LUNCH OBSERVATION PROTOCOL



HEALTHY EATING BY DESIGN

LUNCH OBSERVATION PROTOCOL

NUTR 531

Spring 2006

Colleen Antvelink

Alanna Boynton

Angela Kong

Fei Li

Mary Podrabsky

Joy Supplee

Lunch Observation Procedures

1. Purpose

The purpose of this school lunch observation is to obtain a valid measure of the fruits and vegetables that are consumed during lunch by fifth-grade students at the “intervention” (T. T. Minor) and “control” (Martin Luther King, Jr.) elementary schools.

2. Data collectors

The data collectors will be students enrolled in the Nutrition 531 course who have participated in the training for lunch observation, have become certified as observers at the end of that training, and who are available to observe three lunch periods during the week of May 8, 2006.

3. Sites of data collection

The lunch observations will be held in the cafeterias of T. T. Minor and Martin Luther King, Jr. (MLK) elementary schools.

4. Logistics

The lunch observations will be held during three lunch periods (approximately 11:30am-12:30pm) during the week of May 8, 2006. Each observer will be assigned to observe at only one of the two schools on each of the three dates.

5. Materials needed

Each observer will be provided with a clipboard, pen, and forms to complete during the observation. Several calculators and sets of measuring cups will also be available at the observation. Nametags for the children and labels for the observation sheets will be provided.

6. Advance preparation

Assent forms: IRB-approved assent forms will be distributed to fifth-grade students at T. T. Minor and MLK schools. Only children who sign and return the forms will be observed during the lunch observations. An informed consent form was also sent home to the parents or guardians of the children. If the consent form was not returned, it is assumed by passive consent that the parent or guardian agreed to the child’s participation.

Training session for observers: The training session will consist of two different segments. During the first segment, observers will practice measuring and observing different amounts of foods. They will then move on to a second station, where they will be asked to visually identify the serving sizes of twelve pre-measured fruit and vegetable items. The results from this will give the accuracy (validity) of the observers’ measurements.

The second segment will be a mock observation in which all trainees will observe three students eating lunch and fill out the observation forms. This will allow for measures of inter-observer reliability, as well as another measure of accuracy since the students will consume pre-defined amounts of fruits and vegetables. Trainees will be considered “certified observers” if they are able to correctly estimate serving sizes for 8/12 (~70%) of the fruits and vegetables at station 2, and are able to complete the mock observation with no more than 8 errors (~70% accuracy rate).

7. Observation protocol

Procedures for participating students and teacher: On the day of observation, all children in the classroom who have agreed to participate in the study will be given a nametag by their teacher with a picture and name of a fruit or vegetable. This will serve as their study ID for the duration of the study. The list linking the names of the participating students to the fruit or vegetable identifiers will be kept confidential and stored in a locked filing cabinet. The teacher will be encouraged to ask the children to sit together during lunch, and will explain to them that the observers are present to see what their lunchtime is like. The teacher will also instruct the children to leave their lunch at the table when they are finished.

Procedures for lunchroom observers: The observers will arrive approximately 15-30 minutes before lunch to examine the items that will be offered for lunch that day and to prepare for the observation. Each day, at least one “team leader” will be present. A team leader is a person who designed the observation protocol and conducted the training session. This individual will be responsible for ensuring that the protocol is followed, and that all forms are properly distributed, completed, and collected at the end of the observations.

As the children arrive for lunch, the team leader will randomly assign each observer approximately 3-4 children. The number of children assigned depends on how many observers are present and how many children participate in the study. It is important that each child be observed constantly from the time they enter until they are completely finished eating.

During the lunch period, the observers will fill out the “Lunchroom Observation” forms (see Appendices D and E for instructions and sample forms). The observers should minimize their interaction with the children and try to be as unobtrusive as possible. Only fruit and vegetable items (including potatoes and 100% fruit juice) will be recorded on the forms. All fruits and vegetables must be recorded as cup amounts. For items eaten in very small amounts (for example, raisins from the salad bar), the smallest unit that should be used is 1 TB (1/16 cup; see Appendix C for conversions).

After the lunch period is over, the observer will measure and record the remaining quantities of fruits and vegetables left at the table using standard measuring cups, and will calculate totals for each fruit or vegetable item consumed. Following this, the observer will then turn in their forms to the team leader. The team leader will answer any questions that the observer had during data collection and will double-check that the forms are properly completed. This process will be repeated on each of the three observation days for both the “intervention” and “control” schools.

Bibliography

Baglio ML, Domel SB, Guinn CH, Thompson WO, Shaffer NM, Frye FHA. Assessment of interobserver reliability in nutrition studies that use direct observation of school meals. J Am Diet Assoc 2004; 104: 1385-92.

Domel SB, Baranowski T, Leonard SB, Davis H, Riley P, Baranowski J. Accuracy of fourth- and fifth-grade students’ food records compared with school-lunch observations. Am J Clin Nutr 1994; 59(suppl): 218S-220S.

Hendy HM, Williams KE, Camise TS. “Kids Choice” school lunch program increases children’s fruit and vegetable acceptance. Appetite 2005; 45:250-63.

Whitbeck J. LANA Preschool 5-A-Day study: Lunch and Snack Direct Observation Procedures Manual. Minnesota Department of Health, University of Minnesota. Spring 2006.

Perry CL, Bishop DB, Taylor GL, Davis M, Story M, Gray C, Bishop SC, Warren Mays RA, Lytle LA, Harnack L. A randomized school trial of environmental strategies to encourage fruit and vegetable consumption among children. Health Educ Behav 2004; 31(1): 65-76.

Perry CL, Bishop DB, Taylor GL, Murray DM, Mays RW, Dudovitz BS, Smyth M, Story M. Changing fruit and vegetable consumption among children: the 5-a-day Power Plus Program in St. Paul, Minnesota. Am J Public Health 1998; 88:603-9.

Reynolds KD, Franklin FA, Binkley D, Raczynski JM, Harrington KF, Kirk KA, Person S. Increasing fruit and vegetable consumption of fourth graders: results from the High 5 project. Prev Med 2000; 30: 309-19.

Reynolds KD, Raczynski JM, Binkley D, Franklin FA, Duvall RC, Devane-Hart K, Harrington KF, Caldwell E, Jester P, Bragg C, Fouad M. Design of “High 5”: A school-based study to promote fruit and vegetable consumption for reduction of cancer risk. J Cancer Educ 1998; 13(3): 169-77.

Appendix A: Standard Servings in School Food Service

Pre packaged Fruits and Vegetables

Vegetables

Tossed green salad 1/2 cup

Broccoli florets ~1/4 cup = 3 ea.

Cauliflower crowns ~1/4 cup = 3 ea.

Baby carrots ~1/3 cup = 4 ea. (=1-2 baby carrots per TB)

Cucumber coins ~1/4 cup = 5 ea. (= approx. 1 slice per TB)

Jicama 1/4 cup

Hot vegetables 1/3 cup

(corn niblets,

green beans)

Fruit

Kiwi 1/2 cup = 1 each

Watermelon 1/2 cup

Oranges 1/2 cup (wedges)

Seedless grapes 1/2 cup

Whole fruit 1/2 cup

(apples, petite

bananas, pears)

Canned fruit 1/3 cup

(applesauce, peaches,

pears, pineapples,

mixed fruit)

Possible Salad Bar Items

Cherry Tomatoes 1 cherry tomato=1 TB

Pepper Slices 1 pepper strips=1TB

Mushroom slices 1-2 mushroom slices=1 TB

Carrot sticks 1 carrot stick=1TB

Celery Sticks 1 celery stick=1 TB

Snow or sugar snap peas 1 pea pod=1 TB

Melon 1 melon square=1TB

Pineapple 1-2 pineapple chunks=1TB

Source: Wendy Weyer, RD, Quality Control Supervisor for Seattle Public Schools, personal communication, 4/7/06.

Appendix B: Serving Size Guide of Common Fruits and Vegetables

Appendix C: Measurement Conversions

1 cup = 16 TB

3/4 cup = 12 TB

2/3 cup = 10 TB

1/2 cup = 8 TB

1/3 cup = 5 TB

1/4 cup = 4 TB

1/8 cup = 2 TB

1/16 cup = 1 TB

Appendix D: Lunchroom Observation Form Instructions

The observers should minimize their interaction with the children and try to be as unobtrusive as possible. Please try to write the information as clearly as possible. After the lunch period is over, please check your form to ensure all columns are properly filled out and give your form to the team leader. Thanks again for your help!

|Field |Completion Instructions |

|DATE |Prior to observations, please fill out the date. |

|OBSERVER |Prior to observations, please fill out your name. |

|STUDENT IDENTIFIER |Once the children you are observing are assigned, place a sticker identifying the |

| |child’s nametag in the top corner of the form. |

|SCHOOL LUNCH OR BROUGHT FROM HOME |After children arrive in the lunchroom, check the appropriate box indicating whether |

| |the child bought school lunch, brought lunch from home with an “X”. Please record |

| |only fruit and vegetable items. |

|USED SALAD BAR |Indicate whether the child used the salad bar with an “X”. |

|FEMALE OR MALE |Indicate whether the child is male or female with an “X”. |

|FRUIT OR VEGETABLE ITEM |Each form includes a list of fruit and vegetable items offered by the school for |

| |lunch, and several blank lines for salad bar items, foods brought from home, or foods |

| |obtained from another child. |

|START HOW MUCH? + |All fruits and vegetables must be recorded using cup and tablespoon measurements. See|

| |Appendix A for measures used in school food service. |

| | |

| |If the child does not initially have a fruit or vegetable item, mark a “0” in the |

| |“start how much” column and fill out the amounts of any additional fruit or vegetable |

| |items. |

|ADDED HOW MUCH? -- |If food is taken from another child or he/she receives a second portion of food, |

| |record the amount. |

|GIVEN AWAY/LOST? |If the child gives away any food, drops or spills food, record the amount in the |

| |“given away/lost” column. |

|AT END, HOW MUCH LEFT? |At the end of the meal, please watch to the child to ensure he/she does not remove any|

| |uneaten food from the table. If you are unable to record the amounts immediately, |

| |place a blank piece of paper with the child’s fruit or vegetable identifier written on|

| |it (i.e. strawberry) over the lunch. |

| | |

| |At the end of the observation period, please measure the remaining amounts and record |

| |the quantities. Please review the starting quantity, amount consumed, and the amount|

| |left to ensure the quantities make sense. |

|AMOUNT EATEN |After the lunch period is over, please calculate the total amount of each item eaten. |

|TOTAL FRUITS EATEN |Please add the total number of cups for fruits consumed.* |

|TOTAL VEGETABLES EATEN |Please add the total number of cups for vegetables consumed.* |

|TOTAL FRUITS AND VEGETABLES EATEN |Please add the total number of cups for fruits and vegetables consumed.* |

* See Conversion Sheet to change tablespoons to cups.

Appendix E: Lunchroom Observation Form

Date:___________________ Observer:_____________________________

School Lunch OR Brought Lunch from Home

DID STUDENT USE THE SALAD BAR? Used Salad Bar

Female OR Male

Fruit or Vegetable Item |Start how much + |Added how much ( |Given away/lost ( |At end, how much left? = |Amount Eaten | |#1 | | | | | | |#2 | | | | | | |#3 | | | | | | |#4 | | | | | | |#5 | | | | | | |#6 | | | | | | |#7 | | | | | | |

Total Fruits Eaten______ Total Vegetables Eaten______ Total Fruits and Vegetables Eaten__________

Comments:

School Lunch OR Brought Lunch from Home

DID STUDENT USE THE SALAD BAR? Used Salad Bar

female OR male

Fruit or Vegetable Item |Start how much + |Added how much ( |Given away/lost ( |At end, how much left? = |Amount Eaten | |#1 | | | | | | |#2 | | | | | | |#3 | | | | | | |#4 | | | | | | |#5 | | | | | | |#6 | | | | | | |#7 | | | | | | |

Total Fruits Eaten______ Total Vegetables Eaten______ Total Fruits and Vegetables Eaten__________

Comments:

REMINDER: Please record measurements using cups and tablespoons.

-----------------------

1/4 cup

1/3 cup

1/4 cup

1/2 cup

1/2 cup

1/3 cup

1/6 cup

1/4 cup

1/2 cup

1 cup

1/16 cup

1/8 cup

1/3 cup

1/6 cup

1/2 cup

1/3 cup

1/4 cup

1/8 cup

Student Identifier

Student Identifier

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