Fuel for Fun: Cooking with Kids Plus Parents and Play YEAR
1
Complete C4 FU1 and FU2 data collecon Fuel for Fun: Cooking with Kids Plus Parents and Play is an integrated research, extension, educaon project targeng 4th-grade students. Its long-term goal of reducing the risk of childhood obesity will be addressed by promong healthful food and acvity environments, policies and behaviors through: 1) evaluang the efficacy of a 4th grade comprehensive school-based intervenon, 2) designing, implemenng, and evaluang a family-based intervenon, 3) applying it to an aſter-school seng to broaden its reach, and, 4) disseminang both versions through outreach. This experienal school-based program, designed to enhance fruit and vegetable preference, self-efficacy and atudes toward cooking, and physical acvity levels, has 5 components: YEAR 4 1. CWK – Colorado – hands-on cooking and tasng classroom lessons to enhance cooking skills and provide posive experiences with a wide variety of wholesome, healthy foods. 2. Sports, Play, and Acve Recreaon for Kids (SPARK) Acve Recess – physical acvity program designed to encourage maximum parcipaon for every player, regardless of ability. 3. Fuel for Fun (FFF) Cafeteria – classroom lessons linked to healthful foods in the school cafeteria to encourage students to make more healthful choices. 4. Fuel for Fun (FFF) Family – program that engages parents and reinforces what students experience through the classroom, recess, and cafeteria components. 5. About Eang (AE) – on-line healthy eang and acvity resource for parents. Manuscripts Accepted, Under Review and in Preparaon Cunningham-Sabo, L. Lohse, B. et al. Fuel for Fun: Design of school- and family-based randomized controlled trial to promote cooking skills, vegetable consumpon, and physical acvity among 4th-graders (describes study protocol, BMC-Public Health 2016; 16:444; DOI:10.1186/s12889-016-3118-6) Interviews inform translaon of in-school intervenon for out-of-school sengs: Staff, student, and curricular challenges (describes potenal Fuel for Fun curricular and implementaon changes necessary, under review by Aſterschool Maers) ϯ Exploring the relaonship between parent and child physical acvity measured through accelerometry (baseline comparison, under review by Journal of Medicine and Science in Sports and Exercise) ϯ In preparaon: a) Cognive interviews assess face and external validity of cooking survey items in 3rd-5th grade children*, b) Relaonship of eang competence to food and eang behaviors of predominantly non-Hispanic 4th- grade parents, c) Individual fruit and vegetable weights and pan weights are valid methods to esmate elementary student self-service salad bar porons ϯ Student-led publicaon; * Student parcipated in publicaon development Presentaons Cunningham-Sabo, L. Adapng Fuel for Fun for 4-H/STEM educators along the Front Range. Presentaon and training for Colorado 4-H/STEM Agents; May 17, 2016, Greeley, CO. Cunningham-Sabo L. Cooking with kids improves their food preferences, atudes and self-efficacy. Invited presentaon at: Cook and Health Scienfic Symposium, Basque Culinary Center; November 24, 2015, San Sebasan, Spain. Clifford J. Adapng Fuel for Fun for rural Colorado. Presentaon and training for Colorado Family and Consumer Science extension agents; November 9, 2015, Fort Collins, CO. Accepted Abstracts Society for Nutrion Educaon and Behavior July/August 2016 Lohse, B, Smith, S, Nigg, C, Cunningham-Sabo, L. Self-reported change in physical acvity and screen me in 4th graders shows gender, seasonal and weight status differences even in absence of an intervenon effect (poster). Presco, MP, Lohse, B, Smith, S, Cunningham-Sabo, L. Teacher well-being pracces are posively associated with teacher percepons of Fuel for Fun tasng lessons (poster). Lohse, B (organizer, presenter)(Rochester Instute of Technology), Cunningham-Sabo, L (moderator)(Colorado State University), Cronin, K (University of Wisconsin), Olfert, M (West Virginia University), Franzen-Castle, L (University of Nebraska), Faith, M (SUNY-Buffalo). Calling parents and caregivers. . .are you there?. . . can you hear me? (symposium). Academy of Nutrion and Dietecs, Food and Nutrion Conference and Expo October 2016 Riley, R (moderator)(Straight Talk: Nutrion, LLC.), Reicks, M (University of Minnesota), Cunningham-Sabo, L (presenter). Cooking skills: The missing ingredient in healthy eang? October 16, 2016 (symposium). Cunningham-Sabo, L (presenter), Baker, S, McDonnell, B, Clifford, J, Lohse, B, Smith, S. Challenges and opportunies for integrang cooking experience into EFNEP and SNAP-Ed nutrion educaon for children and youth (poster). Data Collecon and Analysis from Cohort 3 Follow-Up 2 and Cohort 4 Baseline Recruited an Addional Control Cohort (C4) to Strengthen Comparisons of Intervenon Impact Average student parcipaon rate: 72% C4; 81% C3; 73% C2; 80% C1 317 C3 students completed follow-up 2 (FU2) surveys and Ht/Wt (85% of cohort at baseline [BL]). 266 C4 students completed BL surveys and Ht/Wt 63 parents completed C3 FU2 parent survey; 106 parents completed C4 BL 15 parent/child pairs completed C3 FU2 3-day diet assessment; 32 parent/child pairs completed C4 BL 3-day diet assessment Accelerometry data (ACC) gathered at 3 schools: C3 139 students, 118 parents; C4 116 students, 102 parents SOPLAY observaon of students’ recess acvity completed 4 mes/school Plate waste assessed from 281 student lunch trays from C3 FU2 and 171 at C4 BL Cognive Interviews to Assess Face and External Validity of Cooking Items in Fuel for Fun Survey “What Does Cooking Mean to Kids?” Recruited and conducted audio-recorded cognive interviews with 24 Northern CO children (12 boys, 9 entering 3rd, 12 entering 4th, and 3 entering 5th grades); 83% white and 33% Hispanic Survey secons assessed: prior cooking experience, cooking atudes, cooking self-efficacy Major themes for parcipants’ definions of “cooking” in order of most to least frequently menoned: 1. Meal/food preparaon acvies not including pre-made/convenience food 2. Non-baked goods prepared using heat 3. Baked goods/desserts 4. Food prepared without using heat 5. Heang pre-made convenience food. Overall, children demonstrated comprehension for the majority of survey items. Independent analyses by second coder for two cooking experience quesons, “Do you make food with family?” and “Do you cook?” found “Do you cook?” was comprehended by all children. “What Does Physical Acvity Mean to Kids?” Iniated interviews in Rochester, NY to assess face validity of PA survey items. Extension Agents Trained on CWK CO Curriculum Trained 3 Family and Consumer Science (FCS) Extension agents from 3 rural CO counes to deliver the Cooking with Kids Colorado (CWK CO) curriculum Documented acvies and feedback from 2 FCS agents on curriculum delivery Surveyed ~20 4-H/STEM Extension agents from CO “Front Range” counes re: current Science, Technology, Engineering, and Math programming efforts, curricula likes/dislikes, and interest in teaching nutrion educaon with cooking component Delivered tailored CWK CO training to ~20 4-H/STEM Extension agents Parent Engagement Literature Review PubMed and ERIC (Educaon Resources Informaon Center) databases were searched to assemble an annotated bibliography specifically related to parent engagement in nutrion and physical acvity educaon programs in schools. 46 arcles met search criteria; 14 reviews and 32 primary research arcles Findings will inform preparaon of a related manuscript Strategies to Adapt Fuel for Fun for EFNEP Audience Review of youth EFNEP curricula Assessed most widely-used 4th grade curricula for type, frequency and depth of content related to EFNEP educaonal priories: diet quality, physical acvity, food safety, food resource management, and cooking/food preparaon skills All curricula included food group-based lessons; lesson length ranged from 30 minutes to ≥ 2 hours Review revealed few cooking and safe food handling experiences Survey of EFNEP program coordinators’ current and future programming with 3rd- 5th graders Survey scope: 4th grade curricula currently used, their perceived strengths and limitaons, extent of food acvies included, feasibility and barriers when including cooking acvies, importance of teaching cooking skills, preferred curriculum length, extent of parent engagement and esmaon of budget for food acvies. Results: 77% response rate (n=58; represenng all 7 EFNEP funding ers); 79% conduct programs in 4th grade, 90% have future plans to include 3rd-5th grades 64% indicated school day as primary educaonal seng, 29% reported aſter school and 7% reported other sengs, e.g., summer camps, churches and recreaonal childcare facilies 76% thought teaching cooking skills was important, yet only 23% reported current youth programming fully meets food preparaon/cooking skills needs of 3rd-5th grade students 85% reported barriers incorporang cooking acvies, e.g., limited class me, food costs/ budget limitaons, cooking not permied by agency, lack of educator skills or self-efficacy, and lack of cooking equipment Program leaders desire a 6-8 lesson experienal series addressing EFNEP evaluaon objecves, grade-specific academic standards, and cooking and tasng acvies. Responders also support food acvies that comply with school food guidelines, and are sufficiently flexible to accommodate limited classroom me and available resources. Educaon and Research Opportunies for University Students Supported 6 graduate (1 PhD, 3 MS, 2 MPH) and 1 undergraduate students Trained 6 undergraduate and 5 graduate students to conduct data collecon and entry Trained 3 graduate students to conduct cognive interviews with 3rd-5th graders Advised 3 honors undergraduate students on their projects/theses Completed 2 MS student research projects: Fuel for Fun Family Blog: Increasing Parent Involvement in Fuel for Fun Through Social Media What Does Cooking Mean to Kids? Cognive Interviews to Assess Face Validity of Fuel for Fun Survey with a New Audience Fuel for Fun: Cooking with Kids Plus Parents and Play L. Cunningham-Sabo¹, B. Lohse², S. Smith¹, J. Clifford¹, S. Baker¹, B. McDonnell¹ ¹Colorado State University, Department of Food Science ²Rochester Instute of Technology, Wegmans School of Health and Nutrion We acknowledge Thompson School District, Poudre School District, Project Steering Commiee, Project Advisory Commiee, Undergraduate and Graduate Students; specifically Mahew Cady, Tessa Komine and Elizabeth Wayman. Disseminaon of Findings Background A ccomplishments Cohort 4 Baseline Next Steps This material is based upon work supported by the Naonal Instute of Food and Agriculture, U.S. Department of Agriculture, under award number 2012-68001-19603. Any opinions, findings, or recommendaons in this publicaon are those of the authors and do not necessarily reflect the view of the U.S. Department of Agriculture. Funder A cknowledgments About Eang n=22 Control n=63 Interested in Diet Assessment n=85 About Eang n=14 Control n=34 Consented to Diet Assessment n=48 About Eang n=2 Control n=1 Not Completed n=3 About Eang n=7 Control n=22 Completed n=29 2 nd Diet Assessment Baseline About Eang n=7 Control n=21 Completed n=28 3 rd Diet Assessment About Eang n=0 Control n=1 Not Completed n=1 About Eang n=4 Control n=17 Not Interested in Diet Assessment n=21 About Eang n=7 Control n=22 Completed Survey and Diet Assessment n=29 About Eang n=26 Control n=80 Completed Survey n=106 About Eang n=2 Control n=6 No Consent n=8 Control n=88 About Eang n=28 Consented to Parci- pate n=116 About Eang n=2 Control n=3 Survey Not Started n=5 About Eang n=0 Control n=5 Ariters n=5 About Eang n=2 Control n=8 Survey Not Completed n=10 About Eang n=30 Control n=94 Eligible n=124 About Eang n=32 Control n=137 Link Accessed n=169 About Eang n=69 Control n=132 Non-responders n=201 About Eang n=101 Control n=269 Project Flyer Sent Home n=370 1 st Diet Assessment About Eang n=9 Control n=23 Completed n=32 About Eang n=5 Control n=11 Not Completed n=16 Control n=8 n=23 n=7 Not Eligible * n=37 About Eat- ing n=1 n=0 Parent No Diet Assessment Consent n=35 No Parcipant Consent n=104 Completed Survey 1 st Round n=245 Baseline Not Interested in Diet Assessment n=176 No Baseline Survey Declined survey-ht/wt only n=1 Not Completed n=6 Completed n=32 3 rd Diet Assessment Not Completed n=2 Completed n=38 2 nd Diet Assessment Not Completed n=10 Completed n=40 1 st Diet Assessment Consented to Diet Assessment n=50 Total Student Populaon n=370 Consent to Use Survey Data n=266 Completed 2 nd Round n=16 Completed Survey n=261 Absent n=19 Parent Interested in Diet Assessment n=85 Student
Transcript of Fuel for Fun: Cooking with Kids Plus Parents and Play YEAR
� Complete C4 FU1 and FU2 data collection (Spring/Fall 2016)
� Complete all project data entry and analyses � Prepare manuscripts and reports on C1-C4 student
and parent survey, dietary, physical activity, and integrated results
� Continue providing technical assistance to FCS and 4-H Extension Agents to deliver CWK CO
� Draft and begin pilot-testing Youth EFNEP curriculum
� Prepare renewal AFRI application to follow C1-C4 participants longitudinally
� Assess feasibility of intervention adoption in schools serving low-income Blacks
Fuel for Fun: Cooking with Kids Plus Parents and Play is an integrated research, extension, education project targeting 4th-grade students. Its long-term goal of reducing the risk of childhood obesity will be addressed by promoting healthful food and activity environments, policies and behaviors through: 1) evaluating the efficacy of a 4th grade comprehensive school-based intervention, 2) designing, implementing, and evaluating a family-based intervention, 3) applying it to an after-school setting to broaden its reach, and, 4) disseminating both versions through outreach. This experiential school-based program, designed to enhance fruit and vegetable preference, self-efficacy and attitudes toward cooking, and physical activity levels, has 5 components:
YEAR 4
1. CWK – Colorado – hands-on cooking and tasting classroom lessons to enhance cooking skills and provide positive experiences with a wide variety of wholesome, healthy foods.
2. Sports, Play, and Active Recreation for Kids (SPARK) Active Recess – physical activity program designed to encourage maximum participation for every player, regardless of ability.
3. Fuel for Fun (FFF) Cafeteria – classroom lessons linked to healthful foods in the school cafeteria to encourage students to make more healthful choices.
4. Fuel for Fun (FFF) Family – program that engages parents and reinforces what students experience through the classroom, recess, and cafeteria components.
5. About Eating (AE) – on-line healthy eating and activity resource for parents.
Manuscripts Accepted, Under Review and in PreparationCunningham-Sabo, L. Lohse, B. et al. Fuel for Fun: Design of school- and family-based randomized controlled trial to promote cooking skills, vegetable consumption, and physical activity among 4th-graders (describes study protocol, BMC-Public Health 2016; 16:444; DOI:10.1186/s12889-016-3118-6)
Interviews inform translation of in-school intervention for out-of-school settings: Staff, student, and curricular challenges (describes potential Fuel for Fun curricular and implementation changes necessary, under review by Afterschool Matters) ϯ
Exploring the relationship between parent and child physical activity measured through accelerometry (baseline comparison, under review by Journal of Medicine and Science in Sports and Exercise) ϯ
In preparation: a) Cognitive interviews assess face and external validity of cooking survey items in 3rd-5th grade children*, b) Relationship of eating competence to food and eating behaviors of predominantly non-Hispanic 4th-grade parents, c) Individual fruit and vegetable weights and pan weights are valid methods to estimate elementary student self-service salad bar portionsϯ Student-led publication; * Student participated in publication development
Presentations Cunningham-Sabo, L. Adapting Fuel for Fun for 4-H/STEM educators along the Front Range. Presentation and training for Colorado 4-H/STEM Agents; May 17, 2016, Greeley, CO.
Cunningham-Sabo L. Cooking with kids improves their food preferences, attitudes and self-efficacy. Invited presentation at: Cook and Health Scientific Symposium, Basque Culinary Center; November 24, 2015, San Sebastian, Spain.
Clifford J. Adapting Fuel for Fun for rural Colorado. Presentation and training for Colorado Family and Consumer Science extension agents; November 9, 2015, Fort Collins, CO.
Accepted AbstractsSociety for Nutrition Education and Behavior July/August 2016Lohse, B, Smith, S, Nigg, C, Cunningham-Sabo, L. Self-reported change in physical activity and screen time in 4th graders shows gender, seasonal and weight status differences even in absence of an intervention effect (poster).
Prescott, MP, Lohse, B, Smith, S, Cunningham-Sabo, L. Teacher well-being practices are positively associated with teacher perceptions of Fuel for Fun tasting lessons (poster).
Lohse, B (organizer, presenter)(Rochester Institute of Technology), Cunningham-Sabo, L (moderator)(Colorado State University), Cronin, K (University of Wisconsin), Olfert, M (West Virginia University), Franzen-Castle, L (University of Nebraska), Faith, M (SUNY-Buffalo). Calling parents and caregivers. . .are you there?. . . can you hear me? (symposium).
Academy of Nutrition and Dietetics, Food and Nutrition Conference and Expo October 2016Riley, R (moderator)(Straight Talk: Nutrition, LLC.), Reicks, M (University of Minnesota), Cunningham-Sabo, L (presenter). Cooking skills: The missing ingredient in healthy eating? October 16, 2016 (symposium).
Cunningham-Sabo, L (presenter), Baker, S, McDonnell, B, Clifford, J, Lohse, B, Smith, S. Challenges and opportunities for integrating cooking experience into EFNEP and SNAP-Ed nutrition education for children and youth (poster).
Data Collection and Analysis from Cohort 3 Follow-Up 2 and Cohort 4 Baseline Recruited an Additional Control Cohort (C4) to Strengthen Comparisons of Intervention Impact
� Average student participation rate: 72% C4; 81% C3; 73% C2; 80% C1 � 317 C3 students completed follow-up 2 (FU2) surveys and Ht/Wt (85% of cohort
at baseline [BL]). 266 C4 students completed BL surveys and Ht/Wt � 63 parents completed C3 FU2 parent survey; 106 parents completed C4 BL � 15 parent/child pairs completed C3 FU2 3-day diet assessment; 32 parent/child
pairs completed C4 BL 3-day diet assessment � Accelerometry data (ACC) gathered at 3 schools: C3 139 students, 118 parents;
C4 116 students, 102 parents � SOPLAY observation of students’ recess activity completed 4 times/school � Plate waste assessed from 281 student lunch trays from C3 FU2 and 171 at
C4 BL
Cognitive Interviews to Assess Face and External Validity of Cooking Items in Fuel for Fun Survey “What Does Cooking Mean to Kids?”
� Recruited and conducted audio-recorded cognitive interviews with 24 Northern CO children (12 boys, 9 entering 3rd, 12 entering 4th, and 3 entering 5th grades); 83% white and 33% Hispanic
� Survey sections assessed: prior cooking experience, cooking attitudes, cooking self-efficacy
� Major themes for participants’ definitions of “cooking” in order of most to least frequently mentioned: 1. Meal/food preparation activities not including pre-made/convenience food 2. Non-baked goods prepared using heat 3. Baked goods/desserts 4. Food prepared without using heat 5. Heating pre-made convenience food.
� Overall, children demonstrated comprehension for the majority of survey items.
� Independent analyses by second coder for two cooking experience questions, “Do you make food with family?” and “Do you cook?” found “Do you cook?” was comprehended by all children.“What Does Physical Activity Mean to Kids?”
� Initiated interviews in Rochester, NY to assess face validity of PA survey items.
Extension Agents Trained on CWK CO Curriculum � Trained 3 Family and Consumer Science (FCS) Extension agents from 3 rural CO
counties to deliver the Cooking with Kids Colorado (CWK CO) curriculum � Documented activities and feedback from 2 FCS agents on curriculum delivery � Surveyed ~20 4-H/STEM Extension agents from CO “Front Range” counties re:
current Science, Technology, Engineering, and Math programming efforts, curricula likes/dislikes, and interest in teaching nutrition education with cooking component
� Delivered tailored CWK CO training to ~20 4-H/STEM Extension agents
Parent Engagement Literature Review � PubMed and ERIC (Education Resources Information Center) databases were searched
to assemble an annotated bibliography specifically related to parent engagement in nutrition and physical activity education programs in schools.
� 46 articles met search criteria; 14 reviews and 32 primary research articles � Findings will inform preparation of a related manuscript
Strategies to Adapt Fuel for Fun for EFNEP Audience Review of youth EFNEP curricula
� Assessed most widely-used 4th grade curricula for type, frequency and depth of content related to EFNEP educational priorities: diet quality, physical activity, food safety, food resource management, and cooking/food preparation skills
� All curricula included food group-based lessons; lesson length ranged from 30 minutes to ≥ 2 hours
� Review revealed few cooking and safe food handling experiences
Survey of EFNEP program coordinators’ current and future programming with 3rd- 5th graders
� Survey scope: 4th grade curricula currently used, their perceived strengths and limitations, extent of food activities included, feasibility and barriers when including cooking activities, importance of teaching cooking skills, preferred curriculum length, extent of parent engagement and estimation of budget for food activities.
� Results: 77% response rate (n=58; representing all 7 EFNEP funding tiers); 79% conduct programs in 4th grade, 90% have future plans to include 3rd-5th grades 64% indicated school day as primary educational setting, 29% reported after school and 7% reported other settings, e.g., summer camps, churches and recreational childcare facilities
� 76% thought teaching cooking skills was important, yet only 23% reported current youth programming fully meets food preparation/cooking skills needs of 3rd-5th grade students
� 85% reported barriers incorporating cooking activities, e.g., limited class time, food costs/budget limitations, cooking not permitted by agency, lack of educator skills or self-efficacy, and lack of cooking equipment
� Program leaders desire a 6-8 lesson experiential series addressing EFNEP evaluation objectives, grade-specific academic standards, and cooking and tasting activities. Responders also support food activities that comply with school food guidelines, and are sufficiently flexible to accommodate limited classroom time and available resources.
Education and Research Opportunities for University Students � Supported 6 graduate (1 PhD, 3 MS, 2 MPH) and 1 undergraduate students � Trained 6 undergraduate and 5 graduate students to conduct data collection and entry � Trained 3 graduate students to conduct cognitive interviews with 3rd-5th graders � Advised 3 honors undergraduate students on their projects/theses
Completed 2 MS student research projects: � Fuel for Fun Family Blog: Increasing Parent Involvement in Fuel for Fun Through
Social Media � What Does Cooking Mean to Kids? Cognitive Interviews to Assess Face Validity of
Fuel for Fun Survey with a New Audience
Fuel for Fun: Cooking with Kids Plus Parents and PlayL. Cunningham-Sabo¹, B. Lohse², S. Smith¹, J. Clifford¹, S. Baker¹, B. McDonnell¹
¹Colorado State University, Department of Food Science ²Rochester Institute of Technology, Wegmans School of Health and Nutrition
We acknowledge Thompson School District, Poudre School District, Project Steering Committee, Project Advisory Committee, Undergraduate and Graduate Students; specifically Matthew Cady, Tessa Komine and Elizabeth Wayman.
Dissemination of Findings
Background Accomplishments
Cohort 4 Baseline Next Steps
This material is based upon work supported
by the National Institute of Food and Agriculture, U.S. Department of Agriculture, under award number 2012-68001-19603. Any opinions, findings, or recommendations in this publication are those of the authors and do not necessarily reflect the view of the U.S. Department of Agriculture.
FunderAcknowledgments
About Eati ngn=22
Controln=63
Interested inDiet Assessment
n=85
About Eati ngn=14
Controln=34
Consented to Diet Assessment
n=48
About Eati ngn=2
Controln=1
Not Completedn=3
About Eati ngn=7
Controln=22
Completedn=292nd Diet Assessment
Baseline
About Eati ngn=7
Controln=21
Completed n=283rd Diet Assessment
About Eati ngn=0
Controln=1
Not Completedn=1
About Eati ngn=4
Controln=17
Not Interested inDiet Assessment
n=21
About Eati ngn=7
Controln=22
Completed Survey and Diet Assessment
n=29About Eati ngn=26
Controln=80
Completed Surveyn=106
About Eati ngn=2
Controln=6
No Consentn=8
Controln=88
About Eati ngn=28
Consented to Parti ci-pate
n=116
About Eati ngn=2
Controln=3
Survey Not Started n=5
About Eati ngn=0
Controln=5
Att ritersn=5
About Eati ngn=2
Controln=8
Survey Not Completed n=10
About Eati ngn=30
Controln=94
Eligiblen=124
About Eati ngn=32
Controln=137
Link Accessedn=169
About Eati ngn=69
Controln=132
Non-respondersn=201
About Eati ngn=101
Controln=269
Project Flyer Sent Homen=370
1st Diet AssessmentAbout Eati ng
n=9Control
n=23
Completed n=32
About Eati ngn=5
Controln=11
Not Completedn=16
Controln=8
n=23n=7
Not Eligible *n=37
About Eat-ingn=1n=0
Parent
No Diet Assessment Consent
n=35
No Participant Consentn=104
Completed Survey 1st Round
n=245
Baseline
Not Interested in Diet Assessment
n=176
No Baseline SurveyDeclined survey-ht/wt only n=1
Not Completedn=6
Completed n=32
3rd Diet Assessment
Not Completed n=2
Completedn=38
2nd Diet Assessment
Not Completedn=10 Completed
n=40 1st Diet Assessment
Consented to Diet Assessment
n=50
Total Student Populationn=370
Consent to Use Survey Data
n=266
Completed 2nd Roundn=16
Completed Surveyn=261
Absentn=19
Parent Interested in Diet Assessment
n=85
Student
