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Documenting the impact of a salad bar and nutrition education program on children’s eating patterns and attitudes: A Cool Foods pilot study in a Chicago Charter School

Yolanda Suarez-Balcazar, PhD, University of Illinois at Chicago, Joanne Kouba, MS, RD, LDN, Loyola University Chicago, LaDonna Redmond, Institute for Community Resource Development, Maureen Hellwig, PhD, Policy Research Action Group, Loyola University Chicago, Louise Martinez, MPH, University of Illinois at Chicago, Camille Reid, Healthy Schools Campaign

Background
With the emergence of obesity as a common intermediary for adult health problems and the increased prevalence of overweight youth, the quality of children’s eating patterns should be addressed in relation to obesity prevention (CDC, 1997). The Chicago Food Systems Collaborative (CFSC) is an interdisciplinary community-university partnership that has been working to improve the dietary quality and food access of residents in the Austin area of Chicago. The CFSC has identified the lack of access/offerings of F/V in schools as a concern. This study is funded by W. K. Kellogg Foundation and CLOCC.

Purpose
The main goal of the Cool Foods project is to evaluate the impact of the SB option with a nutrition education component on knowledge, attitudes and consumption of foods among children in kindergarten and first grade compared to a school with SB only. The Cool Foods project will increase the offerings of fresh fruits and vegetables (F/V) to Chicago Public Schools (CPS) using salad bars (SB).

Project Design and Subject Selection
This study will use a time series design with an intervention school and a comparison school. Repeated measures will be taken on availability of F/V, children’s intake of F/V, food preferences, knowledge and attitudes toward eating healthy produce. Both schools, the one targeted for the intervention, Namaste, and the comparison school, Oscar DePriest, are predominantly multicultural. All students in Kindergarten and First Grade in the intervention school will participate in the nutrition education sessions which are incorporated as part of the curriculum. Systematic observations of what the children eat in the cafeteria will be conducted randomly of Kindergarteners and First Graders. All 90 Kindergarteners and first graders will be the focus of the pilot.

Methods of Data Collection and Analysis
Researchers will come into each school one week a month, five days in a row, for six months. This strategy will yield 30 days of data collection at each school. Specifically, the methods of data collection will include: a) an inventory of the types and quantifies of foods that are planned, offered and served during the lunch periods, b) Researchers will observe in a non-intrusive manner a random sample of children in the lunch line and record what he/she selects from the salad bar compared to what he/she eats using visual approximation by trained observers. A maximum of 10 children per day will be observed. This strategy will yield 300 records of observed food intake during the lunch meal at each school, C) Twice a month for six months the team will come into the Kindergarten and 1st grade classroom to have an education session related to agriculture and nutrition. Children will be asked to complete a fruit and vegetable short survey to measure knowledge, and preferences toward F/V.

Anticipated Results
It is expected that this pilot study will yield data regarding the impact that a salad bar and a nutrition education curriculum has on the eating patterns and knowledge of young children. Data on the percent of children eating from the salad bar and percent of food eaten will be gathered over a period of six months. Researchers will examine the differences between the target school and the comparison school in knowledge and attitudes toward F/V. The preliminary results will be available in September of 2005. In this study, we hypothesize that nutrition education is necessary to increase the likelihood of children selecting foods from the salad bar. Therefore, a salad bar option alone is not significantly sufficient to increase the consumption of fruits and vegetables. This study will make contributions to the existing body of literature regarding the importance of nutrition education in the schools. This study will also make methodological contributions in terms of direct observation strategies to quantify the amount of F/V that children eat.

Acknowledgements
Researchers will like to acknowledge the support of the school's principals including Ms. Allison Slade from Namaste and Ms. Dorothy N. Jenkins from Oscar DePriest, for their support of this study. We also extend our appreciation to the many teachers, at both schools, supporting the project.

For further information about this study please contact either Yolanda Suarez-Balcazar at (312) 413-0117 or ysuarez@uic.edu or Joanne Kouba at (773)508-8298 or jkouba@luc.edu.

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