Implementing Smarter Lunchrooms Makeovers in New York state middle schools: an initial process evaluation

Area of Science:

• Nutrition Science
• Public Health
• Environmental Interventions

Background:

• The Smarter Lunchrooms Movement (SLM) is a randomized controlled trial (RCT) designed to increase healthy eating among middle school students.
• The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework was adapted to evaluate the process of SLM interventions in school cafeterias.

Purpose of the Study:

• To conduct a process evaluation of the SLM intervention using the RE-AIM framework.
• To identify barriers and facilitators to intervention fidelity and assess implementer training and support needs.

Main Methods:

• A six-week implementation of SLM interventions (fruit, vegetable, or unflavored milk) in 13 New York middle school cafeterias.
• Process evaluation included lunchroom audits, environmental assessments, and interviews with school food service staff and community partners.

Main Results:

• Approximately 75% of students were exposed to the SLM intervention.
• Modest implementation fidelity was observed, with potential contamination from other nutrition activities.
• School staff found treatments acceptable and feasible, but motivation and perceived effectiveness varied; limited protocol maintenance was noted post-intervention.

Conclusions:

• The RE-AIM framework effectively guided the process evaluation.
• Findings highlight implementation barriers and facilitators crucial for interpreting outcome data and informing future SLM RCT iterations.
• Results offer insights for designing effective environmental interventions in school settings.