2017 POSTER SESSIONS
POSTER 1
TITLE: SCHOOL PERSONNEL’S PERCEPTIONS OF BENEFITS AND BARRIERS TO THE HEALTHY HUNGRY-FREE KIDS ACT OF 2010
AUTHOR(S): C. Rickard, MS, CLC, K. LaBrecque, MS, RD, R. AbuSabha, PhD, RD, The Sage Colleges, Troy, NY
LEARNING OUTCOME: Meeting attendees will list three barriers and three benefits to implementing the healthy Hungry-Free Kids Act of 2010.
ABSTRACT TEXT: The school foodservice environment has undergone significant changes since 2012, partially in response to the growing prevalence of overweight and obesity among American children. In 2010, Congress passed the Healthy Hunger-Free Kids Act (HHFKA) which issued revised nutrition guidelines for meals that are served through the National School Lunch and Breakfast programs. The current study examines school foodservice directors (SFSD) and staff’s perceptions of the benefits and barriers to the HHFKA. A total of 112 SFSD and 69 school administrators were contacted from 10 states across the United States. Of those, 47 SFSDs and 46 school administrators agreed to participate. Each participant completed a short survey followed by an audio-recorded interview. The majority of administrators (86.7%) agreed that their school foodservice department prepared nutritionally balanced meals for students and 77.8% indicated that having a nutrition professional on staff was important. Administrators cited several challenges to the HHFKA, including increased food and labor costs, poor student acceptance, reduced participation and declining revenue. Despite these challenges, administrators noted a number of benefits such as greater variety, moving from processed to fresh or whole foods, more scratch cooking, the use of locally sourced foods and salad bars, increased servings of fruits and vegetables and a reduction in student access to vending machines and snack offerings. Similarly, SFSDs described some of the budgetary challenges they encountered when implementing HHFKA, particularly in terms of increased food costs. Additional obstacles included reduced participation, lack of student acceptance (particularly the switch to all whole grain-rich products), reduced portion sizes, food waste and foodservice staff pushback. Difficulties in communicating the new regulations to staff members was one of the most common themes cited by foodservice directors. Benefits to HHFKA cited by SFSDs were similar to those mentioned by administrators and included: increasing the availability of fruits and vegetables, using fresh produce and whole foods, increased quality of food served to students, relying on locally sourced foods, and the increased use of homemade or “scratch” cooking rather than processed foods. Despite the challenges to HHFKA, school personnel and SFSDs agree that the new guidelines have significantly improved the foods offered to students.
POSTER 2
TITLE: SCHOOL FOODSERVICE DIRECTORS’ OPINIONS REGARDING THE MINIMUM PROFESSIONAL STANDARDS REQUIREMENTS FOR SCHOOL NUTRITION PROFESSIONALS
AUTHOR(S): A. DerGurahian, MS, RD, J. Leary, MS, RD, R. AbuSabha. PhD, RD, The Sage Colleges, Troy, NY
LEARNING OUTCOME: Meeting attendees will list two benefits to holding a nutrition-related degree for the school foodservice director
ABSTRACT TEXT: Childhood overweight and obesity remain a serious problem in the United States, with approximately 12.7 million (17%) children and adolescents aged 2-19 years overweight. The school food environment plays a major role in influencing children’s eating behaviors. During the 2012-13 school-year approximately 95% of public schools participated in the National School Lunch Program (NSLP). The latest 2015 rule of the NSLP Healthy, Hunger-Free Kids Act (HHFKA) required minimum training hours/professional standards for all school foodservice directors (SFSD). This study examined the perceptions of SFSD with regards to the minimum professional standards requirements. A total of 47 SFSDs from 10 states across the US were interviewed: 23 held a nutrition-related degree and 24 did not have a nutrition-related degree. Each participant completed a short survey followed by an interview. No statistically significant differences between SFSDs with a nutrition degree and no nutrition degree were found related to number of years on the job, years of experience, total students eligible for free or reduced price lunch and total number of students. However, 95% of SFSDs with a nutrition background had college degrees versus only 56% of the non-nutrition SFSDs (P<.05). Five of 11 (45%) of SFSDs with an Associate or high-school diploma believed there should be no minimum education requirement whereas only 8.6% of directors with a college degree stated no standard is necessary and 30% indicated an Associate’s degree is needed (P<.05). Seventy-two percent of SFSDs with a Bachelor’s degree or higher indicated the minimum standard education requirement to be a college degree, versus only 18% (2 of 11) of SFSD with an associate’s or high-school degree (P<.05). SFSDs with nutrition background listed several benefits to their nutrition training including: Having a better understanding of the comprehensive regulations and being able to explain them easily; understanding the science behind food and thus being better able to help with student food allergies and intolerances; and having experience in menu planning. SFSDs’s opinions of the minimum education standards differ according to their experiences and educational background.
POSTER 3
TITLE: SELLING FRUITS AND VEGETABLES IN SUMMER MEALS
AUTHOR(S): S.I. Hauser, PhD; Associate Professor, The Sage Colleges Nutrition Science Department
LEARNING OUTCOME: Participants will be able to describe effective strategies to improve fruit and vegetable knowledge and attitudes among children ages 6-10 year.
ABSTRACT TEXT: Objectives: To explore innovative strategies to improve attitudes toward, and knowledge and acceptability of fruits and vegetables (FV) among Summer Food Service Program (SFSP) participants. Methods: A six-week non-randomized, controlled trial was conducted in two urban summer camps serving at-risk youth. Weekly nutrition education activities were employed in the intervention group (n=45), along with social marketing tactics aimed at increasing knowledge of and improving attitudes toward FV. Superhero-themed marketing was employed among 6-7 year olds, while sports figures were used to frame FV marketing messages for 8-10 year olds. Hands-on activities and taste testing were used. No intervention activities were conducted among control group participants (n=40) in a camp 1.4 miles away which had comparable demographics and received identical SFSP meal items.
Analysis: Means or X2 tests were performed to detect differences between intervention and control groups on a FV attitudes survey, a 32-item FV picture identification measure, and a FV favorability ratings scale. Pre and post-assessments were also conducted among intervention group participants. Results: The intervention group successfully identified more FV post- vs. pre-intervention (21.4/32 vs. 14.7/32, p=.000) and significantly more than the control group post-intervention (16.9/32), p=.000. Intervention participants rated 7 out of 10 test FVs significantly higher than the control group (p<.05) and reported more favorable attitudes toward FV on all six attitude sub-scores (p<.05). Conclusions: A simple six-week education and social marketing intervention was effective in improving knowledge and attitudes toward FV among elementary school children participating in the SFSP in an urban summer camp setting.
POSTER 4
TITLE: IMPACT OF HOSPITAL MATERNITY CARE PRACTICES ON EXCLUSIVE BREASTFEEDING IN NEW YORK STATE
AUTHOR(S): E. FitzPatrick,1,2 DrPH, MPH, RD, B. A. Dennison,2,3 MD, T. Nguyen,4 MD, DrPH, M. A. Kacica,2,5 MD,MPH, D. Strogatz,2,6 PhD;1Nutrition Science Department, The Sage Colleges, Troy, New York,2 School of Public Health, University at Albany, Rensselaer, New York,3Division of Chronic Disease Prevention, New York State Department of Health, Albany, New York,4Office of Public Health Practice, New York State Department of Health, Albany, New York,5Division of Family Health, New York State Department of Health, Albany, NY,6Center for Rural Community Health, Bassett Healthcare Network, Cooperstown, NY
LEARNING OUTCOME: Participants will understand the ten hospital practices that effect breastfeeding outcomes and identify a specific practice that selectively impacts breastfeeding exclusivity.
ABSTRACT TEXT: Improvements in the prevalence of exclusive breastfeeding (EBF) have lagged behind those achieved for breastfeeding initiation. Implementation of the Ten Steps to Successful Breastfeeding, in hospital maternity care, has been instrumental in improvements in breastfeeding initiation, duration and exclusivity. Utilizing New York State (NYS) linked data from the Maternity Practices in Infant Nutrition and Care (mPINC) and the Pregnancy Risk Assessment Monitoring System (PRAMS), the association of individual maternity practices/Steps to breastfeeding exclusivity was evaluated. The study sample included mothers who participated in PRAMS and gave birth to a healthy infant in a NYS hospital that participated in mPINC in 2007. Weighted multiple logistic regression analysis was conducted to determine the association between individual maternity practices/Steps and breastfeeding exclusivity for eight weeks or longer. The study sample represented 116,198 new mothers. For those mothers who initiated breastfeeding, 36.8 percent breastfed for eight weeks or longer. Mothers who gave birth in a maternity care hospital that reported achieving Step 5 ‘Show mothers’ how to breastfeed’ had a RR=1.77 (95% CI: 1.42-2.20) for exclusively breastfeeding for eight weeks or longer, after adjustment for maternal demographic and hospital characteristics. No other maternity practices/Steps were significantly associated with EBF. Meeting EBF goals is a public health priority. Specific hospital maternity practices demonstrated to improve EBF should be fully implemented in maternity care. Teaching mothers how to breastfeed during their hospital stay, by competently trained health care providers will contribute to improvements in the prevalence of exclusive breastfeeding.
POSTER 5
TITLE: HACCP PROCESS IN A SCHOOL DISTRICT CAFETERIA: CUSTOMIZING STANDARDS OF PRACTICE
AUTHOR(S): J. Adler, BA, MSIS, Dietetic Intern, D. Longton, RD, CDN, M. Morgan, MS, RDN, The Sage Colleges, Troy, NY
LEARNING OUTCOME: Upon review of this poster presentation, viewer will be able to identify 2 key recommendations to improve the HACCP process and food safety.
ABSTRACT TEXT: Hazard Analysis Critical Control Point (HACCP) Process is mandated in school foodservice to protect against food borne illness. The purpose of this study was to review the HACCP Process in a rural school district of approximately 1800 students. Food service and HACCP policies and procedures of the facility were reviewed and the food services director was interviewed. A full day of observations took place in each of the K-8 and 9th-12th grade kitchens. A data collection tool was created to capture 22 observed practices through all processes of the food service operation. The findings showed that the foodservice employees followed many elements of the United States Department of Agriculture general HACCP plan. However, the lack of facility-specific Standard Operating Procedures (SOPs) contributed to several errors, especially controlling for time and temperature. In conclusion, site-specific SOPs should be developed and implemented to meet individual needs of the facility. The purchase of cooling sticks to improve food temperatures is recommended, customize and update policies and procedures, provide hands on food safety training for all employees, and enforce frequent food temperature log recordings.
POSTER 6
TITLE: PATIENT SNACK AVAILABILITY IN A HOSPITAL SETTING: EXAMINATION OF FLOOR STOCK AND CALL DOWN EFFICIENCIES AND PROCEDURES
AUTHOR(S): T. Covone, BS, Sage Dietetic Intern, D. Longton, RD, CDN, M. Morgan, MS, RDN
LEARNING OUTCOME: After viewing the poster presentation, participants be able to identify 2 recommendations for increased efficiency to providing patient snacks in a hospital setting.
ABSTRACT TEXT: An important determinant of patient satisfaction with their overall hospital experience relates to their foodservice experience and if meals, snacks, and other amenities were provided in an efficient and appropriate manner. The purpose of this study was to analyze systems in a 65-bed community hospital for stocking snacks and sending additional tray/items to patient floors to then identify process improvement opportunities. Four foodservice employees were observed stocking snacks to patient floors over three days, and eleven employees were interviewed. Existing floor stock forms, call down procedures and late tray data was collected. Floor stock pricing for two consecutive months were compared to assess differences in prices charged compared to food distributor’s actual price. Results found that floor stock items were not always available due to deliveries to incorrect locations and/or items not being put away properly. Over half of the staff are considered “new hires,” and insufficient training was provided resulting in errors. Current stock forms were incomplete and confusing and item/tray call downs to the kitchen were not always logged properly. Staffing shortages were a consistent contributor to haste and poor performance. In conclusion, revising current forms and policies to increase efficiency, providing employee training, and hiring additional staff could increase accurate stocking of snacks to provide patients. Patient satisfaction can be achieved through the revisions of these processes.
POSTER 7
TITLE: ALLERGENS IN A COLLEGE DINING FACILITY: A HACCP-BASED APPROACH TO IDENTIFYING AND REDUCING CONTAMINATION RISK
AUTHOR(S): M. Garvie, MS, Dietetic Intern, D. Longton, RD, CDN, M. Morgan, MS, RDN, The Sage Colleges, Troy, NY
LEARNING OUTCOME: Viewers will be able to identify high cross-contact risk areas in a college dining setting and name two strategies to reduce risk.
ABSTRACT TEXT: Prevalence of food allergies and intolerances is rising nationally, and cross-contact risk increases with frequency of meals consumed outside the home. The purpose of this study was to identify areas at high-risk for cross contamination of common allergens and to design risk reduction strategies. The study was conducted at a small women’s college in Upstate New York. Food service staff were surveyed to assess food allergy knowledge. The flow of processing and serving food was audited using a validated tool. A student survey identified food allergies and intolerances in 170 out of 323 student diners. Students reporting food sensitivities, food allergies, or both were 25 (14.70%), 14 (8.23%), and 7 (4.12%) respectively. Rates of allergy or intolerance were 13.53% for dairy, 7.65% for wheat/gluten, 5.29% for nuts/peanuts, and 2.94% for pineapple. High-risk cross-contact areas included self-serve stations and main production cooler. Surveyed staff indicated awareness of production of allergen-free food, however, the audit identified practices below standards. Station and cooler planograms were developed. Facility-wide signage was implemented and employees were educated on new policies. Formal food allergy education was scheduled and facility training implemented for the inter-term period. The study findings identified opportunities for process improvement, and implementation of evidence-based standards of practice improved student dining experience and safety.
POSTER 8
TITLE: PRODUCTION RECORD COMPLETENESS FACILITAING IMPROVED NATIONAL SCHOOL LUNCH IMPLEMENTATION
AUTHOR(S): A. Kaplan, BS, Dietetic Intern, D. Longton, RD, CDN, M. Morgan, MS, RDN, The Sage Colleges, Troy, NY