Table 1.
Healthy Hunger-Free Kids Act (HHFKA) provisions assessed in the Healthy Communities Study
| Variable | Effective date | Instrument | Measurement |
|---|---|---|---|
| HHFKA provision | |||
| 1. Reimbursable school meal nutrition standards | July 2012a | Food service manager survey | Original question: “To what extent have each of the following components (reimbursable school meal goals) of the local wellness policy been implemented at this school and for how many years have they been in place?” 1=To a limited extent or not at all (<10% implemented), 2=To some extent (10-50% implemented), 3=To a large extent (51-90% implemented), 4=Completely (>90% implemented) Coded: Yes/no completely implemented reimbursable school meal nutrition standards |
| 2. Nutrition guidelines for competitive foods | July 2014a | Food service manager survey | Original question: “To what extent have each of the following components (nutrition guidelines for all other foods sold such as a la carte, school store, vending, etc.) of the local wellness policy been implemented at this school and for how many years have they been in place?” 1=To a limited extent or not at all (<10% implemented), 2=To some extent (10-50% implemented), 3=To a large extent (51-90% implemented), 4=Completely (>90% implemented) Coded: Yes/no completely implemented nutrition guidelines for competitive foods |
| 3. Wellness committee | June 2017 | School liaison survey | Original question: “How often did your school health or wellness council, committee, or team meet during the past 12 months?” Coded: Yes/no wellness committee met once or more in past year |
| 4. Wellness coordinator | June 2017 | School liaison survey | Original question: “Currently, does someone in your district or school coordinate school health or wellness, for example, a school health coordinator.” Coded: Yes/no wellness coordinator |
| 5. Guidelines for classroom/event foods | June 2017 | Food service manager survey | Original question: “To what extent have each of the following components (nutrition guidelines for foods that are not sold, but offered, such as at classroom parties and social events) of the local wellness policy been implemented at this school and for how many years have they been in place?” 1=To a limited extent or not at all (<10% implemented), 2=To some extent (10-50% implemented), 3=To a large extent (51-90% implemented), 4=Completely (>90% implemented) Coded: Yes/no completely implemented classroom nutrition guidelines |
| 6. Plain, free drinking water | August 2013 | Lunchroom observation | Water available free of charge in the dining room or serving areas from water fountain, pitcher, bottles, dispenser or other sources. Coded: Yes/no any water free of charge available |
| 7. Proportion of competitive foods compliant in schools that served competitive foods | July 2014 | Lunchroom observation | Of schools that serve competitive foods, the proportion of food items (e.g., burritos, chicken burgers, chicken pieces, hamburgers, hot dogs, meat and potato, meat and rice, nachos, pasta, pizza, quesadilla, sandwiches, crackers, desserts, muffins, pastries, cookies) compliant with competitive food guidelines divided by all types of items offered in competitive food venues as a la carte food venue, vending machine or other. |
| 8. Proportion whole grain-rich | Original rule: Half of all grains, whole grain-rich July 2012 All grains, whole grain-rich July 2014 Revised rule: Half of all grains, whole grain-rich July 2019 |
Lunchroom observation | The proportion of whole grain-rich products (e.g., bread, pasta or tortillas, brown rice, corn tortillas) among all grain products served as part of the reimbursable meal. Coded: Proportion whole grain-rich, continuous variable |