Parental Perceptions of the Nutritional Quality of School Meals and Student Meal Participation: Before and After the Healthy Hunger-Free Kids Act.
OBJECTIVES
To examine (1) parental perceptions of school meals and (2) student meal participation before and after the implementation of the Healthy Hunger-Free Kids Act (HHFKA).


DESIGN
Data were collected from telephone surveys of 2 independent cross-sectional panels in New Jersey (2009-2010 and 2016-2017).


PARTICIPANTS
Households with children aged 7-18 years (pre-HHFKA: n = 1,027; post-HHFKA: n = 324).


MAIN OUTCOME MEASURES
Parental perception of school meals and parental reports of student participation in school meals.


ANALYSIS
Multivariable logistic regression models were developed to examine outcome variables. For school meal participation, nested models were analyzed first controlling for sociodemographic variables, followed by parental perception, and then the interaction between perception and time.


RESULTS
Parental perceptions of school meals did not change significantly after the HHFKA. At both time points, school meal participation rates were significantly higher for children of parents who perceived school meals as healthy compared with children whose parents perceived meals to be unhealthy (pre-HHFKA: 89.9% vs 75.1%, P < 0.001; post-HHFKA: 87.3% vs 64.9%, P = 0.02).


CONCLUSION AND IMPLICATIONS
Because higher perception of school meal quality is associated with higher participation, it is important for school food programs to inform parents about the improved nutritional quality of school meals.
['Martinelli|Sarah|S|', 'Acciai|Francesco|F|', 'Au|Lauren E|LE|', 'Yedidia|Michael J|MJ|', 'Ohri-Vachaspati|Punam|P|']
D000293:Adolescent D002648:Child D003430:Cross-Sectional Studies D005260:Female D005522:Food Services D006801:Humans D062409:Lunch D008297:Male D018673:Nutrition Policy D009753:Nutritive Value D010290:Parents D012574:Schools
parents perception Healthy Hunger-Free Kids Act National School Lunch Program nutrition policy