Abstract
To assess the impact of innovative, student-centered strategies based on behavioral economics to increase school lunch participation and intake of fruits and vegetables by middle and high school students in the San Francisco Unified School District in California. Using a cluster-randomized controlled trial design, we will assess the 2-year impact of implementing a 3-pronged intervention involving a SmartMeal technology platform, distributed points of sale, and staff promotion of school meals on school lunch participation and intake of fruits and vegetables by 7th-10th grade students from 12 middle and high schools compared to 12 control schools. The primary outcome is the difference in change over two years in average daily participation in school lunch between intervention and control schools. We will use a linear regression model in order to adjust for school enrollment, free and reduced price school meal enrollment, and race/ethnic composition. Several unanticipated challenges have delayed implementation of the intervention and its subsequent evaluation. These challenges are similar to those faced by many large, urban school districts seeking to implement a project of this scope, and thus provide important insight for districts seeking to implement similar interventions.
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