Project Overview

The Smarter Lunchroom Movement utilizes principles of

behavioral economics to make small, low or no-cost

environmental changes in school lunchrooms to improve the

selection of healthful foods by students.

The current research project aims to build upon findings

from several successful pilot studies, and test these

environmental changes on a larger scale in several urban

and rural public middle school lunchrooms in New York.

• Year 2: Test single lunchroom changes

• Year 3: Test combination lunchroom changes

In Year 3, the objective was to determine the impact of

combining multiple Smarter Lunchroom interventions on the

selection and consumption of healthy food items in the

school lunchroom. This design was informed by the positive

results of single Smarter Lunchroom protocols in Year 2.

Year 3: Intervention Overview

• 11* middle schools from urban and rural districts in

Western New York participated during the 2014-2015

school year.

• Fall 2014: 5 schools (2 urban, 3 rural) received the

intervention, and 6 schools (3 urban, 3 rural) were control

schools.

• Spring 2015: control schools became treatment schools,

and treatment schools became maintenance schools.

• Maintenance schools were observed to see if they

continued implementing Smarter Lunchrooms protocols,

after the intervention period was completed.

• The intervention combined Smarter Lunchroom protocols

targeted at increasing the convenience, visibility, and

attractiveness of fruits, vegetables, and white milk.

• Combined intervention included (See Figure 1):

1. Promotion of fruits: locating fruit first & in multiple

locations, using large fruit bowl & attractive serving cups

for fruits, labeling fruit with creative names, and

displaying fruit factoid posters.

2. Promotion of vegetables: locating vegetables after

entrée & at multiple locations, using attractive serving

cups for vegetables, labeling vegetables with creative

names, and displaying vegetable factoid posters.

3. Promotion of low-fat white milk: labeling white milk,

displaying low-fat white milk in front of flavored milk, and

as 1/3 of visible beverages.

* One urban school was eliminated due to inability to

implement intervention.

Acknowledgements

This project was supported by Agriculture and

Food Research Initiative Grant no. 2012-68001-

19604 from the USDA National Institute of Food and

Agriculture, Childhood Obesity Prevention:

Integrated Research, Education, and Extension to

Prevent Childhood Obesity – A2101.

For more information, visit:

http://www.smarterlunchrooms.org

Smarter Lunchrooms Randomized Control Trial: Results from Year 3Katherine Greene MPH, 1 Gnel Gabrielyan Ph.D. 1 Adam Brumberg, 1

Jamie Dollahite Ph.D., 2 David Just Ph.D., 1 Brian Wansink Ph.D., 1

1 Cornell University, Charles H. Dyson School of Applied Economics and Management 2 Cornell University, Division of Nutritional Science

Year 3: Results

The results below are limited to schools from the Fall

2014 intervention group (n=5). To evaluate

sustainability, we compared Fall 2014 pre intervention

data with Spring 2015 post-intervention data.

• Fruit selection increased overall by 11% (p<0.05),

mainly due to a 33% (p<0.001) increase in urban

schools.

• Fruit consumption decreased overall by 6%

(p<0.001), primarily due to a 7% (p<0.001) decrease

in rural schools.

• Vegetable selection decreased overall by 27%

(p<0.001).

• Vegetable consumption decreased by 4% (p<0.05)

in all schools, mainly due to an 8% (p<0. 001) in rural

schools.

Methods

Quarter Waste Method of Visual Estimation: measures the

percent of each item that was wasted on a tray. Researchers

visited the cafeterias pre- and during-intervention to record

the selection and waste of students who purchased a school

lunch. Researchers observed whether 0%, 25%, 50%, 75%,

or 100% of each food item was left on the tray.

The pre-intervention was a period of 3 weeks, and the

intervention was a period of 6-weeks. Schools switched

conditions at the midpoint of the year.

Year 4: Intervention Overview

Based on process evaluation findings of varying

fidelity, a new research objective was identified to

test a.) fewer protocol items, and b.) food service

ownership of intervention.

• 18 New York middle schools were recruited

during the Spring 2016 semester.

• Schools were allocated into 3 groups: selection,

matched/ assigned, and control

1. Selection: created their own intervention

from a list of protocols

2. Matched/ assigned: matched with selection

school based on practices, and assigned

same protocols.

3. Control: made no changes to existing set up.

• Intervention was completed May 2016.

School Location Group* White Black Hispanic OtherEconomic

Disadvantage**

Enrollment

(Grades 5-8)

1 Rural Control 42% 9% 46% 3% 77% 465

2 Rural Control 76% 5% 10% 9% 62% 509

3 Rural Control 94% 1% 3% 1% 54% 271

4 Rural Treatment 64% 3% 25% 8% 73% 501

5 Rural Treatment 84% 2% 10% 4% 39% 450

6 Rural Treatment 59% 4% 22% 15% 75% 505

7 Urban Control 2% 90% 5% 3% 80% 344

8 Urban Control 5% 13% 78% 4% 88% 337

9 Urban Control 13% 73% 11% 3% 85% 285

10 Urban Treatment 28% 47% 15% 9% 78% 297

11 Urban Treatment 14% 39% 20% 27% 91% 385

Figure 1: Intervention Protocol Diagram

Lunch Line Progression

!"#$%' ( ) * + -1 3-1?>25*3

@*>' & *5*A>*B*>1' 1., 3*7.1

/27 *21->5 1** .0* +(, -. ' 7 3-1?>25

Fruit is

displayed first

on the line.

Monkey Fuel Fantastic

Fruit

Weekly Fruit Factoid

Creative names

displayed on school lunch

menu/ daily menu board.

Broccoli

Bites

Weekly Vegetable Factoid

Large fruit bowl

is displayed at

eye-level

Creative name cards are

displayed next to fruit,

vegetable and white milk

options.

At least 2 fruit options and 2

vegetable options displayed

in 2 separate locations.

Vegetable

displayed after

the entrée.

Ice Cold White Milk

White milk makes up at

least 1/3 of all visible

beverages in each cooler

Laminated Fruit and

Vegetable Factoids

displayed in a visible

location.

X-Ray Vision

Carrots

& Hummus

Today’s Menu:

• Turkey Burger

• Wheat Bun

• Fantastic Fruit

• Monkey Fuel

• X-Ray Vision

Carrots & Hummus

• Broccoli Bites

• Ice Cold White Milk

Year 3 Demographic and Enrollment Data of School Sample

0

0.2

0.4

0.6

0.8

1

1.2

All Urban Rural All Urban Rural

Selection Consumption

Aver

age

Am

ou

nt

of

Fru

it I

tem

s S

elec

ted

or

Con

sum

ed

Fruit Selection & Consumption

Fall 2014 Intervention Schools

Fall Pre

Fall Post

Spring Pre

Spring Post

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

All Urban Rural All Urban Rural

Selection Consumption

Aver

age

Am

ou

nt

of

Veg

etab

le I

tem

s S

elec

ted

or

Con

sum

edVegetable Selection & Consumption

Fall 2014 Intervention Schools

Fall Pre

Fall Post

Spring Pre

Spring Post

Year 3: Discussion

It is possible that combination interventions may not

be as effective as single interventions (i.e. fruit or

vegetable only), which previously had demonstrated

positive results (Greene et al., 2016; Gabrielyan et

al. 2016). Additionally, the amount of protocol items

may have been too difficult for staff to implement.

Additional analysis, including diff-in-diff and group

mean t-tests will be performed to better understand

the impact over multiple groups and periods of time.

Lastly, process data will be incorporated into the

analysis, to determine impacts of fidelity.