Baseline NUTRITION SERVICES QUESTIONNAIRE Instructions: Unless otherwise indicated, all questions refer to the current school year at: School Name Please fill out the questionnaire by clicking once on the circle or box next to the appropriate answer. When indicated, you may choose multiple answers. If the question requires you to write in an answer, please click once within the text box next to the question and type your answer. The purpose of this questionnaire is to gain a better understanding of how nutrition-related policies and practices affect meal participation rates and other outcomes; we do not necessarily recommend any of the practices or policies listed. This questionnaire will take approximately 30 minutes or less to complete. Upon receipt of this questionnaire, this page (which includes the school name) will be removed and a study ID number will be assigned to your questionnaire. Once you have completed the questionnaire, please save it to your computer and then e-mail your completed questionnaire to jshaw@nature.berkeley.edu by May 31, 2007. You may also print the questionnaire, complete it by hand, and mail it to: Jennifer Shaw Center for Weight and Health 3 Giannini Hall University of California, Berkeley Berkeley, CA 94720-3100 If you have any questions, please do not hesitate to contact Jennifer Shaw at the e-mail above or by phone at (510) 643-0312. THANK YOU! A. Title of primary person who completed the questionnaire: B. Titles of others who assisted with completing the questionnaire: -------------------------------------------------------------------------------------------------------------------------- SOME HELPFUL HINTS: To change responses: For responses that are circles or bubbles, you may change your answer by clicking on another answer For responses that are in checkboxes, you may uncheck your answer by clicking on the checked box 1 UC Berkeley Center for Weight and Health RWJ Baseline Nutrition Services Questionnaire 4/30/2007
Site ID: 1. For the current school year, what percentage of students at this school is eligible for: a. Free meals % b. Reduced price meals % 2. The meals at this school are provided by: (choose one) the district nutrition services department a food service management company catered by another school district other, describe: 3. Please indicate the length of the following: a. Length of lunch period: minutes (give range if varies) b. Length of breakfast period: minutes (give range if varies) c. Length of nutrition (or mid-morning) break: minutes (give range if varies) 4. Does this school offer the following? (check all that apply) grab n go lunch 2 nd chance breakfast lunch in classrooms grab n go breakfast breakfast in classrooms Other (please explain): 5. Is the campus: (choose one) closed at lunch time for all students closed at lunch time for some students, explain: open at lunch time (skip to Q7) 6. Do students leave campus despite the closed campus policy? (choose one) yes, many do yes, some do no, very few do 7. Mark the venues that usually sell foods and beverages during each time period listed below: (Check all that apply for each row) Food service ala carte Vending machines School stores Sales by other school groups None a. Before school/ breakfast time b.mid-morning break c. Lunch time d.after school e. All day (during school hours) f. Other times (explain): g.other times (explain): 2 UC Berkeley Center for Weight and Health RWJ Baseline Nutrition Services Questionnaire - 4/30/2007
Site ID: 8. Are the following sources of foods and beverages easily accessible to students off-campus during (or within a half hour) of the school day? a. Fast food restaurants Yes No b. Other affordable restaurants Yes No c. Mobile snack bars, carts, lunch wagons, etc. Yes No d. Convenience stores Yes No d. Other: 9. Please answer the following questions about the nutrition component of this district s wellness policy. a. Does this district have a board-approved nutrition policy? Yes No b. Was this nutrition policy drafted or revised within the last 2 years? Yes No c. Does this district have a written plan for implementing the nutrition policy? Yes No 10. To what extent has the nutrition component of this district s wellness policy been implemented at this school (choose one)? not at all (<10%) to some extent (10-50%) to a large extent (50-90%) completely (>90%) 11. To what extent is each of the following true at this school (regardless of whether or not it is included in the district policy): a. From ½ hour before to ½ hour after the school day all foods and beverages sold for fundraising purposes adhere to the SB 12 and 965 nutrition standards b. Policies have been developed and implemented to restrict the types of foods and beverages which can be offered free to students at school and classroom activities Not at all (<10%) To some extent (10-50%) To a large extent (50-90%) Completely (>90%) c. Foods and beverages are not used as a reward d. Nutrition education is offered to all students in all grades e. A school garden is part of the nutrition education curriculum for all students f. Other interactive educational strategies such as cooking, taste testing, visits to farms or farmers markets are incorporated into the curricula for all students g. The nutrition services department is actively involved in the planning and delivery of nutrition education for students 3 UC Berkeley Center for Weight and Health RWJ Baseline Nutrition Services Questionnaire - 4/30/2007
Site ID: 12. Who currently monitors adherence to the nutrition standards for competitive 1 foods and beverages at this school? (check all that apply) Monitoring plan is not yet in place No one has yet been designated Each sales venue is expected to self-monitor their adherence Principal Nutrition services director Nutrition services site supervisor Other(s), list job title(s) 13. What strategies are currently being employed to ensure implementation and adherence to the nutrition standards at this school? (check all that apply) Elimination or large reduction in food service a la carte food and beverage offerings Elimination or large reduction in other competitive 1 food and beverage offerings (i.e. in vending machines, school stores, etc.) All food and beverage sales have been placed under nutrition services department control Lists of allowable foods and beverages are distributed to all individuals or groups in charge of selling competitive foods and beverages Periodic checks of each sales venue are made to ensure all food and beverage items are compliant Each campus sales venue submits a list of food and beverage items to a school official who must approve all items on the list Other, describe: None 1 Competitive foods refers to all individual food and beverage items sold to students on campus in venues such as food service ala carte, vending machines and school stores. 4 UC Berkeley Center for Weight and Health RWJ Baseline Nutrition Services Questionnaire - 4/30/2007
Site ID: 14. To what extent do the following stakeholders support the implementation of SB 12, SB 965 and related nutrition policies? a. School board Very resistant Somewhat resistant Neutral Supportive, but not very involved Supportive and involved Not applicable b. Superintendent c. Other district administrators d. School principal e. Other school administrators f. Parents g. Parent organizations that sell foods and/or beverages h. Students i. Student organizations that sell foods and/or beverages j. Athletic/other school programs that sell foods and/or beverages k. Classroom teachers l. Nutrition services director m. Nutrition services staff n. School nurse o. PE teachers/specialists p. Community members/residents q. Representatives of community agencies r. Local business representatives 15. During the current school year how has student input been sought regarding which foods and beverages are offered at this school? (check all that apply) no student involvement this year taste testing interviews, questionnaires or surveys of students informal input from students student committee or group helps select menu items on a regular basis students involved in food and beverage product development other, describe: 5 UC Berkeley Center for Weight and Health RWJ Baseline Nutrition Services Questionnaire - 4/30/2007
Site ID: 16. During the current school year how have students at this school been involved in promoting healthy eating and/or the meal program? (check all that apply) not involved participated in presentations for other students developed educational materials participated in a campaign, promotional activities or events other (please specify): 17. To what extent are the following changes needed in terms of SB 12 & 965 compliant foods and beverages that are available to your school district (choose one response for each item): a. More variety b. Less expensive options c. Better tasting options d. More appealing packaging e. Healthier options f. Other (please list): Very much needed Somewhat needed Not needed g. Other (please list): 18. During this school year, about what percent of reimbursable school lunch options at this school included the following? (Please approximate the percentage of meal options at this school that include each item.) a. Low-fat entrees ( 30% calories from fat) b. Deep-fried foods c. Whole grains (grain product containing >50% whole grains) d. Fresh fruits e. Fresh Vegetables (cooked or raw) f. Entrees prepared on-site from basic ingredients g. Heat and serve entrees 0-25% 26-50% 51-75% 76-100% 6 UC Berkeley Center for Weight and Health RWJ Baseline Nutrition Services Questionnaire - 4/30/2007
Site ID: 19. During this school year what efforts have been made to promote the school meal program? (Check all that apply) Distributed free and reduced price meal program applications to parents Displayed promotional materials (posters, displays, etc) on campus Posted promotional materials or information on the school or district website Distributed promotional materials (e.g. specially designed menus, flyers) to parents Distributed promotional materials (e.g. specially designed menus, flyers) to students Placed promotions or information in the school newspaper or newsletter Displayed menu boards that include photos or other design elements intended to promote meal participation Other, describe: 20. To what extent are the district s cafeteria facilities & equipment sufficient to do the following for/at this school? a. Serve students efficiently b. Prepare meals from basic ingredients (as opposed to heat & serve) c. Conduct nutrient analyses d. Conduct menu planning Good Adequate Insufficient 21. To what extent is the district s cafeteria staffing sufficient to do the following for/at this school? a. Serve students efficiently b. Prepare meals from basic ingredients (as opposed to heat & serve) c. Conduct nutrient analyses d. Conduct menu planning Good Adequate Insufficient 7 UC Berkeley Center for Weight and Health RWJ Baseline Nutrition Services Questionnaire - 4/30/2007
Site ID: 22. To what extent are the following barriers to providing healthy meal and a la carte options that appeal to students at this school? a. Labor costs b. Food and beverage costs c. Staff skills d. Inadequate kitchen facilities e. Inadequate points of service f. Inadequate eating/serving equipment/facilities g. Student preferences h. Student complaints/opposition i. Sale of competitive foods not under nutrition services dept. control j. Lack of school/district support k. Lack of parent/community support Not a barrier Minor barrier Major barrier Any additional comments or explanations to your responses in the survey: Thank-you for your time and valuable insights! Don t forget to save this completed questionnaire to your computer if you are filling it out electronically. Instructions on returning the questionnaire are on the front page. 8 UC Berkeley Center for Weight and Health RWJ Baseline Nutrition Services Questionnaire - 4/30/2007
Endpoint NUTRITION SERVICES QUESTIONNAIRE Instructions: Unless otherwise indicated, all questions refer to the 2007-2008 school year at: enter school name Please fill out the questionnaire by clicking once on the circle or box next to the appropriate answer. When indicated, you may choose multiple answers. If the question requires you to write in an answer, please click once within the text box next to the question and type your answer. The purpose of this questionnaire is to gain a better understanding of how nutrition-related policies and practices affect meal participation rates and other outcomes. We do not necessarily recommend any of the practices or policies listed. This questionnaire will take approximately 30 minutes or less to complete. Upon receipt of this questionnaire, this page (which includes the school name) will be removed and a study ID number will be assigned to your questionnaire. Once you have completed the questionnaire, please save it to your computer and then email your completed questionnaire to pegfarrell@gmail.com by May 5, 2008. You may also print the questionnaire, complete it by hand, and mail or fax to: Peg Hardaway Farrell, PhD Center for Weight and Health; 3 Giannini Hall University of California; Berkeley, CA 94720-3100 Fax: 510-642-4612 If you have any questions, please do not hesitate to contact Peg Farrell at the e-mail above or by phone at 510-642-9969. THANK YOU! A. Title of primary person who completed the questionnaire: Is this the same person who completed this questionnaire last year (Spring 2007)? Yes No Comments / Explanations: B. Titles of others who assisted with completing the questionnaire: Are these the same persons who completed this questionnaire last year (Spring 2007)? Yes No Comments / Explanations: Some helpful hints: For responses that are circles or bubbles, you may change your answer by clicking on another answer For responses that are in checkboxes, you may uncheck your answer by clicking on the checked box
Nutrition Services Questionnaire 2 Site ID: enter site ID 1. For the 2007-2008 school year, what percentage of students at this school is eligible for: a. Free meals % b. Reduced price meals % 2. The meals at this school are provided by: (choose one) The district nutrition services department A food service management company Catered by another school district Other, describe: 3. Please indicate the length of the following: a. Length of lunch period: minutes (give range if varies) b. Length of breakfast period: minutes (give range if varies) c. Length of nutrition (or mid-morning) break: minutes (give range if varies) 4. Does this school offer the following? (check all that apply) Grab n go lunch 2 nd chance breakfast Lunch in classrooms Grab n go breakfast Breakfast in classrooms Other (please explain): 5. Is the campus: (choose one) Closed at lunch time for all students Closed at lunch time for some students. Explain: Open at lunch time (skip to Q7) 6. Do students leave campus despite the closed campus policy? (choose one) Yes, many do Yes, some do No, very few do UC Berkeley Center for Weight and Health RWJ Endpoint Nutrition Services Questionnaire - 4/15/2008
Nutrition Services Questionnaire 3 Site ID: enter site ID 7. Mark the venues that usually sell foods and beverages during each time period listed below: (Check all that apply for each row) Before school/ breakfast time Mid-morning break Lunch time After school All day (during school hours) Other times (explain): Food service a la carte Vending machines School stores Sales by other school groups None Other times (explain): 8. Are the following sources of foods and beverages easily accessible to students offcampus during (or within a half hour) of the school day? a. Fast food restaurants Yes No b. Other affordable restaurants Yes No c. Mobile snack bars, carts, lunch wagons, etc. Yes No d. Convenience stores Yes No e. Other: 9. Please answer the following questions about the nutrition component of this district s wellness policy. a. Does this district have a board-approved nutrition policy? Yes No b. Was this nutrition policy drafted or revised within the last 2 years? Yes No c. Does this district have a written plan for implementing the nutrition policy? Yes No 10. To what extent has the nutrition component of this district s wellness policy been implemented at this school (choose one)? Not at all (<10%) To some extent (10-50%) To a large extent (50-90%) Completely (>90%) UC Berkeley Center for Weight and Health RWJ Endpoint Nutrition Services Questionnaire - 4/15/2008
Nutrition Services Questionnaire 4 Site ID: enter site ID 11. To what extent is each of the following true at this school (regardless of whether or not it is included in the district policy): From a ½ hour before to a ½ hour after the school day all foods and beverages sold for fundraising purposes adhere to the SB 12 and 965 nutrition standards Policies have been developed and implemented to restrict the types of foods and beverages which can be offered free to students at school and classroom activities Foods and beverages are not used as a reward Nutrition education is offered to all students in all grades A school garden is part of the nutrition education curriculum for all students Other interactive educational strategies such as cooking, taste testing, visits to farms or farmers markets are incorporated into the curricula for all students The nutrition services department is actively involved in the planning and delivery of nutrition education for students Not at all (<10%) To some extent (10-50%) To a large extent (50-90%) Completely (>90%) 12. Who currently monitors adherence to the nutrition standards for competitive foods and beverages at this school? (check all that apply) Monitoring plan is not yet in place No one has yet been designated Each sales venue is expected to self-monitor their adherence Principal Nutrition services director Nutrition services site supervisor Other(s), list job title(s) UC Berkeley Center for Weight and Health RWJ Endpoint Nutrition Services Questionnaire - 4/15/2008
Nutrition Services Questionnaire 5 Site ID: enter site ID 13. What strategies are currently being employed to ensure implementation and adherence to the nutrition standards at this school? (check all that apply) Elimination or large reduction in food service a la carte food and beverage offerings Elimination or large reduction in other competitive food 1 and beverage offerings (i.e., in vending machines, school stores, etc.) All food and beverage sales have been placed under nutrition services department control Lists of allowable foods and beverages are distributed to all individuals or groups in charge of selling competitive foods and beverages Periodic checks of each sales venue are made to ensure all food and beverage items are compliant Each campus sales venue submits a list of food and beverage items to a school official who must approve all items on the list Other, describe: None 1 Competitive foods refers to all individual food and beverage items sold to students on campus in venues such as food service ala carte, vending machines and school stores. 14. To what extent do the following stakeholders support the implementation of SB 12, SB 965 and related nutrition policies? (Check more than one box if support within a stakeholder group varied.) a. School board Very resistant Somewhat resistant Neutral Supportive, but not very involved Supportive and involved Not applicable b. Superintendent c. Other district administrators d. School principal e. Other school administrators f. Parents g. Parent organizations that sell foods and/or beverages h. Students UC Berkeley Center for Weight and Health RWJ Endpoint Nutrition Services Questionnaire - 4/15/2008
Nutrition Services Questionnaire 6 Site ID: enter site ID i. Student organizations that sell foods and / or beverages Very resistant Somewhat resistant Neutral Supportive, but not very involved Supportive and involved Not applicable j. Athletic / other school programs that sell foods and / or beverages k. Classroom teachers l. Nutrition services director m. Nutrition services staff n. School nurse o. PE teachers / specialists p. Community members / residents q. Representatives of community agencies r. Local business representatives 15. During the 2007-2008 school year, how has student input been sought regarding which foods and beverages are offered at this school? (check all that apply) No student involvement this year Taste testing Interviews, questionnaires or surveys of students Informal input from students Student committee or group helps select menu items on a regular basis Students involved in food and beverage product development Other, describe: UC Berkeley Center for Weight and Health RWJ Endpoint Nutrition Services Questionnaire - 4/15/2008
Nutrition Services Questionnaire 7 Site ID: enter site ID 16. During the 2007-2008 school year, how have students at this school been involved in promoting healthy eating and/or the meal program? (check all that apply) Not involved Participated in presentations for other students Developed educational materials Participated in a campaign, promotional activities or events Other (please specify): 17. To what extent are the following changes needed in terms of SB 12 & 965 compliant foods and beverages that are available to your school district (choose one response for each item): a. More variety b. Less expensive options c. Better tasting options d. More appealing packaging e. Healthier options f. Other (please list): g. Other (please list): Very much needed Somewhat needed Not needed 18. During the 2007-2008 school year, about what percent of reimbursable school lunch options at this school included the following? (Please approximate the percentage of meal options at this school that include each item.) a. Low-fat entrees ( 30% calories from fat) b. Deep-fried foods c. Whole grains (grain product containing >50% whole grains) d. Fresh fruits e. Fresh Vegetables (cooked or raw) f. Entrees prepared on-site from basic ingredients g. Heat and serve entrees 0-25% 26-50% 51-75% 76-100% UC Berkeley Center for Weight and Health RWJ Endpoint Nutrition Services Questionnaire - 4/15/2008
Nutrition Services Questionnaire 8 Site ID: enter site ID 19. During the 2007-2008 school year, what efforts have been made to promote the school meal program? (Check all that apply) Distributed free and reduced price meal program applications to parents Displayed promotional materials (posters, displays, etc) on campus Posted promotional materials or information on the school or district website Distributed promotional materials (e.g. specially designed menus, flyers) to parents Distributed promotional materials (e.g. specially designed menus, flyers) to students Placed promotions or information in the school newspaper or newsletter Displayed menu boards that include photos or other design elements intended to promote meal participation Other, describe: 20. To what extent are the district s cafeteria facilities & equipment sufficient to do the following for/at this school? a. Serve students efficiently b. Prepare meals from basic ingredients (as opposed to heat & serve) c. Conduct nutrient analyses d. Conduct menu planning Good Adequate Insufficient 21. To what extent is the district s cafeteria staffing sufficient to do the following for/at this school? a. Serve students efficiently b. Prepare meals from basic ingredients (as opposed to heat & serve) c. Conduct nutrient analyses d. Conduct menu planning Good Adequate Insufficient UC Berkeley Center for Weight and Health RWJ Endpoint Nutrition Services Questionnaire - 4/15/2008
Nutrition Services Questionnaire 9 Site ID: enter site ID 22. To what extent are the following barriers to providing healthy meal and a la carte options that appeal to students at this school? a. Labor costs b. Food and beverage costs c. Staff skills d. Inadequate kitchen facilities e. Inadequate points of service f. Inadequate eating/serving equipment/facilities g. Student preferences h. Student complaints/opposition i. Sale of competitive foods not under nutrition services dept. control j. Lack of school/district support k. Lack of parent/community support Not a Barrier Minor Barrier Major Barrier 23. On a scale of 1 to 5, please rate the impact the state-mandated nutrition standards (SB 12 and 965) have had on the following at this school. (Please mark one response for each item listed below.) a. Financial Status of the school food service department b. Financial status of other groups or departments that sell foods and beverages on campus c. Sales of individual food and beverage items on campus (not reimbursable meals) d. Healthfulness of the foodservice a la carte foods and beverages e. Healthfulness of the foods and beverages sold by other groups or departments on campus Very Negative Impact Somewhat Negative Impact No Impact Somewhat Positive Impact Very Positive Impact UC Berkeley Center for Weight and Health RWJ Endpoint Nutrition Services Questionnaire - 4/15/2008
Nutrition Services Questionnaire 10 Site ID: enter site ID f. Student acceptance of fat and/ or sugar modified products, such as baked chips, sports drinks, and lower fat/sugar cookies, that are compliant with the nutrition standards g. Student acceptance of other foods and beverages that are compliant, such as fruits, nuts, yogurt, low-fat milk, and water h. Student interest in healthier eating i. School wellness policy adoption and implementation j. Communication with parents and/or other members of the community Very Somewhat Somewhat Very Negative Negative No Positive Positive Impact Impact Impact Impact Impact 24. Do you believe that the items offered at this school that are compliant with the nutrition standards are healthier than the non-compliant foods and beverages you previously (or currently) offered? All or most are healthier Some are healthier None or very few are healthier Any additional comments or explanations to your responses in the survey: Thank-you for your time and valuable insights! Don t forget to save this completed questionnaire to your computer. Instructions on returning the questionnaire are on the front page. UC Berkeley Center for Weight and Health RWJ Endpoint Nutrition Services Questionnaire - 4/15/2008