schools (6 middle and 6 high) will receive the complete school lunch intervention for two school years.	Behavioral: SmartMeal application; The SmartMeal application is a smartphone application that will allow students to pre-order school meals, receive nutrition information about school meals, and provide feedback about school meals to Student Nutrition Services.; Behavioral: Distributed points of sale; To increase points of sale for school meals (outside the cafeteria), school meals will be sold at hot and cold mobile food carts and vending machines throughout the school.; Behavioral: Staff wellness curriculum; A wellness curriculum will be implemented that encourages teachers and staff members to eat school meals and promote them to students.
No Intervention: School lunch control; Control schools (6 middle and 6 high) will not receive the school lunch intervention for two school years. Lunch delivery will proceed as normal.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in school lunch participation	Daily school lunch participation records broken down by grade, gender, and free or reduced-price meal eligibility at each school.	2 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in plate waste during lunch among students who eat school lunch	Individual-level waste of food components achieved through visual estimation and aggregate waste of food components achieved through weighing.	2 school years
Change in fruit consumption at lunch	Student survey that asks about fruits consumed at lunch yesterday	2 school years
Change in vegetable consumption at lunch	Student survey that asks about vegetables consumed at lunch yesterday	2 school years
Change in weekly fruit consumption	Student survey that asks about fruits consumed during a typical week	2 school years
Change in weekly vegetable consumption	Student survey that asks about vegetables consumed during a typical week	2 school years
Change in variety of fruits consumed by students at lunch	Student survey that asks about fruits consumed at lunch yesterday	2 school years
Change in variety of vegetables consumed by students at lunch	Student survey that asks about vegetables consumed at lunch yesterday	2 school years
Change in variety of fruits consumed by students each week	Student survey that asks about fruits consumed during a typical week	2 school years
Change in variety of vegetables consumed by students each week	Student survey that asks about vegetables consumed during a typical week	2 school years
Change in body mass index (index)	BMI data collected each year on 7th and 9th grade students via the California Physical Fitness Test	2 school years

Collaborators and Investigators

• Sponsor: University of California, Berkeley
• Collaborators: University of California
• Investigators: Principal Investigator: Kristine A Madsen, MD MPH, University of California, Berkeley; Principal Investigator: Lorrene Ritchie, PhD RD, University of California Division of Agriculture and Natural Resources

Study record dates

Study Major Dates

• Study Start: February 1, 2016
• Primary Completion (Actual): June 1, 2018
• Study Completion (Actual): June 1, 2018

Study Registration Dates

• First Submitted: June 8, 2015
• First Submitted That Met QC Criteria: June 8, 2015
• First Posted (Estimate): June 10, 2015

Study Record Updates

• Last Update Posted (Actual): May 14, 2019
• Last Update Submitted That Met QC Criteria: May 10, 2019
• Last Verified: May 1, 2019

More Information

Terms related to this study

• Keywords: School lunch; Secondary schools; Plate waste
• Additional Relevant MeSH Terms: Overnutrition; Nutrition Disorders; Overweight; Body Weight; Obesity; Pediatric Obesity
• Other Study ID Numbers: 2014-12-7010