Salad Bars in the National School Lunch Program: Impact on Dietary Consumption Patterns in Elementary School Students

This project is a research study looking at what foods students choose and eat during school lunch and examines how salad bars impact what children eat.

Study Overview

• Status: Completed
• Conditions: Diet, Food, and Nutrition
• Intervention / Treatment: Other: Salad bar; Other: Waitlisted control; Other: Salad bar post-COVID

Detailed Description

This project applies a wait list control cluster randomized controlled trial to evaluate school salad bars. This project uses digital images (pictures) of labeled trays in the cafeteria before and after children eat lunch. This project also asks cafeteria workers about their thoughts about salad bars and their experiences with the salad bar program.

• Study Type: Observational
• Enrollment (Actual): 6269

Contacts and Locations

Study Locations

• United States
  • Virginia
    • Henrico, Virginia, United States, 23229
      • Healthy Lifestyles Center at the Children's Hospital of Richmond at VCU

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 5 years and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

All K-6th students who participate in the school lunch program and all cafeteria personnel at target schools

Description

Inclusion Criteria:

• Students: All K-6th grade students at target schools who participate in the school lunch program on rating day
• Cafeteria staff: All cafeteria personnel at the randomly selected target schools will be eligible to complete surveys

Exclusion Criteria:

• Students: Unsure sex of child
• Cafeteria staff: None

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Prospective

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Schools with salad bars	Other: Salad bar; Schools where the school district has installed salad bars
Schools without salad bars	Other: Waitlisted control; Schools where the school district has not yet installed salad bars
Schools with salad parts post COVID-19; A subset schools with salad bars that were examined pre-COVID-19 will undergo methods again.	Other: Salad bar post-COVID; Schools where the school distract has re-opened salad bars will have methods repeated in a subset of schools post-COVID-19

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
fruits and vegetables (FV) selection	Amount of FV selection will be calculated based on digital photographs of student's lunch trays before consumption	Baseline to up to 6 weeks after salad bars installed
FV consumption	Amount of FV consumed will be calculated by subtracting amount of FV remaining after lunch is consumed from amount of FV selected based on digital photographs of student's lunch trays before and after consumption.	Baseline to up to 6 weeks after salad bars installed

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
energy intake (kcal)	Amount of calories consumed will be calculated by subtracting the total amount of calories remaining on trays from the total amount of calories initially selected based on digital photographs of student's lunch trays before and after consumption.	Baseline to up to 6 weeks after salad bars installed
dietary quality (Healthy Eating Index)	the Healthy Eating Index will be calculated for food and beverages consumed at lunch (amount on the tray before minus after consumption) using NDSR	Baseline to up to 6 weeks after salad bars installed
fruits and vegetables (FV) selection post-COVID-19	To examine the the impact of salad bars on student dietary intake patterns after their reintroduction post-COVID-19 school closures. Amount of FV selection will be calculated based on digital photographs of student's lunch trays before consumption	4-6 weeks after salad bars re-installed
FV consumption post-COVID-19	To examine the the impact of salad bars on student dietary intake patterns after their reintroduction post-COVID-19 school closures. Amount of FV consumed will be calculated by subtracting amount of FV remaining after lunch is consumed from amount of FV selected based on digital photographs of student's lunch trays before and after consumption.	4-6 weeks after salad bars re-installed
energy intake (kcal) post-COVID-19	To examine the the impact of salad bars on student dietary intake patterns after their reintroduction post-COVID-19 school closures. Amount of calories consumed will be calculated by subtracting the total amount of calories remaining on trays from the total amount of calories initially selected based on digital photographs of student's lunch trays before and after consumption.	4-6 weeks after salad bars re-installed
dietary quality (Healthy Eating Index) post-COVID-19	To examine the the impact of salad bars on student dietary intake patterns after their reintroduction post-COVID-19 school closures. The Healthy Eating Index will be calculated for food and beverages consumed at lunch (amount on the tray before minus after consumption) using NDSR	4-6 weeks after salad bars re-installed

Collaborators and Investigators

• Sponsor: Virginia Commonwealth University
• Collaborators: University of North Carolina, Chapel Hill; The University of Tennessee, Knoxville; George Mason University
• Investigators: Principal Investigator: Melanie K Bean, PhD, VCU

Study record dates

Study Major Dates

• Study Start (Actual): February 13, 2019
• Primary Completion (Actual): April 26, 2023
• Study Completion (Actual): April 26, 2023

Study Registration Dates

• First Submitted: October 28, 2022
• First Submitted That Met QC Criteria: October 28, 2022
• First Posted (Actual): November 4, 2022

Study Record Updates

• Last Update Posted (Actual): August 2, 2023
• Last Update Submitted That Met QC Criteria: July 31, 2023
• Last Verified: July 1, 2023

More Information

Terms related to this study

• Other Study ID Numbers: HM20012226

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No