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Cafeteria assessment for elementary schools (CAFES): development, reliability testing, and predictive validity

Kimberly A Rollings1, Nancy M Wells2

  • 1School of Architecture, University of Notre Dame, 110 Bond Hall, Notre Dame, IN, 46556, USA. krolling@nd.edu.

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|October 5, 2018
PubMed
Summary
This summary is machine-generated.

The Cafeteria Assessment for Elementary Schools (CAFES) tool effectively measures school cafeteria environments to improve children's fruit and vegetable intake. This practical assessment helps identify areas for intervention to promote healthier eating habits in schools.

Keywords:
Assessment toolBuilt environmentChildrenDietary intakeElementary school cafeteriaFruit and vegetable consumptionHealthy eatingLunch tray photography

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Area of Science:

  • Nutrition Science
  • Public Health
  • Environmental Health

Background:

  • Childhood obesity and poor nutrition are significant public health concerns.
  • Many U.S. children, particularly from low-income backgrounds, do not meet recommended fruit and vegetable (FV) intake guidelines.
  • School food environments play a crucial role in promoting healthy eating habits.

Purpose of the Study:

  • To develop and validate the Cafeteria Assessment for Elementary Schools (CAFES) tool.
  • To quantify physical attributes of elementary school cafeterias that influence FV selection and consumption.
  • To provide a practical method for assessing and improving school food environments.

Main Methods:

  • CAFES was developed through literature review, expert input, and pilot testing.
  • Reliability was assessed using inter-item correlations, internal consistency (Kuder-Richardson-21), and inter-rater reliability in 50 elementary schools.
  • Predictive validity was evaluated using FV consumption data from lunch tray photography and multi-level modeling.

Main Results:

  • The CAFES tool comprises 198 items across four scales: room, table/display, plate, and food.
  • High internal consistency (KR-21 overall: 0.88) and inter-rater reliability (90%) were achieved.
  • CAFES scores significantly predicted the percentage of FV consumed (p < .05), indicating strong predictive validity.

Conclusions:

  • CAFES is a practical, low-cost tool for assessing school cafeteria environments.
  • It aids in identifying intervention areas and developing strategies to promote healthy eating.
  • Findings can inform guidelines for cafeteria design, food presentation, and operations to boost FV consumption among students.