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Nutrition Report Cards: An Opportunity to Improve School Lunch Selection

Wansink, Brian, David R. Just, Richard W. Patterson, and Laura E. Smith. (2013). Nutrition Report Cards: An Opportunity to Improve School Lunch Selection. PLOS ONE, 8(10), e72008. doi: 10.1371/journal.pone.0072008

With more than 70% of children in grades K-12 eating at least three lunches per week provided by the National School Lunch Program (NSLP), the content of those lunches is a logical target for improving child nutrition. Studies suggest that involving students’ parents can enhance the positive outcomes of such nutrition interventions. In this study, we conducted an evaluation as to whether the “Nutrition Report Card” (NRC) may be a low-cost, scalable intervention to improve students’ nutrition by providing parents with information about which foods their children order at school. Specifically we sought to investigate whether providing information to parents about the components of their child’s school lunch holds any promise of improving what students select for lunch. Additionally, we investigated the implementation feasibility of the NRC and its impact on the transaction time of lunch purchases, from the addition of keys needed to complete the NRC (?). 

Physical letters were sent to all parents in a rural school district in New York inviting them to enroll their child in the study. The sample included students (treatment n=35; control n=1460) ranging from grades K-12. During the five weeks of the study, purchase data for all students was recorded for analysis. This data was compiled in a Nutrition Report Card and sent weekly to parents via email. Each report detailed the child’s lunch selections, and compared it to a healthy, balanced diet. To analyze the impact of altering POS systems, transaction times for the weeks preceding and following the implementation of the system change were compared.  

Those in the NRC treatment group purchased 45% fewer cookies after the intervention. The NRC encouraged some parents to have nutrition conversations with their children and therefore increased children’s awareness that their lunch selections were being observed. The findings also suggest that adding cash register keys to generate detailed NRCs added only 16 seconds of staff time per 100 students after five weeks of implementation. Additionally, a total of about 30 minutes of staff time each week was required to process data, generate report cards, check quality, and send the NRCs to parents.

This pilot study underscores that an NRC intervention is feasible and efficient. Although the results are preliminary, they suggest that Nutrition Report Cards may be helpful in nudging children towards more healthy, less expensive options and away from less healthy, more expensive ones. These changes should come at t little cost to the school district.

For schools with POS systems ready to output student lunch data and communicate with parents via email, implementing an NRC would require minimal programming and ongoing management. Because data processing, report card generation, and email sending are each automated, increasing the number of NRCs a school sends would require little, if any, additional time for  administrators. NRCs have another attractive feature of engaging parents in their child’s decision-making process. This could be especially beneficial to younger children, who are learning to make independent food decisions and can be guided by concerned parents.