What parents and teachers think about the middle school food environment

Nutrition Research Newsletter, Feb, 2005

Schools are recognized as settings that offer access to most young people and environments that influence the eating practices of school-aged youth, a lifestyle behavior linked to a number of prevalent chronic disease conditions, including cardiovascular disease, type 2 diabetes mellitus, certain cancers, and overweight and obesity. Schools have long been considered ideal settings for primary prevention efforts aimed at supporting and promoting lifelong healthy eating. More recently, an epidemic of childhood overweight has refocused attention on the critical role of schools in promoting healthy eating. Young people today spend considerable time at school. It is not surprising then, that several school-related factors have been identified as important and potentially powerful predictors of youth dietary behavior. These include the foods and beverages offered in school vending machines, a la carte programs, and school stores; foods used as rewards and incentives in the classroom or sold as part of school fundraising; parental and peer support of healthy food choice at school; the role modeling behavior of staff and students; and school food policies and practices that support healthy food choices. Research examining these factors generally indicates a school food environment where energy-dense, low-nutrient foods and beverages are readily available in vending machines, school stores, and on school a la carte lines, teachers commonly offer candy and other low-nutrient snacks as student rewards and incentives, and policy support for healthy eating is not the norm. Health professionals, public health advocates, educators, and politicians have all expressed concern about the nutrition integrity of the present-day school food environment. However, little is known about how parents and teachers regard the nutrition environment of schools and the role schools should play in fostering healthy eating among children. As 'insiders' with a vested interest in the health and well-being of students, parents and teachers are key stakeholders in school-related issues that have the potential to impact students' health. Furthermore, awareness and consideration of the concerns of parents and teachers, as well as their involvement in any process that intends to affect sustainable change at school is regarded as essential. The aim of the current study was to assess parents' and teachers' opinions and beliefs about today's school food environment. The population for this research consisted of a convenience sample of parents and teachers of middle school students from 16 schools in the Minneapolis-St Paul metropolitan area who participated in the Teens Eating for Energy and Nutrition at School study, a school-based dietary intervention trial that sought to promote healthful dietary behavior among young adolescents to reduce future cancer risk. The parent sample consisted of parents/guardians (hereafter referred to as parents) of students who completed 24-hour dietary recalls at baseline (fall 1998) and were enrolled as an eighth grader in a Teens Fating for Energy and Nutrition at School study school in spring 2000 when the parent survey was administered. The parent sample did not represent a randomly chosen sample. However, their child's selection to participate in recall interviews was a result of a random sampling process. There were 526 parents invited to participate in the survey; the final sample consisted of 350 parents (response rate=66%).

The eligible teacher sample consisted of all teachers of sixth-, seventh-, and eighth-grade students employed by the 16 Teens Eating for Energy and Nutrition at School study schools during winter 1999 when the teacher survey was administered. There were a total of 701 teachers; the final sample consisted of 490 teachers (response rate=70%).

A subset of items on the parent survey (22 items) and teacher survey (37 items) addressed respondents' opinions and beliefs regarding the school food environment. Parents were mailed a survey, along with a stamped return envelope and a $1-bill incentive. Teachers received a survey in their school mailbox, along with an envelope and one free movie pass. Responses to both surveys were confidential. However, identification numbers on the surveys allowed the linking of parents to students and teachers to schools.

Most parents and teachers agreed that the nutritional health of students should be a school priority. However, only 18% of parents and 31% of teachers believed schools give adequate attention to student nutrition. Among both parents and teachers, 90% agreed that more healthy snacks and beverages should be available in school vending machines and on school a la carte lines. This study suggests that parents and teachers of middle school students are concerned about the nutritional health of young adolescents and the 'state of health' of the school food environment. Indeed, almost all parent and teacher respondents believed schools should offer students more healthful foods and beverages and most would limit or eliminate low-nutrient food options such as candy and soft drinks. Now, more than ever, efforts to promote the nutritional health of school-aged youth require a school focus. This focus is necessary not only because schools are ideal settings for population-based strategies to foster healthy eating practices, but also because the present-day school food environment is in need of attention. This study suggests that many parents and teachers of middle school students agree with this sentiment. Indeed, parents and teachers recognized numerous school-related practices that did not support healthful food choice by students. Parents and teachers are important constituents of the school community and their potential to influence change that promotes and supports a healthful school food environment is great. Efforts to mobilize this support are encouraged. Findings suggest that parents and teachers are concerned about the nutritional health of students and the 'state of health' of the school food environment. Dietetic and other health professionals who work in school settings should engage parents and teachers in the process of affecting and monitoring policies and practices that promote and support a healthful school food environment.