Snack Quality in Afterschool Programs: Most Programs Offer Fruit or Vegetables Daily

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1 Snack Quality in Afterschool Programs: Most Programs Offer Fruit or Vegetables Daily Jean L. Wiecha Pamela A. Williams Kristen C. Giombi (presenter) RTI International is a registered trademark and a trade name of Research Triangle Institute.

2 Background Over 10 million U.S. children participated in afterschool programs in 2014 U.S. Department of Agriculture recommends school-age children consume 1½ to 2 cups of fruit and 1½ to 3 cups of vegetables per day depending on age and sex No regulatory requirements that afterschool programs serve fruit and vegetables Voluntary 2011 National AfterSchool Association (NAA) Healthy Eating and Physical Activity Standards (HEPA) Fox et al. (2012) found 17% of National School Lunch Program (NSLP) menus for snacks included fresh or canned fruit and 2% included a vegetable 2

3 Methods: Participants Survey participants were from NAA s August 2015 membership database (7,953 original records) Eliminated records without an organization name, with addresses outside of the U.S., and that were not service providers 5,650 records of which 3,677 were unique organizational names and addresses Final recruitment sample: 3,217 Final study sample of 729; analytical sample of 684 who served snack daily 3

4 Methods: Online Survey Assessed nutrition practices consistent with the NAA healthy eating standards 5 items assessed staff training for healthy eating 17-item food and beverage checklist on foods served yesterday or on the previous program day if yesterday was a weekend or holiday Assessed the presence of food and beverage items and their qualities 4

5 Site, Program, and Respondent Characteristics of Sample (N = 684) Characteristics N Percentage 21 st Century Learning Center (CCLC) % Licensed % Accredited % CACFP % NSLP % Primary organizational affiliation School district % Miscellaneous public/private % nonprofit Other small nonprofit/for profit % No affiliation 63 9% 5 CACFP, Child and Adult Care Food Program; CCLC, 21st Century Community Learning Center; NAA, National AfterSchool Association; NSLP, National School Lunch Program. Source: Afterschool Healthy Eating Survey, Fall 2015

6 Site, Program, and Respondent Characteristics of Sample (N = 684), continued Characteristics N Percentage NAA membership % Respondent was previously aware of NAA healthy eating standards % Respondent uses one or more of healthy eating standards % CACFP, Child and Adult Care Food Program; CCLC, 21st Century Community Learning Center; NAA, National AfterSchool Association; NSLP, National School Lunch Program. Source: Afterschool Healthy Eating Survey, Fall

7 Methods: Variables Independent Variables Organizational affiliation (school district vs. other) Licensed Accredited CACFP NSLP Staff training on healthy eating NAA membership Awareness of NAA healthy eating standards Current use of one or more of the standards to guide how they plan and serve foods and beverages Dependent Variables Offered fruit but no vegetable (n = 287) Offered a fruit and a vegetable (n = 123) Offered fruit (with or without vegetable) (n = 410) Offered vegetable (with or without fruit) (n = 146) 7

8 Results: Fruit and Vegetables Offered at Afternoon Snack on Previous Program Day (N = 684) 8 Characteristics Only Fruit Only Vegetables Fruit & Vegetables No Fruit or Vegetables N N % N % N % N % 21 st CCLC site % 2% 22% 37% Licensed site % 4% 19% 32% Accredited site % 2% 26% 31% Respondent is NAA member % 3% 14% 35% Respondent aware of NAA healthy eating standards % 3% 19% 34% Respondent is familiar with healthy eating standards % 3% 17% 30% Respondent uses 1+ of healthy eating standards % 3% 22% 29% Site participates in CACFP % 3% 24% 25% Site participates in NSLP % 1% 18% 36% All programs % 23 3% % %

9 Results: Quality of Fruit and Vegetables Served 350 Respondents Offering Fruit and/or Vegetables on the Previous Day Fruit Fresh Frozen/Canned Vegetables 9

10 Results: Training Frequency Among Staff on Healthy Eating Practices Characteristics Never Less than Once a Year Once a Year More than Once a Year N N % N % N % N % 21 st CCLC site % 23% 38% 10% Licensed site % 20% 43% 13% Accredited site % 23% 32% 19% Respondent is NAA member % 21% 38% 16% Site participates in CACFP % 13% 51% 21% Site participates in NSLP % 23% 35% 12% School district % 25% 32% 8% All programs % % % 80 13% 10

11 Results: Regression Analysis Characteristics School district (1=yes) Licensed (1=yes) Accredited (1=yes) Staff trained in HE more than once a year NAA member (1=yes) CACFP (1=yes) NLSP (1=yes) Use NAA standards (1=yes) Fruit (N = 410) OR (SE) 0.647* (0.12) (0.25) (0.24) 3.691** (1.29) (0.13) (0.13) (0.27) 1.855** (0.34) Vegetable (N = 146) OR (SE) (0.19) (0.22) (0.45) (0.40) 2.624** (0.55) (0.27) (0.18) (0.30) Only Fruit (N = 287) OR (SE) (0.14) 1.413* (0.25) (0.16) 1.796* (0.48) 0.515** (0.09) (0.21) (0.25) 1.416* (0.25) Fruit & Veg (N = 123) OR (SE) (0.16) (0.23) 2.013** (0.54) 2.094* (0.67) 2.384** (0.52) (0.30) (0.24) 1.701* (0.40) 11

12 Summary No national set of standards for food served in afterschool programs, BUT many programs have adopted the NAA healthy eating standards in whole or in part In our study: Majority of sites (63%) offered fruit and/or vegetables as part of a snack on the previous day Sites were most likely to offer fruit alone (42%) or with a vegetable (18%) Sites were unlikely to offer vegetables without also offering fruit (3%) 37% of respondents did not offer fruit or vegetables at their previous snack NAA members were more likely to serve vegetables and both fruit and vegetables as part of a snack and less likely to serve only fruit 12 Respondents from sites that trained staff in healthy eating more than once per year were more likely to provide fruit and fruit and vegetables as snacks

13 Conclusions Data from this report can help inform discussion about strategic directions for the NAA healthy eating standards Standards encourage programs to use federal food programs when possible CACFP and NSLP did not confer benefits controlling for other variables Standards call for delivery of training and nutrition education by qualified professionals but provide little guidance on what this means Clear association between staff training and positive fruit and vegetable snack outcomes NAA s healthy eating standards have likely had a positive impact on offering fruit and vegetables in afterschool programs affiliated with NAA members throughout the country 13

14 Potential Limitations No validation of the self-reported information from the survey Possible reporting biases related to social desirability and nonresponse to specific items Possible underestimation of participation in CACFP, licensing, and accreditation variables Not generalizable to all NAA members or afterschool programs No causation; only associations 14

15 Questions? Kristen C. Giombi RTI International