A process evaluation of the Breakfast For Kids (BFK) student nutrition programs: perspectives of program coordinators
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Ensuring students are well fed can have positive social, behavioural, and academic benefits. Schools reach almost all children and the food they consume there can significantly contribute to their overall dietary intake. Universal access to school nutrition programs (SNPs) can ensure that children at-risk for poor nutrient intake have access to safe, healthy foods, thereby promoting growth and development and enhancing academic performance. The purpose of this research study was to evaluate the processes and structures of an Ontario Region’s student nutrition programs and to determine how the public health departments’ staff can support the program. This mixed method evaluation included a quantitative survey (n=62; 76% response rate) and qualitative interviews involving 22 program coordinators. The survey elicited a description of programs and variations in components being offered. Interviews with coordinators provided information regarding strengths, weaknesses, opportunities, and threats. Current and potential partnerships between programs and health units were also evaluated. All school levels were well represented in both quantitative and qualitative methods, with community-based programs being under-represented. Survey results showed that teachers and volunteer program coordinators were the most involved in planning and delivering programs. Also, more programs had public health inspectors involved (22.4%), compared to public health nurses (14.0%) or nutritionist/dietitians (9.1%). Although only 17.3% of coordinators reported wanting more general public health involvement, 27.8% wanted menu planning and nutrition support, and 25.5% wanted food safety training. Overall, qualitative results showed that SNPs in the Region varied enormously. The major strengths reported by coordinators included universality, the ability to reach needy students, and the ability to provide social opportunities for students. Major weaknesses included forming partnerships, lack of volunteers, scheduling/timing issues, and coordinator work-load. Common threats included lack of sustainable funding, complexity in tracking program use, unreliable help, and school administration conflicts. Finally, opportunities described by coordinators included assistance with menu planning, expansion of program offerings, and assistance with finding community partners. This research has identified strategies to help support SNPs. Because not one program in the Region is run the same way, multiple strategies need to be in place to support programs at individual levels. Therefore, health units can have a major role, whether it is through menu planning, food safety training, helping coordinators find healthy food options, or helping them build partnerships to enhance program support and operations.