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Volume 32, Issue 2, Fall 2008 - Rainville;Carr

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 In-Classroom Breakfast: Best Practices in Three School Districts

Alice Jo Rainville, PhD, RD, SNS & Deborah H. Carr, PhD, RD

ABSTRACT

Purpose
The USDA School Breakfast Program is underutilized and to overcome this, some school districts are adopting distribution and service models for breakfast in the classroom. These models include distribution of breakfasts to each classroom by students and/or school nutrition employees and mobile breakfast carts in hallways. The purpose of this study was to determine the best practices of in-classroom breakfast.

Methods
Using case study research methodology, the National Food Service Management Institute Applied Research Division conducted a study to determine best practices of in-classroom breakfast. After a pilot visit in a Southeast USDA region district, three districts of varying sizes in the Western, Midwest, and Mid-Atlantic USDA regions were selected based on recommendations of their state agency for operating an exemplary in-classroom breakfast program. The preparation, distribution, and service of breakfast were observed in one school in each district. Interviews with school nutrition directors, principals, teachers, and other school personnel were conducted.  

Results
Planning for in-classroom breakfast involved school nutrition personnel, school administrators, teachers, custodians, and parents. The distribution and service of breakfast were customized to each school within the districts; therefore, the planning was time-consuming. Teachers and school administrators had positive impressions of in-classroom breakfast based on fewer tardy students, fewer disciplinary referrals, student focus on academics, and creation of a positive school culture.

Applications to Child Nutrition Professionals
In-classroom breakfast improves students’ access to school breakfast. The planning and implementation of in-classroom breakfast can be successful if a school team representing school nutrition, administration, teachers, custodians, students, and parents works together to plan and implement for the good of the children served.

INTRODUCTION

Benefits of the School Breakfast Program (SBP) have been documented, however many of America's neediest children are not participating. In 2007, the National School Lunch Program (NSLP) served more than 30.5 million children daily (U.S. Department of Agriculture [USDA], 2008a). During the same year, the SBP served 10.1 million children daily with 8.1 million receiving free or reduced price breakfast (USDA, 2008b). An evaluation of the SBP using the National Health and Nutritional Examination Survey III showed benefits for children (Bhattacharya, Currie, & Haider, 2004). Children who participate in a SBP consume a better overall diet, consume a lower percentage of calories from fat, are less likely to have a low intake of magnesium, and are less likely to have low serum levels of vitamin C and folate (Bhattacharya et al.).

A recent national trend to improve SBP participation is the integration of breakfast within the school day and in-classroom breakfast. Several states and districts have been leaders in offering in-classroom breakfast programs. These in-classroom breakfast programs dramatically increase student access to school breakfast, while positively influencing the school environment.

Maryland Meals for Achievement
The Maryland State Department of Education started in-classroom breakfast in 1998 in six schools (Murphy & Pagano, 2001). Students were offered a breakfast at no charge and students ate at their desks while teachers took attendance and conducted morning routines. By the 2001 school year, more than 90 schools were participating in the Maryland Meals for Achievement (MMFA) (Maryland State Department of Education, n.d.). Researchers found decreases in tardiness and student suspensions. When MMFA schools were matched with comparison schools in the same school systems, researchers found significant improvement in composite index scores on the Maryland School Performance Assessment Program. In the 2006-2007 school year 189 schools in Maryland offered MMFA in-classroom breakfasts (Maryland State Department of Education, n.d.). Under Maryland state law, any school that participates in the SBP and has at least 40% of its enrollment approved for free and reduced-price meals can apply to be a MMFA school to receive supplemental funding, provided that funding is available. The 2006-2007 Maryland state budget included over $3.1 million for MMFA.

Nutrition Consortium of New York State
In 2003-2004, elementary and secondary schools in upstate New York were chosen for a pilot program designed to produce replicable models for in-classroom breakfast (Nutrition Consortium of New York State, n.d.). Twenty schools in rural, urban, and suburban locations with low or high percentages of students eligible for free and reduced price meals received grants from the Nutrition Consortium of New York State. Each school designed their own distribution and service model (Nutrition Consortium of New York State). Eleven schools delivered breakfasts to participating classrooms. Two schools distributed breakfasts in the cafeteria and students took their meal back to the classroom. Three schools initiated hallway stations for breakfast pick up on the way to the classroom. Four schools used a combination of methods. For example, one school delivered breakfast to grades K-2 while older students came to the cafeteria to pick up their breakfast. Some schools offered both hot and cold breakfasts; some schools served only cold items; and one school served only hot breakfasts. Menus were assessed for feasibility and adjusted after implementation. 

Researchers collected data on student participation, incidences of absenteeism, tardiness, disciplinary referrals, and visits to the school nurse (Nutrition Consortium of New York State, n.d.). Principals, teachers, and SNP directors were surveyed. Every school had increased participation and overall participation increased from an average of 23% in March, 2003 to 58% in March, 2004. Tardiness, disciplinary referrals, and visits to the school nurse were decreased. Prior to implementation, principals reported reluctant support of in-classroom breakfast, but support improved after implementation.

Hunger Task Force in Milwaukee
The Hunger Task Force worked with the Milwaukee Public Schools to improve the nutrition status of children through free breakfasts in some schools (Wong & Hunger Task Force, 2006). In the fall of 2005, six schools began serving all students free breakfast and lunch under Provision 2, which allows schools participating in the SBP to provide meals to children at no charge for up to four consecutive years (USDA, 2002). In the two schools that offered in-classroom breakfast, participation doubled; the four schools with traditional breakfast reported marginal increases and some decreases in breakfast participation. The success of this pilot led to recruitment of schools that would offer in-classroom breakfast the following school year. Schools had to achieve a 95% meal application return rate by the third Friday of the school year and agree to cooperate with the Hunger Task Force on outreach and evaluation.

In the 2006-2007 school year, 61 Milwaukee schools offered Universal Free Breakfast; the breakfasts were pre-packaged and included cereal, juice, and graham crackers. Milk was added to complete the breakfast (Lent & Hunger Task Force, 2007). The preliminary survey results from school personnel in 30 schools showed that 73% of school staff responded that in-classroom breakfast had a positive impact on learning readiness; 57% of staff responded that in-classroom breakfast had a positive or very positive impact on students’ attendance; and 72% of staff responded that in-classroom breakfast had a positive or very positive impact on students’ health.

“Grab ‘n’ Go” Pilot Project in Pennsylvania
In 2002, a "grab ‘n’ go" breakfast program was pilot tested at a middle school in Pennsylvania, where students ate breakfast in the classroom (Conklin, Bordi, & Schaper, 2004). Breakfast was served from a portable station as students walked to class. Access to breakfast was improved and breakfast participation increased by 9%. The authors described issues to consider and suggestions including payment systems, portable serving carts, trash cans, menus, administrative support, teaching and custodial staff support, and data collection for evaluation (Conklin, et al.). Sixty-nine percent of teachers and aides agreed or strongly agreed that grab ‘n’ go service should be continued.

The purpose of this study was to determine the best practices of in-classroom breakfast so that a best practice Web-based resource could be developed to assist SNP directors and managers in implementation and evaluation of an in-classroom breakfast program.

METHODOLOGY

This research project used a case study method to explore best practices of in-classroom breakfast. Conclusions from each study site (school) contributed to the whole study. This type of methodology can be used to conduct a detailed contextual analysis of a program in which data is collected through a review of documentation and archival records, direct observation, and structured interviews (Yin, 2003). In this research project, structured and informal interviews, examination of documents, and direct observations were used to collect data. The University of Southern Mississippi and the Eastern Michigan University Human Subjects Committee approved the protocol and interview questions. Each school nutrition program (SNP) director signed a consent form indicating a willingness to participate in the study.

Participants
State agencies overseeing the SNP in four states were contacted via electronic mail for recommendations of three to four SNP directors in their state operating an exemplary in-classroom breakfast program. The SNP directors were contacted via telephone and electronic mail to describe the study and ask whether they would be willing to participate. Four SNP directors (one for the pilot) were contacted by the researchers and all agreed to participate in the study.

Instruments
A two-part research instrument was developed using case study methods outlined by Yin (2003). Part I of the data collection instrument was designed to collect demographics and general information about the school district and breakfast program. Part II of the data collection instrument included a structured interview guide with pre-determined questions designed to collect data about the school’s in-classroom breakfast. The interview guide included questions for SNP directors, principals, and teachers.

Procedures
Dates for site visits were established with SNP directors. Follow-up letters were mailed to SNP directors, superintendents, and principals verifying the visit and arranging for the SNP director to assist the NFSMI researchers with data collection prior to and during the visit. A brief discussion of the types of data important for the case study research was included, along with Part I of the data collection instrument. This allowed participants time to gather the appropriate data and ensure accuracy. All documents requested for review were from the 2005-2006 school year.

The researchers field tested the data collection instrument and the procedures for direct observation of in-classroom breakfast during a one-day site visit to the pilot school district. The pilot case study site in the Southeast USDA region was chosen based on convenience, access, and geographic proximity. In addition to easy access and convenience, the site was also judged by the researchers to have characteristics typical of most in-classroom breakfast programs. Based on the pilot study, minor modifications were made to the data collection instrument.

On-site data collection and direct observation of the in-classroom breakfast occurred during a one day visit in each school district. Site visits included the following research activities:

  • Overview of the in-classroom breakfast by the SNP director
  • Structured formal interviews conducted by researcher(s)
  • Document and records review
  • Review and discussion of the demographics portion of the data collection instrument
  • Informal discussion with the SNP director
  • Direct observation of the in-classroom breakfast at one school in each district including food preparation, delivery, and service
  • Informal discussion with school nutrition manager and nutrition staff

Data Analysis
After completion of the site visits, the researchers examined all raw data using several analytical strategies outlined by Yin (2003). Interview responses and field notes were organized, categorized, and when appropriate, clarified with a follow-up electronic mail correspondence. Data were tabulated and cross-checked from each site visit. After the individual case studies were analyzed for pertinent data, a cross-case search for patterns was conducted. In the cross-case analysis, the data was analyzed across all three districts and then data about each site’s activities were compared to determine commonalities and differences in the in-classroom breakfast programs.

The draft report was sent via electronic mail for participants to corroborate the facts and information in the report. This enhanced the accuracy of the case study, increasing the construct validity of the study (Yin, 2003).

RESULTS AND DISCUSSION

Demographics
After a pilot visit in a Southeast USDA region district, three districts of varying sizes in the Mid-Atlantic, West, and Midwest USDA regions were visited. To protect the anonymity of study participants, school districts were designated as A, B, and C. School districts chosen for the case study ranged in size from a district with 15 schools and an enrollment of 7,208 students to a very large district with 199 schools and 137,798 students (Table 1). Average daily participation for in-classroom breakfasts served in 2005-2006 ranged from 628 in the smallest district to 5,334 in the largest district (Table 1).

Table 1. Selected Demographic Information for School Districts Chosen as Case Study Sites

Variables District A District B District C
USDA Region Mid-Atlantic Western Midwest
Student enrollment 137,798 10,603 7,208
Number of schools 199 16 15
Revenue for 2005-2006 $39,275,322 $3,880,833 $3,736,567
Number of schools with in-classroom breakfast 23 3 6
Percentage of students approved for free meals 17.8% 48.3% 37.8%
Percentage of students approved for reduced price meals 7.6% 10.0% 8.8%
Student in-classroom breakfast ADP* 5,334 631 628
Student breakfast ADP* 9,385 3,969 2,265
Student lunch ADP* 51,903 6,807 4,757


  * ADP = Average Daily Participation in 2005-2006

Description of Service in District A
An elementary school in District A in the Mid Atlantic USDA region was visited in January, 2007; an average of 260 in-classroom breakfasts were served each day. Delivery carts with five shelves (three wire shelves on top for menu items on trays and two solid shelves on the bottom for milk crates) were loaded and delivered to 26 classrooms by three school nutrition personnel. Cards with children’s names and barcodes were kept in the classroom and when a child took a breakfast, the card was placed in a clear plastic bag.

Students quietly ate while starting morning work.  Students were responsible for taking wrappers and milk cartons to garbage containers in the hallways.  Custodians were responsible for taking the garbage out.  School nutrition personnel picked up the cards, trays and milk crates and counted remaining menu items.  The cards were scanned into the point of sale register by the school nutrition manager after breakfast and placed in teacher mailboxes.  Counts for remainders were recorded on a daily sheet so that forecasts could be adjusted. 

Description of Service in District B
A middle school in District B in the Western USDA region was visited in February, 2007; the school had morning announcements first and breakfast immediately following. Approximately 631 students were served in six minutes from three mobile carts/kiosks that were taken by school nutrition personnel to three hallways within the school. Teachers led their students to the carts/kiosks; students lined up on both sides of the carts/kiosks; and chose menu items to take back to the classroom. The school nutrition programs were operating under Provision 2 so school nutrition employees had hand-held counters to keep track of the number of students served. Per the state agency, teachers were allowed to be given breakfast too since they were assisting with service.

Students ate while the teacher began the first lesson. Students who had physical education in the first period of the day were served last. Each classroom had a small trash bag that was picked up by the custodian.

Description of Service in District C
A middle school in the Midwest USDA region was visited in February, 2007; approximately 245 students were served in 26 classrooms. Bins with cold breakfast items were delivered to the classrooms before school by two school nutrition personnel. One student from each classroom came to the cafeteria serving area to pick up the correct number of hot menu items, placed on a small plastic serving tray.  Students who ate in-classroom breakfast were marked on the roster.  Students who had physical education in the first period of the day were served in the cafeteria serving area.  The school nutrition manager entered the reimbursable breakfasts into the point of sale register after breakfast service. The trash went into the classroom wastebasket and was picked up at the end of the day. 

Team Approach for Planning
All three districts used a team approach for planning and implementation of the in-classroom breakfast service. Principals, teachers, school nurses, custodians, and school nutrition personnel were involved in planning. In District B, the middle school health improvement team suggested in-classroom breakfast to the SNP director as a means of improving student health. In all three districts, the distribution and service of breakfast were customized to each school within the district; therefore, the planning was time-consuming, but the outcome better suited the needs of each school. Table 2 contains principals’ comments on a team approach for planning.

Table 2. Principals’ Comments on a Team Approach for Planning In-Classroom Breakfast

 
“Use a team approach and effectively communicate the benefits.”

“Get a group of staff involved early.”

“Visit a successful in-classroom breakfast program.”

“I sold it (in-classroom breakfast) to the teachers. They were skeptical but once they experienced it, they liked it.”

 

Menus and Menu Planning
All three districts used traditional food-based menu planning for in-classroom breakfast. Districts A and C had one week cycle menus with two daily options. District B had three week cycle menus that varied by school. All three SNP directors were actively searching for additional menu items and working with food manufacturers to identify foods and beverages appropriate for in-classroom breakfast.

Logistics of Distribution and Custodial Duties
The SNP directors and managers showed exceptional planning and organizational skills and communication skills. The SNP directors and supervisors maintained good communication with school principals. The timing of distribution and service was important and therefore, school nutrition personnel followed precise time schedules that were designed to provide service to hundreds of students within defined time constraints. The SNP Director in District B used blueprints of schools to identify traffic patterns that would be most beneficial for distribution and service of in-classroom breakfasts.

The school nutrition personnel in all three districts had routines and procedures to ensure food safety. Milk was added to carts immediately before delivery of the meal. Hot menu items were prepared just before service and kept warm until delivery or pick up. Menu items were wrapped or packaged to ensure safety. Equipment was cleaned and sanitized daily.

Custodial duties for in-classroom breakfasts varied by district. In District B, the custodian was initially opposed to in-classroom breakfast but after implementation, was one of the strongest supporters. The principal in District B stated that in-classroom breakfast saved custodial time because custodians do not have to clean the cafeteria following breakfast service. However, the SNP Director in District C stated that gaining support from custodial staff was one of the barriers to implementation in additional schools. Instead of food and beverages confined to one location, the cafeteria, in-classroom breakfast means that food and beverages are distributed throughout the school. There are many variables that affect custodial time and support, including physical layout of the school and carpeting in classrooms. Observations of in-classroom breakfast in the three schools revealed small trash volumes.

SNP directors and principals suggested visiting schools that have an in-classroom breakfast program to see the program in action and gain valuable logistics and distribution information from school personnel. Table 3 contains quotations from the SNP directors regarding planning, logistics of distribution, and service.

Table 3. School Nutrition Directors’ Advice for Planning In-Classroom Breakfast

“Market in-classroom breakfast through the superintendent and teachers. They are the ones who need to get excited about it.”

“Go see someone’s successful program and ask questions. Bring your principal and custodian.”

“Do a thorough check of equipment, storage space, logistics, and work with custodial staff.”

“It has initial hurdles but the program is so beneficial to academic success. It is worth the effort.”

“It (in-classroom breakfast) sells itself once it is up and running.”

“I feel valued. They (principals and teachers) appreciate what we do.”

“We need to do what is best for the child.”

 

Student Issues/School Culture
All three districts and the pilot district reported increased student participation in the breakfast program after implementation of in-classroom breakfast. Improved nutrition intake for students does have an impact on student success and readiness for learning. In Districts A and B, the principals mentioned that students were getting to school on time; students had fewer referrals to the school nurse; and fewer students were hungry.

In District A, the flow of the morning routine was smoother after implementation of in-classroom breakfast. In District B, four minutes were added to the first period so that in-classroom breakfast would not decrease instructional time. In the District C middle school, the principal stated that students depend on in-classroom breakfast for sustenance and convenience; students who are not hungry can concentrate.

Districts B and C reported decreased disciplinary referrals; a sense of community in the school; and increased student responsibility. The principal of the middle school in District B predicted better learning for students but was pleased to also see a decrease in disciplinary referrals. The principal of the middle school in District C found that in-classroom breakfast gave students a reason to come to school on time. Table 4 contains quotations from a superintendent, principals, teachers, and a school nurse regarding the positive effects of in-classroom breakfast on students and school culture.

Table 4. School Personnel Comments on Student Issues and School Culture Related to In-Classroom Breakfast

Superintendent

“Once we got the (in-classroom breakfast) program off the ground, teachers and custodians saw the positive effects.”

“Teachers have more time in the classroom.”

Principals

“Kids are getting to school on time.”

“The number of tardy students has decreased.”

“We have children who come on time for breakfast. They might otherwise come late.”

“There are fewer hungry children.”

“It meets the needs of our students and our students depend on it.”

“We have appetizing, healthy foods that are individually wrapped.”

“We’re so committed to it (in-classroom breakfast) because we’ve seen the benefits.”

“Referrals for negative behavior have decreased and I didn’t anticipate that.”

“We develop a sense of community when we eat together.”

“It (in-classroom breakfast) brings more order to the day.”

“It helps in getting the children to their classrooms and keeping them there (children don’t have to go the cafeteria).  It keeps the children safe and they begin learning.”

“Adults had concerns about clean up but the students have been responsible. It has empowered our students.”

“It saves custodial time.”

“Noise levels are down.”

“I’ve had positive comments from parents.”

Teachers

“Children aren’t eating at home so they need school breakfast.”

“Students are hungry in the morning and classroom breakfast gives them a good start.”

“It wakes kids up.”

 “It takes a little time from the day, but it is worth it.”

“It taught kids tidiness and responsibility. You throw away your own trash.”

“It doesn’t cause disruption. Kids are used to it.”

“It (in-classroom breakfast) becomes a routine and a habit.”

“It (in-classroom breakfast) keeps them on task for learning.”

“It (in-classroom breakfast) creates a sense of community within the school and in each classroom.”

“Students are healthier and happier.”

School Nurse

“Students are focused.”

 “We had children with headaches and stomachaches. We hardly see any now.”

“It (in-classroom breakfast) is a fabulous program.”



CONCLUSIONS AND APPLICATIONS

This study involved visits to three schools in three school districts in three USDA regions. It is possible that results would have been different if three different districts in the same or other USDA regions were used for the study.

Benefits of in-classroom breakfast included increased student participation in the breakfast program, decreased disciplinary referrals, a sense of community in the school, and increased student responsibility. Challenges included gaining support from all school personnel, implementation of distribution and service in limited time, and planning menus that have good variety and incorporate foods that are nutritious, individually packaged, and well-accepted by students. The distribution and service of breakfast were customized to each school within the district; therefore, the planning was time-consuming.

Students in all schools would benefit from in-classroom breakfast. It makes breakfast a normal part of the school day and removes the possible stigma of going to the cafeteria for breakfast. The benefits of in-classroom breakfast outweigh the challenges and the challenges can be overcome with careful planning. The benefits of in-classroom breakfast need to be shared with school nutrition directors, managers, and staff, superintendents, principals, teachers, school nurses, students, and parents.

Resources from the Food Research and Action Center (n.d.a; n.d.b; n.d.c; n.d.d), Child Nutrition Foundation (2002), and Hunger Task Force (2006) can assist school personnel in learning about in-classroom breakfast. An outcome of this study was the development of a best practice Web-based (www.nfsmi.org) resource titled NFSMI Best Practice Guide for In-Classroom Breakfast. The resource can assist SNP directors and managers in implementation and evaluation of an in-classroom breakfast program.

The in-classroom breakfast program involves many stakeholders in the school district, including principals, students, teachers, parents, and custodians; therefore, a continuous quality improvement approach would be valuable. Continuous Quality Improvement Process Tailored for the School Nutrition Environment, can be used to improve in-classroom breakfast after implementation (Lambert, Carr, & Hubbard, 2006).

School personnel in this study and other recent studies have reported positive outcomes for students who participate in school breakfast programs (Conklin, et al., 2004; Lent & Hunger Task Force, 2007; Murphy & Pagano, 2001; Wong & Hunger Task Force, 2006). Additional studies that objectively document student outcomes of daily breakfast including increased student academic achievement, decreased tardiness, improved attendance, and improved student health and behavior would serve as further evidence of the beneficial effects of daily breakfast. District-level financial analyses of in-classroom breakfast would provide quantitative evidence of the financial implications of increased revenues from increased breakfast participation. A study of custodial time requirements for traditional school breakfast versus in-classroom breakfast would provide objective results to address custodians’ concerns. In addition, a study of teacher time requirements for in-classroom breakfast would be useful. In-classroom breakfast has been shown to be successful in elementary and middle schools. High school students can benefit from in-classroom breakfast too and a survey of high school students, parents, and principals found the majority preferred in-classroom breakfast to a grab ‘n’ go breakfast (Mehra & Hunger Task Force, 2007). Additional research studies should explore the expansion of in-classroom breakfast to high schools.

ACKNOWLEDGEMENTS

This publication has been produced by the National Food Service Management Institute – Applied Research Division, located at The University of Southern Mississippi with headquarters at The University of Mississippi. Funding for the Institute has been provided with Federal funds from the U.S. Department of Agriculture, Food and Nutrition Service, to The University of Mississippi. The contents of this publication do not necessarily reflect the views or policies of The University of Mississippi or the U.S. Department of Agriculture, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.

The information provided is the result of independent research produced by NFSMI and is not necessarily in accordance with U.S. Department of Agriculture Food and Nutrition Service (FNS) policy. FNS is the federal agency responsible for all federal domestic child nutrition programs including the National School Lunch Program, the Child and Adult Care Food Program, and the Summer Food Service Program. Individuals are encouraged to contact their local child nutrition program sponsor and/or their Child Nutrition State Agency should there appear to be a conflict with the information contained herein, and any state or federal policy that governs the associated Child Nutrition Program. For more information on the federal Child Nutrition Programs please visit www.fns.usda.gov/cnd.

REFERENCES

Bhattacharya, J., Currie, J., & Haider, S. J. (2004). Final report: Evaluating the impact of school nutrition programs. Retrieved May 18, 2007, from http://www.ers.usda.gov/publications/efan04008/efan04008.pdf 

Child Nutrition Foundation. (2002). Expanding breakfast. Alexandria, VA: Author.

Conklin, M. T., Bordi, P. L., & Schaper, M. A. (2004). Grab ‘n’ go breakfast increases participation in the School Breakfast Program. Journal of Child Nutrition and Management, 28 (1). Retrieved from http://docs.schoolnutrition.org/newsroom/jcnm/04spring/conklin/

Food Research & Action Center. (n.d.a). Child nutrition fact sheet: Breakfast for learning. Retrieved June 29, 2007, from http://www.frac.org/pdf/breakfastforlearning.PDF

Food Research & Action Center. (n.d.b). Child nutrition fact sheet: School breakfast program. Retrieved June 29, 2007, from http://www.frac.org/pdf/cnsbp.PDF 

Food Research & Action Center. (n.d.c). Universal school breakfast programs. Retrieved June 29, 2007, from http://www.frac.org/pdf/universal_sbp.PDF 

Food Research & Action Center. (n.d.d). What is Provision 2? [Fact sheet]. Retrieved June 29, 2007, from http://www.frac.org/pdf/provision2.PDF

Hunger Task Force. (2006). New options for school breakfast [Fact sheet]. Retrieved October 31, 2007, from  http://www.hungertaskforce.org/userimages/understandinghunger_factsheets_Alternative_Breakfast.pdf

Lambert, L., Carr, D., & Hubbard, S. (2006). Continuous quality improvement process tailored for the school nutrition environment. University, MS: National Food Service Management Institute. Retrieved August 22, 2008, from http://nfsmi-web01.nfsmi.olemiss.edu/documentLibraryFiles/PDF/20080221022907.pdf

Lent, M., & Hunger Task Force. (2007). Preliminary findings from the 2006-2007 Universal Free Breakfast Initiative in Milwaukee Public Schools. Retrieved October 31, 2007, from http://www.hungertaskforce.org/userimages/Hunger_Task_Force_UFB_Evaluation_2006-07_FINAL.pdf 

Maryland State Department of Education. (n.d.). Meals for Achievement. Retrieved June 11, 2007, from http://www.marylandpublicschools.org/MSDE/programs/schoolnutrition/meals_achieve 

Mehra, A., & Hunger Task Force. (2007). Exploratory assessment of high school breakfast programs in Milwaukee Public Schools 2006-2007. Retrieved June 14, 2007, from http://www.hungertaskforce.org/userimages/EXPLORATORY_ASSESSMENT_OF_HIGH_
SCHOOL_BREAKFAST_PROGRAMS_IN_MILWAUKEE_PUBLIC_SCHOOLS.PDF
 

Murphy, J. M., & Pagano, M. E. (2001). Effects of a universally free, in classroom breakfast program: Final report from the third year of the Maryland Meals for Achievement Evaluation. Baltimore: Maryland State Department of Education. Nutrition Consortium of New York State. (n.d.). Academics and Breakfast Connection Pilot. Retrieved August 22, 2008, from http://www.hungernys.org/programs/documents/abcfinal.pdf

U.S. Department of Agriculture, Food and Nutrition Service. (2002). Provision 2 guidance. Retrieved August 3, 2007, from http://www.fns.usda.gov/cnd/Governance/prov-1-2-3/Prov2Guidance.pdf 

U.S. Department of Agriculture, Food and Nutrition Service. (2008a). National School Lunch Program [Fact sheet]. Retrieved August 22, 2008, from http://www.fns.usda.gov/cnd/Lunch/AboutLunch/NSLPFactSheet.pdf 

U.S. Department of Agriculture, Food and Nutrition Service. (2008b). The School Breakfast Program [Fact sheet]. Retrieved August 22, 2008, from http://www.fns.usda.gov/cnd/breakfast/AboutBFast/SBPFactSheet.pdf 

Wong, K., & Hunger Task Force. (2006). Evaluation of the 2005-2006 Provision 2 Pilot in Milwaukee Public Schools. Retrieved June 14, 2007, from http://www.hungertaskforce.org/userimages/publications_provision2_report.pdf 

Yin, R. Y. (2003). Case study research: Design and methods. Thousand Oaks, CA: Sage Publications.

BIOGRAPHY

Rainville is Professor of Nutrition and Dietetics at Eastern Michigan University in Ypsilanti, MI. Carr is Director of NFSMI, Applied Research Division, at the University of Southern Mississippi in Hattiesburg, MS.


 


 
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