Exploring strategies to increase school breakfast consumption in middle schools

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DESCRIPTION (provided by applicant): School food environments are coming under increased scrutiny because of the obesity epidemic. However, school breakfast (SB) is often overlooked. Implemented in 1966, the SB program was designed to provide free or reduced price breakfast for eligible children to reduce hunger that might impair learning. In addition to learning improvement, SB consumption has also been linked to better attendance and classroom behavior, and important health benefits. Among children, breakfast consumption was related to lower daily energy intake, plasma cholesterol levels, and body weight, important factors related to reduced risk for diabetes and other chronic diseases. However, participation in the SB program is low; only 42% of eligible children received SB in the 2002-03 school year, and participation declines with age. Therefore the goal of this exploratory study is to investigate delivery methods and promotional strategies to improve SB participation among middle school students, implement the delivery methods and promotional strategies, and obtain participation rate data needed to calculate intervention effect and sample size for an R01 application. In Year 1, focus groups and interviews will be conducted with all stakeholders: students, parents, teachers, school administrators, and food service staff to identify issues associated with SB delivery, and to identify delivery methods, marketing strategies and methods to promote the free breakfast program. In year 2, selected SB delivery methods and promotional methods will be implemented and evaluated in three intervention schools. Participation rates between the different intervention schools will be compared, and also compared to one control school and the previous year SB rate data. Anonymous breakfast lunch records will be collected during breakfast to look at consumption. A subset of students will complete 24-hour recalls on 4 occasions during the school year in order to look at meal specific and meals source specific dietary behaviors. Outcomes data related to learning and the school environment (aggregate school level data on attendance, test scores, tardiness, and discipline and nurse visits) will also be collected and evaluated, as well as process data and evaluations from all stakeholders. Improving SB participation may be an important public health environmental intervention with both significant health and academic outcomes.