Joshua Bennetts, Jennifer White, Hayley Croft, Joyce Cooper, Dawn McIvor, Nicholas Eadie, Marcelle Appay, Aaron L Sverdlov, Doan Ngo
Pharmacist-led medication management services: a qualitative exploration of transition-of-care cardiovascular disease patient experiences
BMJ open
strategies reduce childhood obesity improve nutrition include creating school food environments promote healthy eating despite welldocumented health benefits fruit vegetable fv consumption many us schoolaged children especially lowincome youth fail meet national dietary guidelines fv intake cafeteria assessment elementary schools cafes developed quantify physical attributes elementary school cafeteria environments associated students selection consumption fv cafes procedures require observation cafeteria environment preparation serving eating occur staff interviews photography scoring cafes development included three phases first assessment items identified via literature review expert panel review pilot testing second reliability testing included calculating interitem correlations internal consistency kuderrichardson21 coefficients interrater reliability percent agreement based data collected 50 elementary schools lowincome communities 3187 national school lunch program participants four us states least 43 participating schools students qualified free reducedprice meals third fv servings consumption data obtained lunch tray photography multilevel modeling used assess predictive validity cafes cafes 198 items grouped 108 questions capture four environmental scales room 50 points tabledisplay 133 points plate 4 points food 11 points internal consistency kr21 088 overall 080 room 072 table 083 plate 058 food room subscales include ambient environment appearance windows layoutvisibility healthy signage kitchenserving area table subscales include furniture availability display layoutpresentation serving method variety interrater reliability percent agreement final cafes tool 90 predictive validity analyses indicated total cafes four measurement scale scores significantly associated percentage consumed fv served p 05 cafes offers practical lowcost measurement tool school staff design public health practitioners researchers identify critical areas intervention suggest low nocost intervention strategies contribute guidelines cafeteria design food presentation layout operations aimed promoting healthy eating among elementary school students