Nollen Nicole L, Kimminau Kim S, Nazir Niaman
Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, USA.
J Am Diet Assoc. 2011 Jun;111(6):879-83. doi: 10.1016/j.jada.2011.03.017.
Reducing à la carte items in schools-foods and beverages sold outside the reimbursable meals program-can have important implications for childhood obesity. However, schools are reluctant to reduce à la carte offerings because of the impact these changes could have on revenue. Some foodservice programs operate with limited à la carte sales, but little is known about these programs. This secondary data analysis compared rural and urban/suburban school districts with low and high à la carte sales. Foodservice financial records (2007-2008) were obtained from the Kansas State Department of Education for all public K-12 school districts (n=302). χ² and t tests were used to examine the independent association of variables to à la carte sales. A multivariate model was then constructed of the factors most strongly associated with low à la carte sales. In rural districts with low à la carte sales, lunch prices and participation were higher, lunch costs and à la carte quality were lower, and fewer free/reduced price lunches were served compared to rural districts with high à la carte sales. Lunch price (odds ratio=1.2; 95% confidence interval, 1.1 to 1.4) and free/reduced price lunch participation (odds ratio=3.0; 95% confidence interval, 1.0 to 9.8) remained in the multivariate model predicting low à la carte sales. No differences were found between urban/suburban districts with low and high à la carte sales. Findings highlight important factors to maintaining low à la carte sales. Schools should consider raising lunch prices and increasing meal participation rates as two potential strategies for reducing the sale of à la carte items without compromising foodservice revenue.
减少学校里的单点菜品——即在校内有偿用餐计划之外出售的食品和饮料——可能对儿童肥胖问题产生重要影响。然而，学校不愿减少单点菜品供应，因为这些变化可能会对收入产生影响。一些餐饮服务项目的单点销售额有限，但人们对这些项目了解甚少。这项二次数据分析比较了单点销售额低和高的农村与城市/郊区学区。从堪萨斯州教育部获取了所有公立K-12学区（n = 302）2007 - 2008年的餐饮服务财务记录。使用卡方检验和t检验来研究变量与单点销售额之间的独立关联。然后构建了一个与低单点销售额关联最紧密的因素的多变量模型。与单点销售额高的农村学区相比，单点销售额低的农村学区午餐价格和参与率更高，午餐成本和单点菜品质量更低，提供的免费/减价午餐更少。在预测低单点销售额的多变量模型中，午餐价格（优势比 = 1.2；95%置信区间，1.1至1.4）和免费/减价午餐参与率（优势比 = 3.0；95%置信区间，1.0至9.8）仍然存在。在单点销售额低和高的城市/郊区学区之间未发现差异。研究结果突出了维持低单点销售额的重要因素。学校应考虑提高午餐价格和提高用餐参与率，作为在不影响餐饮服务收入的情况下减少单点菜品销售的两种潜在策略。
