FORMATIVE RESEARCH TO ASSESS KEY FACTORS ASSOCIATED WITH THE DIET QUALITY OF HOME-PACKED LUNCHES IN YOUNG SCHOOL CHILDREN
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In the United States, about 46% of elementary students who are not eligible for school meal (SM) benefits do not participate in the National School Lunch Program (NSLP) and bring home-packed lunches (HPL). With considerable criticism directed at the NSLP, parents may believe that they can pack healthier lunches that respond better to their children’s tastes than the SM. Nonetheless, previous studies have found that HPL needed nutritional improvement. This study’s objective was to assess how key parent psychosocial factors related to young school-aged children’s diet quality. Using a cross-sectional study design, nine public schools were randomly selected in one school district in Maryland. In-depth interviews with principals and vice-principals were conducted and a web-based survey was sent to kindergarten and first-grade teachers. Parents of children, in those grades, who frequently consume HPL were invited to complete a web-based survey and to report their children’s food intake using the Automated Self-Administered 24-hour Recall (ASA24-2016). Children’s diet quality was assessed using the HEI-201 and HEI-2015. 19 teachers and 100 parents completed the survey. 71 parents reported at least one day of their child’s food intake. Interviews with 15 school administrators revealed that HPL contain too much food and are nutritionally diverse depending on children’s country of origin. The survey showed that more than half of the teachers considered HPL more nutritious than SM. Moreover, children’s overall diet quality was better when parents scored higher their self-efficacy for enacting healthy diet behaviors in their children and when parents were more closely monitoring their child’s food intake. Children of parents with the same higher self-efficacy had better total vegetable scores and were consuming more vegetables in their HPL. They also had better empty calories scores, and more precisely better added sugars scores and were consuming less added sugars in their HPL. Future interventions aiming to improve HPL’s nutritional quality should take into account school lunch policies and the cafeteria environment and incorporate parents’ key psychosocial variables.