Survey Report January 2015

Survey Report January 2015 TABLE OF CONTENTS Infographic Page 3 Introduction Page 4 Methodology Page 7 Results Demographics Page 8 Descript...
Author: Pearl York
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Survey Report January 2015

TABLE OF CONTENTS

Infographic

Page 3

Introduction

Page 4

Methodology

Page 7

Results Demographics

Page 8

Descriptive statistics for all students

Page 12

Descriptive statistics for non-breakfast eaters

Page 26

Descriptive statistics for hungry students

Page 31

Impact of beliefs

Page 35

Impact of Virginia Foundation for Healthy Youth Region

Page 36

Appendices

Page 37

INTRODUCTION More than 16,000,000 (22%) children in the United States are living in poor families and over 15,000,000 (21.6%) children in our country experience food insecurity daily.1,2 Food insecurity is defined as having limited access to food as a result of economic or social constraints.3 In Virginia, over 274,000 (15%) children live in poor families and more than 299,000 (16%) live in food insecure homes.4,5 Lowincome and food insecure children are especially vulnerable to obesity, one of the leading public health problems facing our nation. Perpetuated by limited access to healthy and affordable foods, unsupportive built environments, and overall limited resources, low income and food insecure children are at a greater risk of becoming overweight or obese as compared to their wealthier peers.6 In our state, over 26% of high school (21% national) and 30% of middle school students (18% national) are overweight or obese. Self-reported surveys estimate that 22% of children aged 10-17 are overweight or obese (31% national).7, 8, 9 Federal child nutrition programs such as the National School Lunch Program (NSLP) and the School Breakfast Program (SBP) aim to fight both hunger and obesity by providing reimbursements for schools and organizations that serve healthy meals to eligible students.10 80% of children in the U.S. and 62% of children in Virginia are income eligible for federal child nutrition programs such as those listed below: •

Supplemental Nutrition Assistance Program (SNAP) (below 130% of federal poverty level)



Women, Infants, and Children (WIC) (130-185% federal poverty level)



Charitable donations (above 185% federal poverty level)5

Children in Virginia are not hungry because of a lack of federal child nutrition programs; rather food insecurity is bolstered by an underutilization of these programs by those eligible. The United States Department of Agriculture estimates that of those eligible for SNAP benefits in Virginia, only 75% are participating in the program (75% national participation rate).11 The SBP is one of the most underutilized child nutrition programs; an alarming statistic as eating breakfast is essential for success in the classroom. Students who miss breakfast have slower memory recall, are more likely to make errors and

National Center for Children in Poverty. United States Demographics of Poor Children. 2012. http://www.nccp.org/profiles/US_profile_7.html. Feeding America. Child Hunger Fact Sheet. 2012. http://www.feedingamerica.org/hunger-in-america/impact-of-hunger/child-hunger/child-hunger-factsheet.html?gclid=CMqCk6rr_cICFeZj7AodgBIAhQ. 3 United States Department of Agriculture. Economic Research Service. Measurement. 2014. http://www.ers.usda.gov/topics/food-nutrition-assistance/foodsecurity-in-the-us/measurement.aspx#hunger. 4 National Center for Children in Poverty. Virginia Demographics of Poor Children. 2012. http://www.nccp.org/profiles/VA_profile_7.html. 5 Feeding America. Map the Meal Gap. 2012. http://www.feedingamerica.org/hunger-in-america/our-research/map-the-meal-gap/. 6 Food Research and Action Center. Fighting Obesity and Hunger. 2010. http://frac.org/initiatives/hunger-and-obesity/. 7 Virginia Foundation for Healthy Youth. Obesity. 2013. http://www.vfhy.org/statistics/obesity. 8 Virginia Foundation for Healthy Youth. Obesity. 2010. http://www.vfhy.org/statistics/obesity. 9 Centers for Disease Control and Prevention. Childhood Obesity Facts. 2012. http://www.cdc.gov/healthyyouth/obesity/facts.htm. 10 United States Department of Agriculture. Food and Nutrition Service. School Meals: Child Nutrition Programs. 2014. http://www.fns.usda.gov/schoolmeals/child-nutrition-programs. 11 United States Department of Agriculture. Food and Nutrition Service. Reaching Those in Need: State supplemental nutrition assistance program participation rates in 2010. 2010. http://www.fns.usda.gov/sites/default/files/Reaching2010.pdf. 1 2

be tardy, and are more likely to repeat a grade.12 Hungry children are more frequently sick, more likely to be hospitalized, and can experience more behavioral and social problems. Additionally, hunger can impair a child’s physical and cognitive development.13 Of the 20 million children in the United States eligible for free and reduced price lunch, less than 10 million participate in the SBP.12 For every 100 students participating in free and reduced price (FR/P) lunch in Virginia, only 51 participate in the FR/P school breakfast (51.3%). If this ratio increased to 70%, an additional 78,369 students in Virginia would receive breakfast daily.14 Table 1 clearly illustrates the disparity between the NSLP and the SBP. Table 1: National School Lunch Program vs. School Breakfast Program Student Participation Numbers in Virginia.15 National School Lunch Program

School Breakfast Program

743,719

266,676

Various barriers prevent children from eating school breakfast. Many children are unable to arrive early enough via bus or alternate ride for breakfast in the cafeteria. Children who arrive on time may not be able to eat before the bell if the cafeteria is far from their homeroom. Additionally, some children do not want to face the stigma of eating a FR/P meal or being different from their friends. These issues can be addressed. On November 20, 2014, Governor Terrence McAuliffe signed into effect Executive Order Number Thirty Four; thus introducing the Commonwealth Council on Bridging the Nutritional Divide. Chaired by the First Lady of Virginia, Mrs. Dorothy McAuliffe, this initiative aims to bridge the nutritional gap in Virginia through key objectives, which strive to eliminate childhood hunger by increasing participation in child nutrition programs through alternative breakfast models.16 The Virginia Foundation for Healthy Youth (VFHY) and the VFHY’s youth volunteer group Y-Street have partnered with the Office of the First Lady to create the Great Starts with Breakfast (GSwB) initiative. The GSwB initiative aims to expand availability, accessibility, and participation in the SBP as breakfast is one of the best ways to support the health and academic potential of children in Virginia. School breakfast decreases the risk of food insecurity, can improve nutrition, and protects against obesity. GSwB student surveys were drafted and disseminated with the goal of identifying barriers and opportunities to school breakfast participation, thus increasing participation through alternative

No Kid Hungry. Fact Sheet: School Breakfast Program. nd. http://www.nokidhungry.org/pdfs/school-breakfast-program-factsheet.pdf. Cook J, Jeng K. Child food insecurity: The economic impact on our nation. 2009. http://www.nokidhungry.org/sites/default/files/child-economy-study.pdf. 14 Food Research and Action Center. School Breakfast Scorecard – Virginia. 2013. http://frac.org/map/pdf/VA/. 15 Food Research and Action Center. Virginia demographics, poverty, and food insecurity. 2012. http://frac.org/wp-content/uploads/2010/07/va.pdf. 16 Commonwealth of Virginia Office of the Governor. Executive Order Number Thirty Four. 2014. https://governor.virginia.gov/media/3456/eo-34-bridgingthe-nutritional-divide.pdf. 12 13

breakfast models.17Alternative breakfast strategies or “breakfast after the bell” initiatives that have proven effective include “breakfast in the classroom” and “grab n’ go” breakfast items.12, 18, 19, 20, 21 •

Breakfast in the classroom: Breakfast in the classroom is an alternative model in which breakfast can be served after the start of the school day using a distribution system in which staff or students may deliver breakfast using carts, coolers, or other insulated containers. Deliveries can occur at varying times (either the start or end of first period) depending on the school’s preference.12



Grab n’ go: Grab n’ Go is an alternative model where food components are packaged and can be easily picked up from mobile carts in areas of high traffic such as hallways or entryways. Students may grab their food and go eat in the cafeteria, classroom, or other designated areas of the campus. The mobile units can be made available before school or between classes depending on the school’s preference.12

The results of the GSwB survey are outlined in this report. The VFHY would like to thank all of the partners who contributed their knowledge and leadership to make this initiative possible. Critical Partnerships: Virginia Department of Education School Nutrition Association Partners for Breakfast in the Classroom Fuel Up to Play 60! Action for Healthy Kids VFHY and Y Street

Virginia Foundation for Healthy Youth. Board of Trustees Meeting Draft Minutes. 2014. No Kid Hungry. Fact Sheet: School Breakfast Program. nd. http://www.nokidhungry.org/pdfs/school-breakfast-program-factsheet.pdf. 18 Olsta J. Bringing breakfast to our students: a program to increase school breakfast participation. The Journal of school nursing : the official publication of the National Association of School Nurses. 2013;29:263-270. 19 Nanney MS, Olaleye TM, Wang Q, Motyka E, Klund-Schubert J. A pilot study to expand the school breakfast program in one middle school. Translational Behavioral Medicine. 2011;1:436-442. 20 Food Research and Action Center. School breakfast scorecard: 2012-2013. 2014. http://frac.org/pdf/School_Breakfast_Scorecard_SY_2012_2013.pdf. 21 School Nutrition Association. Growing school breakfast participation. 2011. http://www.schoolnutrition.org/uploadedFiles/GrowingSchoolBreakfastParticipation.pdf. 17 12

METHODOLOGY The GSwB survey was a quantitative cross-sectional study that targeted low-income students with no inclusion/exclusion criteria except for being a student in elementary, middle, or high school in the state of Virginia. Objectives of the GSwB initiative are outlined below: 1. Measure Virginia public school students’ attitudes about breakfast and their reported behaviors in terms of how and where they usually eat breakfast during the school year. 2. Explore reasons why students make the breakfast choices they make and what influences their choices, including measuring student awareness of the importance of breakfast. 3. Measure student receptivity toward a range of different school breakfast approaches, or practices, to offer and serve breakfast. 4. Engage groups across the state including Y-Street, Healthy Community Action Teams, VA School Nutrition Association, and school and community partners A total of 1,744 surveys were collected through a convenience sample of classrooms in elementary, middle, and high schools across the commonwealth. Trained in administration (Appendix A), Y-street youth volunteers administered surveys and data were collected through a 9 question survey with a total of 20 items and 5 demographic questions (Appendix B). The survey included questions on typical breakfast consumption, reasons for not eating breakfast at school, frequency of hunger, beliefs/attitudes about the importance of breakfast, and preference of proposed alternative options. Surveys were disqualified if any questions were left blank or responses were deemed erroneous. Of the 1,744 surveys collected, 239 were disqualified. Therefore, data analysis and results were based on 1,505 complete surveys (86.3% of study population). Prevalence was analyzed for each question and demographic item. Statistical significance was assessed via crosstabulation of certain items at the 95% confidence level. School level and gender were controlled for, as they may have been possible confounders. Students were classified as either breakfast eaters (eat breakfast before coming to school, eat breakfast at school, or combination of school and home) or non-breakfast eaters (don’t eat breakfast at all) based on responses. Students were also classified as starting the day feeling hungry (most of the time, all of the time, or sometimes) or not hungry (never or not very often) based on the frequency at which they reported feeling hungry on a typical school morning. Data were analyzed using the Center for Disease Control and Prevention’s (CDC) program, EpiInfo 7 (version 7.1.1.0).

DEMOGRAPHICS Figure 1: Age of students

• • • • • • •

The majority of students (26.38%) were between the ages of 10 -