contextual research

Research PROPOSAL

FOCUS STATEMENT

METHODS

LOCATIONS

PRIMARY LOCATION

Heard Elementary SchoolPhysical AspectsConsent

SECONDARY LOCATION

St. Andrews SchoolPhysical AspectsConsent

RECRUITING

Active observationRecruitin Inventory

Interviews

Recruiting ScriptsPassive observation

Cafeteria workerSchool nurseTeachersParent Lunch AidsParentsPrincipal

ROLES AND RESPONSIBILITIES

ROLES DURING OBSERVATIONS

SCHEDULE OVERVIEW

DAYS AND TIME GROUPMEMBERS ARE AVAILABLE

OUTLINE OF DUE DATES

ACTIVE OBSERVATION SCRIPTS

School nurseCafeteria worker

TeachersParent Lunch Aids

INTERVIEWS

ParentPrincipal

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“Exploring how health issues are addressed in elementary schools in order to better accommodate and serve students and their families.”

4 FOCUS STATEMENT

5SITESPrimary LocationHeard Elementary School St. Andrews School

Secondary Location

Physical Aspects

Heard Elementary School is located on 414 Lee Boulevard in Savannah, Georgia. Heard is one of 25 elementary schools in the Savannah-Chatham County Public Schools System. The elementary school is a Title 1 Distinguished School and a 2011 Georgia School of Excellence.

Serving grades Pre Kindergarten through Fifth, the students are required to wear uniforms. The school is located in a middle class neighborhood. All the surrounding homes appear to be well taken care of due to their

groomed yards and nice brick façades. The school itself is in good condition as well.

They are undergoing the addition of a new wing in the near future indicating that they are well funded. This location is unique in that it is a public school. It is a model for how many other schools in the area function and applying change here could result in changing many other schools.

Consent

The Principal, Ms. Sylvia Wallis, has agreed to give us access to the school’s cafeteria, nurse, and teachers. The school has fully agreed to allow access the students and faculty in order to research during lunch hours, 11:00 am to 1:00 pm Monday through Friday.

Physical Aspects

St. Andrew’s School is located at 601 Penn Waller Road in Savannah, Georgia and has students from Pre Kindergarten through grade 12. The school is located on Wilmington Island and is considered a college preparatory school. Its location is in a wooded area of the island, surrounded by oak trees. It is very well manicured and taken care of. They are also looking to do renovations in the near future. Approximately 500 students attend St. Andrews and, unlike Heard Elementary, are not required to wear uniforms.

Students are also required to go through an admissions process to enter the school. Consent

Assistant Head of School, Mrs. Beth Aldrich, has consented to give us access to the school cafeteria and its workers along with staff, such as the school nurse. Their lunch period is from 11:00 am to 11:45 am for elementary school students Monday through Friday.

6 METHODSRecruiting

Recruiting Inventory

Active Observation

At least one cafeteria worker, one school nurse, and one parent lunch aid are needed from each school for active observations.

Interviews

One Principal and two parents from each school are needed for interviewing.

Passive Observation

A passive observation will be done in the cafeteria of each school during lunch hours. Also a Parent Teacher Association meeting passive observation will be conducted at the primary location, Heard Elementary School.

Recruiting Scripts Cafeteria Worker The following questions will be asked of cafeteria workers to determine if they are a good fit for further observation. The necessary answers are provided:

Q: Do you work in the school cafeteria?A: Yes.Q: How long have you worked there?A: At least one year.Q: What are the hours of your shift?A: Hours that coincides with our proposed schedule.Q: Are you involved in food preparation or food service?A: Either answer is satisfactory.

School Nurse

The following questions will be asked of the school’s nurse to decide if they are right to observe.

The necessary answers are provided:Q: Are you the school nurse?A: Yes.Q: How long have you been the school nurse?A: At least one year.

Teachers

The following questions will be asked of teachers in the lunch room to decide if they are right to observe. The necessary answers are provided.Q: Are you present in the cafeteria during the student’s lunch period?A: YesQ: How long have you been a teacher at this school?A: At least a year.

Parent Lunch Aids The following questions will be asked of parent lunch aids to determine if they will be actively observed.Q: Do you help in the cafeteria?A: Yes.Q: How often do you work in the

cafeteria?A: At least once a month.

Parents for Interview

The following questions will be asked of potential parents to actively observe. The necessary answers are provided:Q: Do you pack your children bagged lunches?A: No.Q: Does your child have any food allergies?A: Yes or no is satisfactory.

Principal for Interview The following question will be asked.Q: Are you the principal of this school?A: Yes.

Active Observation Scripts

Cafeteria Worker The following list is to be answered during an active

7observation of a cafeteria worker. This script will be used twice, once at Heard Elementary and once at St. Andrew’s School.

1. What are your roles and responsibilities in the cafeteria?

If involved in food preparation:

i. What is the process of preparing the food each day?ii. What foods are prepared on a regular basis?iii. Are there any foods that you do not serve?iv. Have there been any changes to the menu based on student needs?v. How often does the menu change?vi. Is cross contamination a concern?vii. Where do the ingredients come from?

If involved in food service:

i. Do you wear gloves at all times?ii. What are the portion sizes

served?iii. Have you come to know any students with special dietary needs?1. If so, how do you address these needs?iv. Do the students have any say in what they get on their plate?1. If so, does this affect the price of their meal?v. Do you track what the students are eating?

School Nurse The following list is to be answered during an active observation of a school nurse. This script will be used twice, once when observing the school nurse at Heard Elementary School and once wile observing the school nurse at St. Andrew’s School.

1. Have you ever had students come to you with food poisoning?2. Do you deal with any students with food allergies?a. If so, what is the procedure for dealing with them?3. What is the protocol when a

8student comes to you with an illness?4. How many children do you treat daily?5. Do you promote health issues in the classroom?6. What are common health concerns at your school?

Teacher

The following list is to be answered during an active observation of a teacher during lunch time. This script will be used twice, once while observing at Heard Elementary School and once while observing at St. Andrew’s School.

1. What is your role in the cafeteria?2. Do you eat the cafeteria food?a. If no, why not?3. Do you ever take note of which students are eating what?4. Do parents ever ask you to take note of what their child is eating?5. Do you ever ask students to eat more of their healthy items?6. Do any of your students have

any special health issues?7. Are students required to wash their hands before meals?a.If so, what is the procedure for this?

Parent Lunch Aid The following list will be answered during an active observation of a parent lunch aid during the lunch period. The script will be used when a parent, rather than a teacher, is present during the lunch period. 1. What is your role as a parent aid?2. As a parent, how do you feel about the food the students are served?3. Do you eat the cafeteria food?a. If no, why not?

Interview Scripts

Principal

The following list of questions will be asked when interviewing the principal of the school. This list

will be used twice.1. How many students do you know of with food allergies?2. What is your budget for the cafeteria?3. What is your budget for the school nurse and promoting health?4. Does your school take time to promote health issues with the students?5. How often do you have Parent Teacher Association meetings?6. How do you communicate with parents about health issues?7. What health concerns are the main issue for your school?8. Are students from the immediate area or do they travel far to attend your school?

Parent

The following list of questions will be asked when interviewing parents of students. The list will be used up to four times.

1. Does your child have any health issues?2. How does the school address

these health issues?3. How do you go about brining up health issues with the school?a. Do you feel they are responsive about your concerns?4. Does your child eat in the cafeteria?a. If so, how do you feel about the food they are served?5. Do you talk to your child about health issues at home?

ROLESRESPONSABILITIES

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Roles during observationsEach group member will be required to take on each role during observation at least twice. Active Observation 1: School Nurse at Heard Elementary

•Interviewer: Lauren Andersen•Note Taker: Ana Oropeza•Video recorder: Ian Felton•Transcriber: Carrie Curtin

Interview 1: Principal at Heard Elementary School

•Interviewer: Ian Felton•Note Taker: Carrie Curtin•Video recorder: Ana Oropeza•Transcriber: Lauren Andersen

SCHEDULE OVERVIEW10

Days and Times Group Members are Available. Mondays:

• All group members are available before 1:30 pm.

• Ana, Ian, and Carrie are available after 5 pm. Tuesdays:

• Ana, Lauren, and Ian are available after 1:30 pm.• All group members are available after 4:30 pm. Wednesdays:

• All group members are available before 1:30 pm• Ana, Ian, and Carrie are available after 5 pm. Thursdays:

• All group members are available after 1:30 pm.

Fridays:

• Ana, Lauren, and Carrie are available all day. Saturdays:

• Ana, Lauren, and Carrie are available all day. Sundays:

• All group members are available all day.

Outline of due dates.I) Interviews and observations done by: February 6, 2012.

a. Active observation dates:1. Nurse at Heard Elementary – January 30.2. Teacher/parent aid at Heard Elementary – January 31.3. Cafeteria worker at Heard Elementary – February 2.4. Nurse at St. Andrew’s school – February 1.5. Teacher/parent aid at St. Andrew’s school – February 2.6. Cafeteria worker at St. Andrew’s school – February 3.

b. Interview Dates:1. Principal at Heard Elementary – January 30. 2. Principal at St. Andrew’s – February 1.3. Parent 1 at Heard Elementary – February 2.4. Parent 2 at Heard Elementary – February 2.5. Parent 1 at St. Andrew’s –

February 1.6. Parent 2 at St. Andrew’s – February 1.Transcriptions done by: February 8, 2012.

Book assembled by: February 11, 2012.

Presentation assembled by: February 12, 2012.

Ethnography report and presentation: February 13, 2012.

Heard Elementary School

PASSIVE OBSERVATION

ACTIVE OBSERVATION

SCHOOL TEACHER

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SCHOOL PROTOCOL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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INTERVIEW 18

FORMS 17

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CAFETERIA MANAGER 13

SCHOOL NURSE 15

SCHOOL PRINCIPAL 18

SCHOOL PROTOCOL14Schools are very strict with their policies. We got full access to Heard School through the principal, Ms. Sylvia Wallis. To be able to go to the school we had to send an email explaining the project, the email had to have all of our names and had to be send to her school mail and we had to send a copy to our professor. We had a very positive respond and the principal told us we were welcome to come anytime.

Once we got the school we notice that there is an American flag and a sign that addressed us to were the main office is located. We entered and talked to the secretary (first door to the left) she made us sign a sign in sheet with our names, time and destination in the school (cafeteria). She gave us a sticker where we had to write our name, we were told to keep the sticker on as long as we were inside the school at all times, saying that this is a way to show that we are visitors.

PASSIVE observationSchool Cafeteria- The cafeteria is large and open.- It has two columns of tables and seven rows per column.- The tables and benches are a one piece that folds to be store. - The Cafeteria is painted yellow with lots of windows.- It has 3 exits.- The lighting comes from the ceiling and the room is very well lighten. - There is a separate room at the back where students enter to get their food.- The kitchen is also located at the back of the room.

- There is a mural on the back wall of the rain forest.- There is a small window at the back of the cafeteria where the

15cleaning items are located.- Hand sanitizer dispenser on wall.- Almost every kid ate at the cafeteria.- Some students with packed lunches bought their drinks in the cafeteria.- Six healthy eating posters near where kids get their food. - The day menu was either pizza (cheese) or taco (bean).

- Cheese is served separately for the tacos.- Kids pay with cash or their student card.- Kids clean up after themselvesTheir trays get thrown away – appear to be Styrofoam.- Oatmeal raisin cookies.- Stage at the front of the cafeteria crowded with stuff.- A full tray is : entree (one taco or

one slice of pizza), a vegetable (raw brocoli with ranch dressing), a fruit (an orange), desert (a cookie) and a small milk carton.- Not all students had a full tray.- Few students ate their broccoli.- There was a teacher handing out candy (chocolate) to her students – fun sized bars.- No recycling bins in the cafeteria.

- One custodian working during lunch hours.- Nice flat screen in the corner and speakers which were not in use though music was playing.- At the end of the lunch period all of the tables were folded up and moved to the side of the room.- At any given time there were about 200 students in the cafeteria with 160 of them eating school

lunch and 40 with packed lunches.- Music would play and the kids would fall silent.- Kids were in charge of cleaning the tables by wiping them down and sweeping.- All of the kids had fruit on their plates.- Classes have assigned tables.- Teachers eat with students, but they bring packed food with them.- Theachers have a basket with money and cards.- When kids arrive at the cafeteria they are aligned to buy food and then brought to their table.- After the kids eat the teacher align them again in the center aisle while two of their classmates clean the lunch area.

ACTIVE observation16

School Teacher

Mrs. Victoria Maner

Interviewer: AnaNotes: IanVideo: LaurenTranscriber: Ana

The teacher and students were at the cafeteria when we got there; the teacher was standing by the students with a basket filled with cards, money and the list of the students in the lunch line (where kids stand to buy there food), she was not buying food, just supervision and watching over her class. She was giving each kid a card with a number, this number is the student ID and it shows how much the kid has to pay for the

meal. She pointed out that most of the students at this school don’t pay at all, but the few who do, have a reduced lunch plan. She is a first grade teacher. The room was noisy and classic music started playing. The teacher raised her hand and some of the kids did too. All of the sudden, the room was quite. She explain that the music is a new method to make the kids quiet down. When it is getting noisy, when one classroom stands to leave the cafeteria the music will play and the teacher raises her hand. This method really works.

The lunch routine starts before they go to the cafeteria, each teacher is supposed to take the kids to the bathroom to wash their hands or use sanitizer (she pointed out that she didn’t do it that day) Not all teachers do it even though they are supposed to. As we spoke she was looking at the students in the line and bringing them to the table. Most of them had vegetables (broccoli with ranch) on their plate, and all of them had

fruits (an orange) and it was either a slice or pizza or a hard shell taco. We asked what she gave the kids on the lunch line and she explained how the card worked, each student gives the card to the person in the computer at the end of the line and if they have to pay, they pay there according to what the card shows.

The kids were eating the entrée (pizza or taco) first, not all of them ate the broccoli, most of them didn’t even touch it. The kids where sitting at the second table to the right if you are entering the cafeteria, from there you could see that there is a table different than the rest, it was not horizontally aligned as the other and it had plastic chairs instear of the attached benches from the rest of the tables. We assumed that this was the teachers table, when we asked we found out that it is not, this table is assigned to kids with special needs. Heard Elementary School has two classrooms for special need kids and most of them are autistic children. These

children eat the same food as the rest of the kids and the lunch process is the same as well.

By the time all the kids arrived to the table the teacher sat with them and took out her own lunch (she brought it with her). The music started playing again, and just like the previous time, all the kids quiet down and the music stopped. When the students finished their lunch, the teacher called out two students. They went to a small window next to the exit of the lunch line and came back to the table with a broom and cloth. The rest of the class lined up in the center of the cafeteria. The music started playing again. The tables have to be cleaned by the students and they take turn to do it. The teacher tells them who has to clean each day. After the two kids that were cleaning were done, they left the cleaning items back were they got them and came to the line with the rest of their classmates. They left the cafeteria in single line and the teacher followed them.

17

Cafeteria Manager

First attempt

We followed one of the cafeteria workers during lunch. She is the assistant manager and she was supervisiong the workers and working at a computer where she asked for each student ID card and typed the ID number into the computer. Most of the students showed the card and walked out, but sometimes after she entered the number she asked the student to pay, each time this happened, the student payed cash.She told us that it is not always this crowed, she thinks one of the teachers got late and this delayed the whole process.

After she was done with the students it was already past 1:00 and we asked if she could answer some question since we couln not do it during the lunch rush. She said yes, but as soon as we started asking question she started

hesitating. She told us that the law is changing on a daily basis and there are some things that she was not able to answer, this continued for each question we asked. So she gave us her manager’s card and told us to make and appointment.

Second attemptMrs. Barbara Wright-Chamber

We made appointment with the cafeteria manager, she told us that she works at 3 different schools and she is at Heard in the morning, so instead of lunch we had to go at 9 am.

Interviewer: AnaVideo: CarrieNotes: LaurenTranscriber: Carrie

The school cafeteria is bright yellow, and well lit. There is chatter in the background from the start, though the cafeteria is empty. There are 4 kids in line for breakfast. There is student artwork on the walls. Mrs. Wright-Chambers was sitting in her office behind the kitchen when we came in. Her staff was serving breakfast. Kids would go through the line and ask for what they wanted. Her work is mainly on the kitchen area, the custodians are more in charge of the cafeteria are but she did point out that she makes sure that the cans are together. She is in charge of menus, production, preparing, she

orders the food (quantity and supplies according to menu), she receives the groceries, stores them and dates them. She is in charge of work schedules and attendance. She does the taste testing, portion control. She affirms she does “A little bit of everything”.

We were able to observe part of the process of the food preparation since they were starting to prepare what they were going to serve (the school doesn’t serve meat on Mondays). They already have a menu, this menu comes from the nutrition department and it is given directly to Mrs. Wright. Once she has the menu, she sits down and forecast, she forecast what the numbers might be for the two items they serve daily, and she places the order. These orders are placed two weeks before the menu date, they come in the door the week before the menu date, and then the day of the menu or the day before the menu depending what it is they prep it out. If it’s spaghetti or lasagna they prepare the day

18before. Ready items like pizzas are made the same day. Depending on what it is determines the prep time and store of that particular item (That day they had lasagna and pizza, they had two people preparing the pizza and the lasagnas were still stored).

The day begins with the work schedule. One Mrs. Wright has gotten the work schedule together with everybody itemizing what their responsibilities are to come in the morning. By the time we got there she was almost ready with breakfast and was setting up the sinks, she had the food baked off, the milk set up, the utensils set up, the ovens on. Everything was ready to go. She has three people at the kitchen that come in at 7 when they come in at 7 o’clock they start right where they left off the prior day. Setting everything ready in the line for the kids’ breakfas. Breakfast starts an hour later at 8, they have one person on the register and the other person on the server. The third person is prepping out what ever is for

lunch weather it is making certain that the food is panned and ready to go, making sure the vegetables are panned and seasoning them getting them ready so that when breakfast is done (at nine o’clock) they can go right into lunch serve cause its starts at 10:30. Once lunch starts the rotation is arrange so that if it is a ready made item, like pizza, they cook off just what they are going to need and then batch cook the rest of the day so everything’s fresh (Fresh out of the oven to the line). The lasagna is prepped out the day before and they heat them in the warmers and they stay there (there are two warmers). They put a pan on the line at a time, rotate it out, take a pan from the oven and serve it out of the pan. Same thing happens with the vegetables. Everything is prepped out so that when it hits the serving line its straight out of the oven or out of the warmer hot.

The process through the children is that every student has a student number that will be with them from pre k to fifth grade. That

19number must be entered in, identifying who that student is whether is a paying student or a reduced student or a free student it still has to have accountability for each child. Once they are done with that, the cashier counts down her drawer, same after breakfast, counts down the drawer gives Mrs. Wright a total of what they have, fills out all the necessary paper work, bring it into Mrs. Wright’s office. Then Mrs. Wright takes what the worker has given her, what’s in the drawer, and what the computer show and she balances out those three things to make certain that what the worker has in her drawer is what they should have based on what she’s entering into the computer. She costs out what is actually there, in terms of breakfast, and then she counts down again to make sure she gets her deposit together, and on a daily basis they have to drop the money to the bank. The inventory is counted down everyday as well.She also makes sure that the temps on items are ok; if it’s a salad it stays cold and hot items

stay at a hot temp. Milks are also temped out. There are thermometers in everything that either chills or heats, there’s a thermometer that makes them notice that each item stays between a certain ranges as far as the temps are concerned.

They serve fruits and vegetables everyday. The menu in itself changes everyday. There is nothing that they have everyday, except for milks. Because the state gives them funding it has to be a reimbursable meal. Which means, if it’s a breakfast item it has to have two components. And those two components can be a chicken biscuit, even though its one item, its still two components (meat and bread). Lunch is the same thing except instead of two components it has to be three components. Three components can be a cheeseburger and a milk. Its two items, but still three components. So they get their entrée. The must pick either entrée or a meatless entrée, which means they don’t even have to get a lasagna or a

20cheeseburger. They can just get two vegetables and a fruit or milk, juice, and keep going but they have to have at least three components from the kitchen.

We asked about there menu, she told us that since it was Monday they don’t serve meat on their menu but they had chicken sandwich and hot dog on the board menu. She told us that they haven’t change the menu on the board and that what was on it was Friday’s menu. The menu could be adjusted by parents or students, and how they do this is that if there is a request from a parent or a request from a student they will order what the request said just for that particular school (she told us that they are working on three different schools). The menus are set up based on the USDA guidelines so in a week’s menu the proportions in that menu and nutrients in that menu fall under the USDA guidelines.

Food contamination is a huge concern. What happens with that

is if there’s a kind of allergies or food specifics dealing with the health of a student they must fill out a form. The form must be in Mrs. Wright’s file. And what that does is it gives her the opportunity as well as affords her legally to change in my computer information in that Childs permanent record file so that they can list there their allergies of soy and peanuts and whatever other allergies they may have. They address the allergies by offering the child two completely different items, so he can also have his or her two choices. These options will not affect the cost of the meal. The only thing that it does is it alerts whoever the server is, whoever is at the POS, so that when that child gets to that POS they know they’re not going to walk out with an allergic reaction based on something that they offered.

21

School Nurse

Mrs. Debbie Beall Interviewer: LaurenVideographer: IanNotes: Ana and CarrieTranscriber: Lauren

At heard the nurse office in the building located to the right of the main entrance, where the main office is. Once you go through the entrance, the fourth door to the left would be the nurse’s office.

The nurse office is sterile white, linoleum with blue furniture. There is a desk facing the door. On the left wall two blue stretchers, next to the stretchers there is a scale and storage furniture. The room also had a washer and dryer, she has a sink at her office and there was a closed door with is her personal bathroom.

The school nurse is a woman between 40-50 years old. She was dressed in a sporty way, to make

her job more comfortable. She is very busy and had gotten into a point where she doesn’t have time to have lunch.

We went into her office right after lunch, which is her “rush” hour. Some kids come with indigestion, others for regular medication. She always knew what each kid needed without asking. We were asking her about cases of allergic reaction in the school, when a boy interrupted her story about a little boy who collapsed in front of her by the cafeteria door, she gave the boy two pain relief pills, the child took them and left the room (he didn’t take them in the room). She continued the story about the child with allergic reaction (this is the most sever case she had had in 12 years of duty), when she saw him, his lips and face were already swollen in hive (the child did not know that he had a peanut allergy). That the kid’s mom was her boss at the school board so she was able to call the mom and get her to give permission to provide the child with the drugs

(Benadryl) he needed and she also told the mother that she had to go to the school immediately. The kid was taken to the doctor and almost getting admitted into the hospital, they ended up giving him a lot of epinephrine shots. Thanks to the fact that she knew the mom’s number, the nurse could act faster with the health issues’ protocol.

She has a cabinet next to her desk where she stores the medications. Parents give medicine to the nurse with a signed form before she can distribute the medications to the kids. The protocol for the medication is very strict, so parents need to make the kids physician to complete several forms (see page 17) to notify the nurse of any health issue and allow her to act in an emergency. She has epipens up in her cabinets, and teachers who have students that might need the epipen are taught by the nurse to use it. If the child has an allergic reaction and the allergy is know by the nurse, the epipen is used. If the kid has one and the nurse had no knowledge of the allergy the epipen is not use because each parent has to supply the epipen and he can not use another child’s pen. If she can not reach a parent 911 will be called. Especially if it involves breathing.

If a child has to go to the nurse office for any reason there is also a protocol to be followed. The kid is

supposed to have a form (see page 17) from a teacher that says what the child needs. But a lot of them have gotten where they do not send one. She is supposed to send them back herself, but because of time issues she does not do this. She said: “If they are coming to me for a reason so I just let them come in here and yeah know see them instead of going back and forth.”

The main allergy at Heard Elementary, according the nurse, is peanuts, there are a few kids with fish allergies (not an issue), some kids are allergic to pollen and there are several asthmatic and she has breathing treatments and their inhalers in her office.

Health and healthy eating is promoted at Heard, the nurse doesn’t go to the classrooms but the school is hooked up with Healthier Generation and Health Empowers. This is a new program that just started at the school. Personal from the program come in and teach the students about

health issues. The nurse also makes flyers that are given to the children to take home with them once a month. There have been times when teachers ask the nurse to go to a class and teach a health related issue. She has done hand washing with little kids. She does this mostly at the beginning of the school and mainly with students from pre-K – 3rd grade, she also screen them for hearing and vision. By this time of the year she did the screen for the kids. And now is the flu and virus season so she is swamped with work taking care of the kids who come with in issues. The kids also have health hours where the teacher talks about health. She said that she would like to be more involved with the health teaching but she does not have the time to do it.

22

Interviewer: LaurenVideographer: IanNotes: Ana and CarrieTranscriber: Lauren

At heard the nurse office in the building located to the right of the main entrance, where the main office is. Once you go through the entrance, the fourth door to the left would be the nurse’s office.

The nurse office is sterile white, linoleum with blue furniture. There is a desk facing the door. On the left wall two blue stretchers, next to the stretchers there is a scale and storage furniture. The room also had a washer and dryer, she has a sink at her office and there was a closed door with is her personal bathroom.

The school nurse is a woman between 40-50 years old. She was dressed in a sporty way, to make

her job more comfortable. She is very busy and had gotten into a point where she doesn’t have time to have lunch.

We went into her office right after lunch, which is her “rush” hour. Some kids come with indigestion, others for regular medication. She always knew what each kid needed without asking. We were asking her about cases of allergic reaction in the school, when a boy interrupted her story about a little boy who collapsed in front of her by the cafeteria door, she gave the boy two pain relief pills, the child took them and left the room (he didn’t take them in the room). She continued the story about the child with allergic reaction (this is the most sever case she had had in 12 years of duty), when she saw him, his lips and face were already swollen in hive (the child did not know that he had a peanut allergy). That the kid’s mom was her boss at the school board so she was able to call the mom and get her to give permission to provide the child with the drugs

(Benadryl) he needed and she also told the mother that she had to go to the school immediately. The kid was taken to the doctor and almost getting admitted into the hospital, they ended up giving him a lot of epinephrine shots. Thanks to the fact that she knew the mom’s number, the nurse could act faster with the health issues’ protocol.

She has a cabinet next to her desk where she stores the medications. Parents give medicine to the nurse with a signed form before she can distribute the medications to the kids. The protocol for the medication is very strict, so parents need to make the kids physician to complete several forms (see page 17) to notify the nurse of any health issue and allow her to act in an emergency. She has epipens up in her cabinets, and teachers who have students that might need the epipen are taught by the nurse to use it. If the child has an allergic reaction and the allergy is know by the nurse, the epipen is used. If the kid has one and the nurse had no knowledge of the allergy the epipen is not use because each parent has to supply the epipen and he can not use another child’s pen. If she can not reach a parent 911 will be called. Especially if it involves breathing.

If a child has to go to the nurse office for any reason there is also a protocol to be followed. The kid is

supposed to have a form (see page 17) from a teacher that says what the child needs. But a lot of them have gotten where they do not send one. She is supposed to send them back herself, but because of time issues she does not do this. She said: “If they are coming to me for a reason so I just let them come in here and yeah know see them instead of going back and forth.”

The main allergy at Heard Elementary, according the nurse, is peanuts, there are a few kids with fish allergies (not an issue), some kids are allergic to pollen and there are several asthmatic and she has breathing treatments and their inhalers in her office.

Health and healthy eating is promoted at Heard, the nurse doesn’t go to the classrooms but the school is hooked up with Healthier Generation and Health Empowers. This is a new program that just started at the school. Personal from the program come in and teach the students about

health issues. The nurse also makes flyers that are given to the children to take home with them once a month. There have been times when teachers ask the nurse to go to a class and teach a health related issue. She has done hand washing with little kids. She does this mostly at the beginning of the school and mainly with students from pre-K – 3rd grade, she also screen them for hearing and vision. By this time of the year she did the screen for the kids. And now is the flu and virus season so she is swamped with work taking care of the kids who come with in issues. The kids also have health hours where the teacher talks about health. She said that she would like to be more involved with the health teaching but she does not have the time to do it.

23FORMS

School Principal

Ms. Sylvia Wallis

Interviewer: IanVideo: AnaNotes: Carrie and LaurenTranscriber: Lauren

The principal at Heard Elementary School, Sylvia Wallis, was sitting at her desk wearing a light blue shirt on top of a white tang top; she was sitting at her desk and agreed to answer some of our questions with a smile on her face. She looked like she had a big amount of work judging by

24 INTERVIEWthe amount of papers and folders she was looking at on her desk before we went in. Her phone rang several times, she forwarded the calls to her secretary and we had all her attention.

She answered all our questions with great confidence, she told us that she gives the forms to know about each child’s allergy but is actually the nurse who hands it down to the parents, this form has to be completed by the child’s physician and then handed back to the school nurse. Then the nurse notifies the nutrition manager, this way the kitchen is well aware of what to serve to certain kids. The teachers with kids with allergies are aware of it as well, they also have to revise the registration form, and they are with the students at all times, they eat and stay with them in the cafeteria during lunch (30 min.) The teachers have baskets where they carry the student’s lunch cards, this is just and ID with their lunch number, it doesn’t have any information about the students, it

only shows if they receive free or reduced lunch.

The cafeteria budget it’s not run by the school, she pointed out that that goes through the nutrition department. Nutrition in general is standardized over the country (at public schools).

Students from Heard Elementary come from all over the Chatham County, and some of them are home base population, but that is not a requirement.

She re-affirmed the lunch routine, everybody, from pre K to 5th grand, are supposed to apply hand sanitizer or go to the bathroom before going to the cafeteria or at the cafeteria and then after they eat the teacher has to take the students to the bathroom.

When we did our passive we notice that at the back of the cafeteria, no one used them, and they just seem to be there. Once we asked we found out that they are just for the PTA, and students

don’t and can’t use them. We also asked about the teacher’s lunch, every teacher had packed lunches, so we asked if they could eat at the cafeteria, since none of them did. The principal told us that it’s their choice, the cafeteria food is available for them, but they can either eat there or bring their own lunch.

At Heard Elementary, PTA meetings are held once a month and they do discuss health issues in them.

St. Andrew’s School

Interviewer: CarrieNotes: Ana and LaurenVideo: IanTranscriber: Carrie

Beth Aldrich, sits at her desk, glasses poised atop her head. The sleeves of her light blue sweater are pushed up above her elbows and her hands are clasped on the desk. Her office is well lit with

fluorescent lights and a lamp sitting on her desk casts a warm light across the papers she is reviewing. Her desk is full of stacks of papers and knick knacks, but there is a paper sized area directly in front of her that is clear. Her office is the first office located off of the outer main office where a receptionist is located.

The papers she is going over are the budget overview for the school year. She is clearly a well organized individual, as she located the budget papers in no more than a minute with in her stacks of material. She explains the school’s budget for cafeteria and health related programs. The school, she notes, sub contracts the company Sudexo to take care of their cafeteria food. She states that lower school lunch revenue takes in $17,500 per year but that $39,000 is spent on food service for the same grade set. “So obviously that didn’t work as well you see because what was our income for it? 17 and it cost us 39 so it’s not working for us,” She

says with a chuckle. She also explains that the school uses $53,000 for employee lunch benefits, although not all employees use their allotted lunch money. She further explains how the lunch service differs for the youngest grades that are located on the adjacent campus. “They get a set lunch that is an entrée a desert a fruit (2:49). They eat differently than they do over here. We don’t do grapes and things that they can choke on unless we slice the grapes up so it’s very different what goes over there,” she says. The food service there is sent over in trays so the teachers there are responsible for filling their trays and the classes eat family style. However, the lower school meals are prepared in the same cafeteria that the other food is prepped in.

On the subject of health, Beth was unaware of the exact amount of money that goes to health education and the nurse. This item was missing from the budget report in front of her. All she had to say on the matter was that the

school nurse does get a budget and that she decides where to spread her money out. The assistant principal also was unaware of how many students had food allergy concerns. She said that the school nurse shares that information with her and the rest of the faculty and staff at the beginning of the year and that she has the information written down somewhere. Thus it is clear that the communication and collaboration between the nurse and administration does have some weaknesses. Aldrich was asked about how the school promotes health issues to its students. She replied that there are several students with parents who are professional nutritionists so the school tries to get them to come in and talk to the kids about healthy eating. According to her, health and science classes also cover basic health concepts and Sodexo has health eating information up on the school’s website. She also says “in the lower school we send a Friday folder every Friday with the student’s home,” where they send

information, including that on health, out. “And also I do an email blast twice a week to all of our parents,” she says as she gestures toward her computer.

In her opinion though, the largest health concern of St. Andrews is the spread of germs. In her words, “the main health concerns this time of year with colds and allergies and things and just the spread of disease with this many small children who don’t wash their hands and touch everything. So wash your hands when you leave!”

Lastly, Aldrich outlines where the 440 students of St. Andrews, 170 of which are in the lower grades, commute from. “About 80% of our children are probably within a 15 mile radius but then the other 20% are from all over savannah all the way to Richmond Hill, which I think is a drive,” She says and mentions that busses go out to all of these areas to help transport the students to school.

PASSIVE OBSERVATION

ACTIVE OBSERVATION

SCHOOL TEACHER

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18

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INTERVIEW 26

FORMS 24

20

CAFETERIA MANAGER 20

SCHOOL NURSE 22

SCHOOL ASSISTANT PRINCIPAL 26











28 SCHOOL PROTOCOLSt. Andrews has two campuses, one next to the other, when you are driving to the location the first campus to your left is the one for Pre K-4th grade.The next one on your left, is where the sport’s fileds, the main office, the gym, the cafeteria and grades from 5th-12th are.

We arrived at the school before 11 am and into the main office, where we signed in a form specifying destination, name, date and time.

We received one sticker each, where we wrote our names in and we were told to wear them at all times. Mrs. Aldrich, the assistant principal, accompany us to the cafeteria and stayed with us the whole time.











PASSIVE observationSchool Cafeteria- The cafeteria is located in the same building where high school is.

- The cafeteria is painted with the school colors, the sides and back walls are blue (light blue, with a darker blue strip) and the front wall, were the food is located is bright yelllow.- Very nice cafeteria.- Kids have a wide selection and can make requests.- No uniforms.- Teacher don’t sit with the kids, they all sit at the first table once you enter the cafeteria.- A lot of kids with bag lunches still have trays.- Predominantly caucasian students.

- Food served on Styrofoam plates or paper containers.- Non-disposable trays.- Some had trays just to put their food on but didn’t buy anything.- There was sanitizer on the wall but it was by choice for students to use it.- Students got up and sang happy birthday.- A cafeteria manager cleaned the table.- 160 seats in the cafeteria.- Fries = non whole grains.- Parents are allowed to eat with children.- Most kids who bought drinks bought sports drinks.- There are six drink dispensers.- There is a sald bar.- The kitchen is located at the back of the room, the students for a line and order hot food here.- In general, the cafeterian and kitchen are well organized.- There is one worker packing and handeling public and four prepar-ing and serving food, plus the manager.- The people serving the food have uniforms.

- Everything is label, so kids can find everything they need easily.- They were serving nachos with cheese and beans, pretzels, corn dogs, green beans, french frieds and wraps (only one teacher got it).

- Only two girls had green beans.- Every container were they serve the food is disposable.- The furniture in the kitchen are all stainless steel.- There were no dirty dishes in the sink.

- There is only one row of tables, the tables are separate from the chairs.- They do have chairs, no benches.- The workers know the students by name and are very friendly.

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30 ACTIVE observationSchool Teachers

Mrs. Lisa Hill, Colleen Jama and Emily Calhoon

Interviewer: LaurenNotes: CarrieVideo: AnaTranscriber: Ian

When we got to the cafeteria elementary school was already there, the students were buying food, almost all by that time were buying food, they went to through the line and then out of the kitchen to the computer were they paid with a card.The teachers were sitting at a separate table, we approach them and they wanted to help but they did not like the fact that we

interrupted their lunch hour. There were three female teachers sitting and mostly one answered our questions.

The lunch routine starts before the children are taken to the cafeteria, the teachers are supposed to take the students to the bathroom and make them wash their hands. There are also hand sanitizers at the entrance to the cafeteria and in every classroom. They pointed out that the students are pretty good about doing it themselves.

For allergies the parents have a form that they have to fill out by a doctor at the beginning of every year and that gets sent out to all the teachers. Some of the kids also carry their epi pens on them, but all of the teachers are taught how to apply them.

Teachers have a credit at the cafeteria, they have a set balance throughout the year, she estimate that around 50/50 of the teachers bring their own lunch, but they can usually get through the year

eating in the cafeteria on credit. She said that they also have a habit of asking the prices before we buy so we can keep track of what we do.

While we were observing the teachers some students got up on a stage located at the right wall once you enter the cafeteria, and started singing happy birthday to a girl who was turning eleven. The teachers explained that whenever there’s a birthday all of the kids get up on stage and sing. “Its great they do it themselves”. The teachers really do not pay attention to the students while they eat, after the teachers ate they stayed talking to themselves and looking at their watches. Once it was time, each of them called out there classes and left the cafeteria in a line.

Cafeteria Manager

Mrs. Rasheedah McGill

Interviewer: LaurenVideo: CarrieNotes: Ana and IanTranscriber: Carrie

At St. Andrew’s school Rasheedah McGill, a cafeteria worker, was a subject of contextual inquiry. When we approached, she was busy cutting fruit and placing it in











31individual containers before the next lunch rush began. The fruit was then put out in a cooler in the front of the cafeteria where a convenience store like area was located. She wore gloves while she cut the food and cleaned up her station immediately when she finished the job.

The menu above the serving line outlined that day’s menu: pretzels, corndogs, mac and cheese, nachos, peaches, lima beans, fries, and bread sticks. The menu seemed to be heavy on carbohydrates and fried foods and

light on the produce. The peaches and lima beans, the only fruits and vegetables available on the line, were from cans making them look far less appealing than the fresh fruit Rasheedah had just cut. This observation lead to questions as to whether kids were required to choose the healthy options during lunch, or free to eat what they please. Rasheedah was if the lunch staff ever monitors what the students are eating. She informed us that there are a handful of parents that ask the cafeteria to put restrictions on their child’s accounts. This means that they ask the staff to tell their children if they can not eat certain unhealthy items. “Only a small number, I can tell you off hand it’s no more than ten,” she said in regards to how many students they have this sort of relationship with. When asked about the portion sizes served to the students, she answered that the kids are able to ask for multiple portions of any item. If a student does so, they are informed that the price of their plate has gone up, but nothing

about the nutritional repercussions of their choice.

There were also a lot of questions about food allergies and dealing with student needs to be asked. Rasheedah explained that food contamination is a big concern for the cafeteria staff since there are kids with allergies and food restrictions to take into account. It was observed that the process for avoiding this was to prepare certain food items in certain areas.

Raw meat was taken care of at one station, fruit at another. Each station was wiped down and gloves were changed when the preparation was complete. She did concede, however, that because of a small kitchen and a small staff that “if it’s [food allergy] so sever that the kids have a pen I encourage the parents to please pack a lunch.” The most common food allergies at St. Andrews were, by far, peanuts, followed by dairy. Rasheedah explained that the cafeteria staff was only aware of the youngest children in the school’s allergies were. The school nurse sends the cafeteria staff information on the young children’s allergies to the staff and they also have contact with several parents about their children’s allergies. She explained that “sometimes the parents will send me an email. I talk to my staff about it and we have pictures of them also so they know how they look.” She also mentioned that the older kids are responsible for themselves in making sure they avoid the foods they are allergic to.











32Rasheedah said that these protocols were necessary not only for children with food allergies, but children with dietary restrictions; say children who didn’t eat pork based on religious reasons. She mentioned too that the cafeteria provides a vegetarian option for its students on a daily basis. The staff at St. Andrew’s really wanted to make sure that they were working within a protocol that would make the cafeteria an option for all students to eat in.

Then the next wave of students came pouring in for their lunch time. They lined up single file through a doorway to the rest of the cafeteria as the food line is separated from the open cafeteria space by a wall. Only two students of about the 60 who came through the line at that time ordered the lima beans. Not one student ordered the peaches. On average, students ordered two items from the lunch line. The strong majority of those who ordered multiple items ordered different items that

were carbohydrate saturated item: Two breadsticks or a pretzel and chips, for example. It was observed that the breads served were not whole wheat. The students, after ordering and receiving their food, turned to the wall next to the exit door where there were plastic utensil dispensers. They then exited and found the register along the outside of the wall. A staff member would key in what the students had on their trays and the kids would punch in their pin numbers to pay before heading to the tables to sit and eat. Rasheedah











explained this process of paying by saying “if its pre-k and kindergarten the school pays for it. Basically it’s in their tuition. First grade through twelfth grade they’re on what’s called a declining balance. Their parents put money on their account and they enter their pin number.” She also explained that the cafeteria decided to opt for the pin number system because they thought that the kids would lose their student cards if that sort of system were used.

It took roughly 15 minutes for the rush to filter through the line. During the crowd, the cafeteria did run out of pretzels and it was observed that the students did return their trays back to the cafeteria to be washed and reused. It was also noted that there were a total of six soda machines in the cafeteria and ice cream, cookies, and chips were for sale.

33

School Nurse

Mrs. Rosemary Schuster

Interviewer: LaurenVideo: IanNotes: Carrie and AnaTranscriber: Carrie

Another subject of active observation at St. Andrew’s school was school nurse, Rosemary Schuster. St. Andrew’s is made up

of two adjoining campuses, one for pre-k through 4th grade, and one for 5th through 12th grades. Rosemary splits time between the two campuses, having office hours for each. She was found at her office in the upper school building, as it was lunch time and that is also where the school’s only cafeteria is located. Her office there was located in a hall way adjacent to the main office down which there were several other rooms as well as hers. Since there were other staff members working in the hall, it was noisy and constantly had people passing through. The hallway was lit with fluorescent lights and paved with blue carped and grey walls. Inside the nurse’s office, however, the floor was instead laminate. She was busy attending to a young student who had fallen ill during lunch and was awaiting the arrival of his parents. She took his temperature, then shut off the lights, and stepped out into the hallway to be asked questions while he rested.

Rosemary mentioned that lunch time is often busy for her and that although nobody has ever come to her with food poisoning, she does get frequent visits from students with indigestion. She was happy to say though that no student has ever come to her with a sever food allergy related episode. Upon sharing this news though, she said she was very superstitious and so she knocked on wood in hopes to keep this streak alive. Rosemary has had experience with students coming to her with hives or swelling, which is the early stages of a food allergy episode, and has had to administer an antihistamine to them. She further explained the protocol she follows for students with food allergies.

Every year, students are asked to complete a health form upon which parents can specify what sorts of allergies their child has. The form also records any other health needs a child has while at school. She said that St. Andrews does not require a doctor’s sign off on this document, that it is

acceptable to take the parent’s word for whatever health needs a student has. Rosemary said that for every student with a documented food allergy, she has the authority to use an epinephrine pen. She was thrilled, too, to share the news that the Georgia legislature had recently passed a bill which “allows schools to stock generic epinephrine pens and allows faculty and staff who are trained to recognize signs of anaphylaxis to give the pen even if they don’t hold the diagnosis.” She explained the medical response team St. Andrew has as well. There is team there made up of faculty and staff who are trained in first aid and CPR. If there is ever an event that they are needed, say for a anaphylaxis episode, whoever is dealing with the students sends an all school page to the response team who brings AED’s and first aid kits, which are stocked with epinephrine pens, to the scene. It was made clear too that if epinephrine is needed, the nurse is obliged to call 911. She mentioned











34also how important it is in an elementary school scenario to recognize the signs of an allergic reaction and shared that there had recently been news of a young girl who had died of a peanut allergy reaction while at school.

In addition to this conversation on food allergies, the question of advocating health issues was brought up. Rosemary stated that she is rarely invited into the classrooms to promote health issues, but that she has made herself available to do so. Se said that “the only health class we have is an upper school 9th grade health class which is outrageous but before I retire that is my goal before I retire to have middle school health from grade 4.” This made it clear that there is a void at St. Andrews for health education and Rosemary was obviously upset about this.

At this time, a student who was roughly of 4th grade age entered the hallway. Rosemary asked her if she needed her inhaler. This

made it clear that Rosemary did know her students by face, name, and health concern. The girl said that no, she was not there for her inhaler, but that she had a headache. Rosemary expressed her sympathies for the girl but told her there was nothing that she could do for her and sent her back to class. The nurse explained that, other than the recent epinephrine pen exception, she was not allowed to give out any medications with out a parent first supplying it and giving her the ok to administer it. Rosemary was asked how many students come to her on a regular basis for things such as inhalers and she replied that she had administered five medications thus far that day. Interviewer: Carrie

Notes: Ana and LaurenVideo: IanTranscriber: Carrie










FORMS 35











36











Assitant Principal

Mrs. Beth Aldrich

INTERVIEW 37











38




















Lastly, Aldrich outlines where the 440 students of St. Andrews, 170 of which are in the lower grades, commute from. “About 80% of our children are probably within a 15 mile radius but then the other 20% are from all over savannah all the way to Richmond Hill, which I think is a drive,” She says and mentions that busses go out to all of these areas to help transport the students to school. Analysis











43

AFFINITY CHARTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

42

CONTINUUM GRAPHS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

CAFETERIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

43

CAFETERIA MANAGERS

SCHOOL TEACHERS 44

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .SCHOOL PRINCIPALS 44

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .SCHOOL NURSES 45

50

PERSONAS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

48

SCHOOL BOY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

48

DEDICATED TEACHER

CAFETERIA WORKER 52

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .BUSY SCHOOL NURSE 54

60

INFOGRAPHICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

56

MODELS (FLOW, PHYSICAL, CULTURAL, ARTIFACT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

56

HEALTH FORMS

LUNCH OPTIONS 61

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .SCHOOLS STRUCTURES 62











42 Af�nity Charts

43











The Cafeteria

Conclusions drawn:

Conclusions drawn:

Passive Observation

Workers

-Claim to listen to student requests, but ultimately follow strict protocol-Staff actively tries to prevent reactions-There are strict guidelines for documenting food allergies-All allergies are communicated to the cafeteria from the nurse, not directly from the parent-Heard requires students are served balanced meals while St. Andrews doesn’t take note.-Heard is more concerned with kids not eating enough as opposed to eating too much-St. Andrews don’t watch portions of students as long as they pay forthe extra food- Price is a huge factor at Heard where most students can’t pay for the meal with out help

-The nurses want the opportunity to teach the students more about health.-The nurses want to be more involved with the students-Peanut allergies are the most common issue in elementary school-The nurses are very experienced-Public schools are more limiting on what the school nurse can and can not do











44

-St. Andrew’s had more freedomwith the use of Epi pens than Heard-Strict order in the lunchtime routineat Heard-Teachers at St. Andrews don’t egage with the kids during lunch time-Clealiness of the cafeteria is directly affectetd by the level of order: more order results in greater cleanliness-Teachers actually ate the cafeteria food at St. Andrews but not at Heard-Teachers are not in the communication loop with health issues

-Principals are not in the main communication loop on health-Public school principals have less influence over procedures than private school principals-There are few PTA meetings, so parents do not have a chance to voice their concerns often-Private school principals are more involved

Teachers

Principals

Conclusions drawn:

Conclusions drawn:

45











-The nurses want the opportunity to teach the students more about health.-The nurses want to be more involved with the students-Peanut allergies are the most common issue in elementary school-The nurses are very experienced-Public schools are more limiting on what the school nurse can and can not do

The Nurses

Conclusions drawn:











46 CONTINUUM GRAPHSDevelopment of Personas

Care primarily about completing tasksgiven to them

Key

PrincipalsCafeteria workersNursesStudentsTeachers

Care primarily about quality of tasks

given to them

Quantity Quality

Not concerned with cost

Concernedwith cost

Not focused onfollowing procedure

Focused onfollowing procedure

Taste of food Health of food

Does not interactwith technology

Interacts withtechnology

Method of paymentunimportant

Method of paymentimportant











47

Rely on freedom Rely on structure

No personal relationshipswith students

Personal relationshipswith students

Unconcerned with food contamination

Food contaminationmain concern

Do not rely on paperwork

Rely on paperwork

Unconcerned with cleanliness

Cleanliness is a main priority

Unconcerned withmenu

Concerned withmenu

Do notrely on communication

Rely on communication

Able to administerEpi-pen

Unable to administerEpi-pen











48

Meet Tyler Johnson. He is your average eight-year-old elementary school student. Today, Tyler woke up today at 7 am just like any other day of school. Tyler hates the uniform that he has to wear; he would love to be able to put on his favorite transformer t-shirt instead, but he puts his uniform on anyways. His mom kisses him good-bye as he walks to take the bus to school. Everything goes as usual, but once he enters the lunch line he starts to get nervous. Tyler would like to blend in and be like his friends but thanks to his severe allergy to peanuts he fells very different at lunch. A lunch box would save him the shame of the line, but since he is in a reduced lunch plan he has to eat there everyday. He stops to look at the menu and hesitates whether to ask or not for the ingredients on his meal. Every time he asks he delays the line and loses his lunchtime. But he knows that if he even smells peanuts something really bad can happen. He thinks about his epi-pen and the long distance between the cafeteria and the nurse office where the pen is and he asks the cafeteria worker about the ingredients. After 10 minutes discussing what he can eat he is finally the last to seat at the table. Tyler applies sanitizer and starts eating, but since he spent so much time at the line he is not able to finish his lunch. He loved his math class in the morning but now is time for his least favorite class, PE. Tyler stops at the nurse’s office for his daily medication, and he walks sadly to the gym. He dreams of being home playing his favorite video games instead of being at the gym.

• 8 years old, in the 4th grade. • Eats in the cafeteria 99% of the time because he is on a reduced rate.• Sever peanut allergy.• Goals: fit in, socialize, and get good grades.• Loves computer games.• Doesn’t play sports.• Loves pizza day.• Hates his uniform.• Thinks the hand sanitizer is fun.• Doesn’t bother washing his hands half the time.

“I love pizza day”

IP.E.

Tyler Johnson

School boy











49



given to them

Quantity Quality


Concernedwith cost














Rely on paperwork




Concerned withmenu





50

Meet Patricia Greene. A dedicated school science teacher, whose passions are children and teaching. Today, like any other day, Patricia woke up at 6 am to drink her so desired cup of coffee and start another day. She goes into her kitchen and makes herself two toasted breads, kisses her husban and kids, and grabs her notes to jump into the car, and drive to the school where she’s been working for 12 years. Patricia got to school around 7 am and plans her classes for an hour, when the students start to arrive. Patricia is with Tyler’s science class when she realizes that is lunch time, her favorite part of the day. She walks the kids to the bathroom where they wash their hands before lunch and then proceeds to walk them to the cafeteria. Patricia lines the kids up in the lunch line and gives each one their lunch cards, like she does every day. After she supervises the line, she sits and talks with her students, finding out about the rest of their classes, discussing cartoons and talking about their interests. After lunch she has the kids clean up the tables and then takes them back to the bathroom so they can wash their hands again. She finishes up her classes, takes some time to grade any tests and drives home to cook dinner for her husband and kids, tired but in a great mood since she loves her job and her school days.

• 38 years old.• Married with two kids.• Have been working at the same school for 12 years.• She loves teaching. It is her passion.• Goals: teach, nurture the students growth, make the day go smoothly.• Science teacher.• Never eats the cafeteria good – has eaten it once or twice.• Knows how to use an epi pen but has never had to.

“We are supposed to takethekids to the bathroom before lunch”

Dedicated teacher

Patricia Greene

51



given to them

Quantity Quality


Concernedwith cost














Rely on paperwork




Concerned withmenu





52

Hope Brow

n

Meet Hope Brown, a 42-year-old cafeteria worker at Tyler’s school. She has been working at the same public elementary school for fifteen years though she is not particularly passionate about her job there. Today, Hope woke up at 5 am, just like any other morning, to cook for her 5 children. This morning she got up feeling really tired and reminded herself that she really needs a steady job, she has 6 mouths to feed including her husband who’s currently unemployed, and since all she has is a high school degree, this is the best job she could find. Hope got to school at 7 am and started preparing breakfast. The children start to arrive at 8:15 am and she just goes through the motions without paying attention to the children. Hope is required to wear gloves all day long so she complains about having dry hands with her friend Sheedah. After breakfast comes lunch and she repeated the same routine. She just does what her manager asks of her. Though the job itself doesn’t bring her a lot of joy, she does like interacting with the kids. Hope knows quite a few of them by name, including Tyler, whom she also knows has a peanut allergy. Her favorite part of the day is working the cash register because she gets the best opportunity to interact with the students, who remind her of her own children, but today she wasn’t very lucky and she had to stay in the kitchen all day. It is already 3 pm and Hope is done cleaning the kitchen and preparing food for the next day. Hope says goodbye to her co-worker and goes straight to her second job, as a cashier at a local restaurant. She got home around 10 pm and her kids are already sleep.

• 42 years old.• Has five children.• Unemployed husband.• Worked there for 15 years.• Knows Tyler by face and knows of his allergy.• Goal: follow orders from above her.• Keeps this job just to make ends meet.• Wears gloves all day.• Has two jobs.

“There is nothing that we have everyday, except for our milks ”

Cafeteria worker

53



given to them

Quantity Quality


Concernedwith cost














Rely on paperwork




Concerned withmenu





54

Cathy Turner

Meet Cathy Turner, she has been a nurse in the education system for about 25 years, and has been at heard for 14. She completed nursing school and has been working at various schools ever since. Today, Cathy woke up at 7 am and made heself a healthy breakfast. Like every morning she called her daughters to check on them. One is in college and the other one married, her day started today with the news that her grandson is starting to walk. Since she lives very close to the school so she left her house only 10 minutes before 8 am. Cathy got to her office and checked on all the medications in her cabinets, she did all the pending paper work, and gave medication to the kids that she has to after breakfast. Cathy stopped and look at her watch, she realized that it is already her lunch time. She has an hour for lunch, but she can never take it, today was no exception. Lunch is her busiest hour and she now has 4 kids in line waiting for medication (fon indigestion, advil and even inhalers). She hates the beginning of school year when she has to take care of the form protocol, but since is the middle of the school year she doesn’t have to worry about that for now.After she was done giving medication she went into her cabinet again, this time she looked at the students Epi pens, she had to give one kid Benadryl and just the thought of having to use the Epi pen scared her. Cathy checked her agenda and realized that today she has to send the monthly news health flyers with the kids.

• 50 years old.• Loves her job, and thinks she is good at it.• Has two daughters and a grandson.• Goals: care for sick children, keep track of formal documents, administer medications, and making sure to get the goverment of her back when it comes to her job.• Knows the students with daily needs by name and face.• Concerned with being prepared for all events.• Would like to interact more with children, but she doesn’t have time.

“If I had not been able to reach her or anybody I would probably call 911. ”

Busy school nurse

55



given to them

Quantity Quality


Concernedwith cost














Rely on paperwork




Concerned withmenu





56 Infographics

Meet Patricia Greene. A dedicated school science teacher, whose passions are children and teaching. Today, like any other day, Patricia woke up at 6 am to drink her so desired cup of coffee and start another day. She goes into her kitchen and makes herself two toasted breads, kisses her husban and kids, and grabs her notes to jump into the car, and drive to the school where she’s been working for 12 years. Patricia got to school around 7 am and plans her classes for an hour, when the students start to arrive. Patricia is with Tyler’s science class when she realizes that is lunch time, her favorite part of the day. She walks the kids to the bathroom where they wash their hands before lunch and then proceeds to walk them to the cafeteria. Patricia lines the kids up in the lunch line and gives each one their lunch cards, like she does every day. After she supervises the line, she sits and talks with her students, finding out about the rest of their classes, discussing cartoons and talking about their interests. After lunch she has the kids clean up the tables and then takes them back to the bathroom so they can wash their hands again. She finishes up her classes, takes some time to grade any tests and drives home to cook dinner for her husband and kids, tired but in a great mood since she loves her job and her school days.

62

Solutions

VIDEO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

STORY BOARD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

SCRIPT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

69

BLUMBAND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

68

BRACELET . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68

WEBSITE

66 Story Board

Meet Tyler, your typical fourth grader, who just happens to be on his way to lunch. Tyler has a peanut allergy but still eats in the cafeteria every day because he is on a reduced lunch rate.

Every day in line Tyler’s teacher, Mrs. Greene, hands out the students ID cards so they can pay for lunch. Tyler reaches the line, card in hand, and is served his meal.

Upon checkout, however, the computer system alerts the cafete-ria worker of Tyler’s allergy and

notices that there is an item on his tray that he cannot have. Tyler receives his new plate of food and approaches the checkout once more. He enters the cafeteria and goes to sit down with the rest of his classmates. The holdup Tyler experienced in the lunch line means he only has a few minutes to eat his lunch before the students line up and go back to class. Back in the classroom, Tyler glances up and realizes that he has forgotten to take his daily medication. Tyler raises his hand and gets a hall pass from Mrs. Greene. He arrives at the nurse’s office and announces that he is there to take his medi-cine. The nurse goes to her medi-cine cabinet and searches through the bottles to find Tyler’s sitting empty. She sends him back to class and asks him to please let his mom know that he needs a refill. After the rest of his school day, he is picked up by his mother who he forgets to tell about the prescrip-tion refill in his excitement to share what he learned in math class today. On their way home, Tyler’s mom asks him what he ate at lunch today because she is trying to keep him eating healthy. He lies and tells her he ate a salad as he thinks back to the greasy plate of fries he ate earlier that

day. Tyler’s day was full of unexpected complications that would have been easily avoided with the use of a BlumBand. The small, unas-suming bracelet is all he needs for a smooth day at school.

He walks into the cafeteria with his class and lines up for his meal. He scans his bracelet before he is served and the cafeteria worker is alerted of his allergy. He goes immediately to the checkout where he scans his bracelet again and the cafeteria worker immedi-ately uploads his meals informa-tion to BlumBand’s website where Tyler’s mom can check up on him during her break at work. He sits down to enjoy a healthy meal with his friends and is rewarded with a happy green light from his Blum-Band when he eats his broccoli. On his way back to the classroom, his BlumBand lights up again. This time, the bracelet reminds him that it is time for his medi-

cine. Without needing to interrupt class, he gets his hall pass and runs to the nurses office before science even starts.

This time when she realizes that his medication is running low she says “I will be sure to let your mom know that you need a refill.” Then she goes to her computer and sends Tyler’s mom a message through BlumBand’s website. This time, when Tyler’s mom picks him up from school, she already knows that he made good deci-sions today at lunch and is in need of a prescription refill. She rewards him with a big hug and they head home.

67Script

68

Blumband was designed for public school system after an ethnographic study made inside Heard Elementary School. The system that Heard’s is using to control what kids eat, how they pay, and how the cafeteria is notified about each student payment method and health information, such as allergies or health related issues, it’s through an ID card. Each teacher is in charge of handing each student their proper ID card, this method is not only archaic but it delays the lunch line and gives students less time to actually eat their lunches. At the beginning of the school year, when the health forms arrive to the nurse’s office, she will upload each student’s information after carefully revising it. Then the band will go to the school principal where she will upload the payment information and she will also give each student their proper Blumband.

Each student will have a bracelet whether they have any health problem or not. The bracelet will substitute the ID card and the teacher could actually relax and just supervise the kids during lunch hours.Once the students are lined for lunch the bracelet will be scanned at the beginning of the line so that the cafeteria workers can check the allergy’s information. The food will be served to each kid making sure that they can eat what they have on their plates. At the end of the line the bracelet will be scanned again to show if the student have a reduced or free lunch plan.

One feature that will be added to the bracelet is: health recognition. If the kid chooses vegetables, or milk or any healthy item as his lunch components then the bracelet will flash a green card as a sign of approval and reward.

The bracelet can also be programmed to remind the students, teachers and nurse about regular medication. A light will flash at the programmed time to let them know that it is time for that medicine.

BLÜM BANDBracelet

69

The bracelet is not the only feature that would be improved at the public school system. With the Blumband bracelet comes an electronic platform that was created to allowed parents to check on their kids health and to help the nurse with her daily notifications.

The Blumband website is a friendly electronic source where parents can check not only the lunch menus, but also the monthly health flyers that the nurse uploads; what the kids are doing in PE; and it will serve as a direct way of communication between the nurse and the parent.

With the help of Blumband’s email account the nurse will notify the parents about the amount of prescript medication their kids have in the nurse’s cabinet. Making it easier for the nurse to let them know when they need to provide her with more, and it will give parents a decent amount of time to go and get the new prescription.

Each time the bracelet is scanned at the end of the line, and the cafeteria worker updates the

BLÜM BANDWebsite

system with the components each student is eating, the information will be immediately posted on Blumband’s website to allow parent to check what their kids are actually eating.

contextual research

Documents

elementary school students

school cafeteria

distinguished school

georgia school of excellence

college preparatory

elementary schools

schools cafeteria

lunch hours