Reduce Sodium - SLT

Appendix B1.

Prescreening Web Survey

INTRODUCTION-1

This is a web survey that you will complete online. As you answer the survey, please note the following:

• Do not use your browser's “back” button during the survey. Instead, use the "Back" button at the bottom of each screen.

• Answer all questions.

• Please feel free to ask for assistance from other individuals in your SFA who conduct the nutrient analysis.

• Unless you see the words "select all that apply" after a question, please select only one answer for each question.

• You may complete parts of the survey and save it by clicking “Save & Continue” at the end of each page.

• After saving, you can exit by closing the browser.

• You can log in again using the same link, username, and PIN to continue the survey at a later time.

• To view the USDA Sodium Targets at any point in the survey, click on the link “USDA Sodium Targets Table” on the right side of your screen.

We encourage you to complete the survey as soon as possible. Know that the information you provide will be kept private to the extent allowed by law.

If you have any questions about the study or about completing this survey, please email [email protected] or call 1-866-465-7738 (toll free).

INTRODUCTION-2

Upon completing the survey, you may be contacted again and invited to participate in an in-depth interview with our research team. You will be notified in March 2017 if you have been selected.

This survey is being conducted for the U.S. Department of Agriculture (USDA) Food and Nutrition Service (FNS) as part of a study of the National School Lunch Program (NSLP), School Breakfast Program (SBP), and other USDA food programs throughout the country. All responses will be kept private; no names will be used in our reports, and only aggregated results will be reported.

Section 305 of the Healthy, Hunger-Free Kids Act of 2010 states that “States, State educational agencies, local educational agencies, schools, institutions, facilities, and contractors participating in programs authorized under this Act and the Child Nutrition Act of 1966 (42 U.S.C 1771 et seq.) shall cooperate with officials and contractors acting on behalf of the Secretary, in the conduct of evaluations and studies under those Acts.”

Send comments regarding this burden estimate displayed below or any other aspect of this collection of information, including suggestions for reducing this burden, to:

[FNS CONTACT NAME]

U.S. Department of Agriculture
Food and Nutrition Service
Office of Policy Support
Alexandria, VA 22302

We thank you for your cooperation and your participation in this very important study.

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB number. The valid OMB control number for this information collection is XXXX-XXXX. It will take you, on average, 15 minutes to complete this survey.

INTRODUCTION-3

2M Research Services and its partner, Abt Associates, are conducting this survey for the U.S. Department of Agriculture (USDA) Food and Nutrition Service (FNS) as part of a study called “Successful Approaches to Reduce Sodium in School Meals.”

FNS has commissioned this study to identify

• successes and challenges while working towards reducing sodium in your school meals; and

• strategies, best practices, tools, or resources that supported your sodium reduction efforts.

Your SFA site has been selected to participate in this important study. The survey is designed to be completed within 15 minutes, and should be completed by the SFA director or designated members of the SFA’s staff.

INTRODUCTION-4

The Healthy, Hunger-Free Kids Act of 2010 (HHFKA) authorizes funding and sets policy for school meal programs. Sodium reduction targets are among these policies (shown in Table 1).

Table 1. USDA Sodium Targets

Grades	Target 1: July1, 2014 SY 2014–2015 (mg)	Target 2: July1, 2017 SY 2017–2018 (mg)	Target 3: July1, 2022 SY 2022–2023 (mg)
School Breakfast Program1
K–5: 6–8: 9–12:	≤ 540 ≤ 600 ≤ 640	≤ 485 ≤ 535 ≤ 570	≤ 430 ≤ 470 ≤ 500
National School Lunch Program2
K–5: 6–8: 9–12:	≤ 1,230 ≤ 1,360 ≤ 1,420	≤ 935 ≤ 1,035 ≤ 1,080	≤ 640 ≤ 710 ≤ 740
Source: U.S. President Final Rule. Nutrition Standards in the National School Lunch and School Breakfast Programs. 77 Fed. Reg. 17, (January 26, 2012). https://www.gpo.gov/fdsys/pkg/FR-2012-01-26/pdf/2012-1010.pdf

Q1. When did your SFA begin actively lowering sodium in school meals? _ _ _ _ - _ _ _ _ (SY)

Q2. For these questions, please record your responses separately for:

• elementary schools (i.e., schools composed of any span of grades from kindergarten through 6th grade);

• middle or junior high schools (i.e., schools that have no grade lower than 6 and no grade higher than 9);

• high schools (i.e., schools that have no grade lower than 9 and continue through 12th grade); and

• if any school does not meet the definition for elementary, middle/junior high, or high school, please include it in the “other school” column.

NUMBER OF SCHOOLS	ELEMENTARY SCHOOL	MIDDLE/ JUNIOR HIGH SCHOOL	HIGH SCHOOL	OTHER SCHOOL	TOTAL
a. How many schools in your SFA are participating in the School Breakfast Program (SBP)?
b. How many schools in your SFA are participating in the National School Lunch Program (NSLP)?
c. What is the total number of schools in your SFA?

[If number entered in “Other School” column in Q2, go to Q2A. If no number entered, go to Q3]

Q2A. What grade spans are included in the “other schools” in your SFA?

________________________________________________________________________

Q3. What is the total number of students enrolled across all schools in your SFA? (select one)

1 ☐ <1,000

2 ☐ 1,000–2,499

3 ☐ 2,500–4,999

4 ☐ 5,000–9,999

5 ☐ 10,000–24,999

6 ☐ 25,000–99,999

7 ☐ 100,000+

Q4. Please indicate the daily average number of free, reduced-price, and paid meals served during the month of October 2016 across all of the schools within your SFA.

TYPE OF MEAL	NUMBER OF STUDENTS
a. Daily average number of free meals served during the month of October 2016.	___
b. Daily average number of reduced-price meals during the month of October 2016?	___
c. Daily average number of full-price meals during the month of October 2016?	___

Q4A. Do any of your schools provide free meals or foods through any of the following programs? (select all that apply)

1 ☐ After School Snack Program
2 ☐ Child and Adult Care Food Program (CACFP)

3 ☐ Community Eligibility Provision (CEP)
4 ☐ Fresh Fruit and Vegetable Program (FFVP)
6 ☐ Summer Food Service Program (SFSP)
7 ☐ Team Nutrition
8 ☐ Other (Specify) ________________________________________

Q5. Revised school meal requirements for maximum daily sodium content vary by meal type and grade level. Do your schools meet the breakfast or lunch Target 1 sodium standards in any elementary, middle school/junior high, high school, or “other school?” [display link to USDA sodium targets table]

SCHOOL TYPE	BREAKFAST				LUNCH
a. Elementary School	Yes	No	Don’t Know	N/A	Yes	No	Don’t Know	N/A
b. Middle/Junior High School	Yes	No	Don’t Know	N/A	Yes	No	Don’t Know	N/A
c. High School	Yes	No	Don’t Know	N/A	Yes	No	Don’t Know	N/A
d. “Other School”	Yes	No	Don’t Know	N/A	Yes	No	Don’t Know	N/A

[if yes to any, GO TO Q5A. if no to all, GO TO Q7. if Don’t know to all, GO TO Q6]

Q5A. How do you know if your schools meet this standard? (select all that apply)

1 ☐ State review

2 ☐ Nutrient analysis software

3 ☐ Other (Specify) ________________________________________

[If number higher than “0” entered in “Other School” column in Q2, go to Q5b. If no number entered, go to Q6]

Q5B. In your “other schools,” do you need to address more than one sodium standard because of multiple grade levels (e.g., K-8)? (select one)

1 ☐ Yes [go to Q5B1]

2 ☐ No [go to Q6]

Q5B1. Can you describe how you address different sodium standards within a single campus?

____________________________________________________________________

Q6. Thinking about Target 2 sodium standards, would you say that the average weekly sodium content of your school meals is “not meeting,” “close to meeting,” “meeting,” or “exceeding” the sodium (mg) standards set for both the School Breakfast Program and National School Lunch Program? [display link to USDA sodium targets table]

For this question, please record your responses separately for:

• elementary schools (i.e., schools composed of any span of grades from kindergarten through 6th grade);

• middle or junior high schools (i.e., schools that have no grade lower than 6 and no grade higher than 9);

• high schools (i.e., schools that have no grade lower than 9 and continue through 12th grade); and

• if any school does not meet the definition for elementary, middle/junior high, or high school, please include it in the “other school” column.

SCHOOL TYPE	STATUS OF TARGET 2 SODIUM STANDARDS
School Breakfast Program
a. Elementary School	☐ Not Meeting	☐ Close to Meeting	☐ Meeting	☐ Exceeding	☐ Don’t Know/ Not Sure
b. Middle/Junior High School	☐ Not Meeting	☐ Close to Meeting	☐ Meeting	☐ Exceeding	☐ Don’t Know/ Not Sure
c. High School	☐ Not Meeting	☐ Close to Meeting	☐ Meeting	☐ Exceeding	☐ Don’t Know/ Not Sure
d. Other School	☐ Not Meeting	☐ Close to Meeting	☐ Meeting	☐ Exceeding	☐ Don’t Know/ Not Sure

National School Lunch Program
a. Elementary School	☐ Not Meeting	☐ Close to Meeting	☐ Meeting	☐ Exceeding	☐ Don’t Know/ Not Sure
b. Middle/Junior High School	☐ Not Meeting	☐ Close to Meeting	☐ Meeting	☐ Exceeding	☐ Don’t Know/ Not Sure
c. High School	☐ Not Meeting	☐ Close to Meeting	☐ Meeting	☐ Exceeding	☐ Don’t Know/ Not Sure
d. Other School	☐ Not Meeting	☐ Close to Meeting	☐ Meeting	☐ Exceeding	☐ Don’t Know/ Not Sure

Q7. Have you used any of the following approaches to reduce sodium content and/or increase the acceptability of lower sodium foods among students? (select all that apply)

Q7A. Utilizing alternative purchasing techniques:

1 ☐ DoD’s Fresh Fruit and Vegetable Program

2 ☐ Farm-to-school programs

3 ☐ Food buying co-op or group purchasing

4 ☐ School or community gardens

5 ☐ USDA food purchases

6 ☐ Other (Specify) _______________________________

Q7B. Learning about and purchasing lower sodium products:

1 ☐ Asking vendors for lower sodium products

2 ☐ Attending trade shows

3 ☐ Discussing student acceptance of lower sodium products with vendors

4 ☐ Working with vendors to gain information about the sodium content in food products

5 ☐ Other (Specify) _______________________________

Q7C. Using effective menu planning:

1 ☐ Implementing a self-serve condiment station or providing individual condiment packets

2 ☐ Limiting popular higher sodium items to certain days of the week

3 ☐ Providing students with more food choices for each meal

4 ☐ Serving new/unfamiliar items on multiple days to encourage uptake

5 ☐ Using lower sodium products

6 ☐ Using more fresh and/or frozen fruits and vegetables

7 ☐ Other (Specify) _______________________________

Q7D. Changing food preparation methods:

1 ☐ Cooking with more herbs and spices

2 ☐ Decreasing the portion size of higher sodium items

3 ☐ Maintaining or increasing use of scratch cooking

4 ☐ Roasting vegetables

5 ☐ Other (Specify) _______________________________

Q7E. Involving students, staff, and/or parents in changes to gain acceptance of new foods:

1 ☐ Conducting taste tests with students, staff, and/or parents

2 ☐ Bringing chefs into the schools to teach about cooking

3 ☐ Hosting food tasting parties to expose students, staff, and/or parents to different foods

4 ☐ Obtaining feedback from students, staff, and/or parents on new menu items

5 ☐ Sampling of vendor’s products by students, staff, and/or parents

6 ☐ Other nutrition education activities at the school level (Please specify) __________
7 ☐ Other (Specify) _____________________________________________

Q7F. Using available resources:

1 ☐ Modifying recipes already in use by the school district

2 ☐ Using Healthier U.S. Challenge’s Smarter Lunchroom techniques

3 ☐ Using recipes available through State agency and/or USDA

4 ☐ Other (Specify) _______________________________

Q7G. Training staff on lower sodium food preparation:

1 ☐ Bringing in local chefs for training

2 ☐ Conducting in-house training

3 ☐ Sending school nutrition staff to culinary training

4 ☐ Other (Specify) _______________________________

Q8. You indicated that your SFA had implemented the following approaches: [DISPLAY BELOW THE ITEMS CHECKED IN Q7A-G including “other (specify)” fields]. Use your mouse to drag up to five approaches in the box on the right. Then use your mouse to arrange these five approaches in rank order, with the most effective in reducing sodium content closer toward the top. [RANKING IS LIMITED TO FIVE ITEMS. IF NO ITEMS SELECTED IN Q7A-G, GO TO Q9. IF NO ITEMS RANKED, GO TO Q9]

Most Effective	DISPLAY CHECKED ITEM FROM Q7A-G
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	DISPLAY CHECKED ITEM FROM Q7A-G
	DISPLAY CHECKED ITEM FROM Q7A-G
	DISPLAY CHECKED ITEM FROM Q7A-G
	DISPLAY CHECKED ITEM FROM Q7A-G
	DISPLAY CHECKED ITEM FROM Q7A-G
Least Effective	DISPLAY CHECKED ITEM FROM Q7A-G

Q8A. Among the approaches you use, indicate the ones in which you have implemented using innovative/creative approaches and the ones that have been well received by students. [IF NO ITEMS SELECTED IN Q7A-G, GO TO Q9. IF NO ITEMS SELECTED Q8A, GO TO Q9] (select all that apply)

Approaches You Use	Q8A1. Implemented using innovative/creative approaches	Q8A2. Have been well-received by students
DISPLAY CHECKED ITEM FROM Q7A-G	☐	☐
DISPLAY CHECKED ITEM FROM Q7A-G	☐	☐
DISPLAY CHECKED ITEM FROM Q7A-G	☐	☐
DISPLAY CHECKED ITEM FROM Q7A-G	☐	☐
DISPLAY CHECKED ITEM FROM Q7A-G	☐	☐
DISPLAY CHECKED ITEM FROM Q7A-G	☐	☐

Q8B. [FOR EACH Q8A1 CHECKED] Describe how the approach is innovative or creative. [IF NO ITEMS SELECTED IN Q7A-G, GO TO Q9]

Approaches You Use	Description
DISPLAY CHECKED ITEM FROM Q8A1
DISPLAY CHECKED ITEM FROM Q8A1
DISPLAY CHECKED ITEM FROM Q8A1
DISPLAY CHECKED ITEM FROM Q8A1
DISPLAY CHECKED ITEM FROM Q8A1
DISPLAY CHECKED ITEM FROM Q8A1

Q9. What kind of communication do you use to inform others (e.g., staff, parents, students, community members, etc.) of the sodium standards or meal changes made to meet the standards? (select all that apply)

1 ☐ Send letters home to parents/guardians

2 ☐ Hang posters or signage in the cafeteria

3 ☐ Display sodium content of meals and foods

4 ☐ Hold interactive events for students (such as taste tests)

5 ☐ Give presentations to parents/guardians and/or the community

6 ☐ Post on social media

7 ☐ Publish articles in the media

8 ☐ Attend meetings (where you were an attendee but not a presenter) held by

community stakeholders

9 ☐ None: Good nutrition in general is advertised, but sodium specifically is not

10 ☐ None: We work hard to not bring attention to sodium reductions

11 ☐ None: Sodium standards have not been communicated

12 ☐ Other (Specify): ________________________________________________________

Q10. You mentioned that your SFA has implemented the following communication approaches to inform others of the sodium standards or meal changes made to meet the standards. [DISPLAY THE FOLLOWING ITEMS if any selected IN Q9] Use your mouse to drag up to five approaches in the box on the right. Then use your mouse to arrange these communication approaches in rank order, with the most effective for communicating to audiences toward the top. [RANKING IS LIMITED TO FIVE ITEMS. IF NO ITEMS SELECTED IN Q9, GO TO Q11. IF NO ITEMS RANKED, GO TO Q11.]

Most Effective	Send letters home to parents/guardians
	Hang posters or signage in the cafeteria
	Display sodium content of meals and foods
	Hold interactive events for students (such as taste tests)
	Give presentations to parents/guardians and/or the community
	Post on social media
	Publish articles for the media
	Attend meetings (where you were an attendee but not a presenter) held by community stakeholders
	None: Good nutrition in general is advertised, but sodium specifically is not
	None: We work hard to not bring attention to sodium reductions
	None: Sodium standards have not been communicated
Least Effective	Other [SHOW RESPONSE FROM Q9(12) Other (specify)]

Q10A. Describe any effective or innovative practices related to the communication approaches you selected on the previous page: [LIST EACH OF THE TOP five METHODS respondent selected] [IF NO ITEMS SELECTED IN Q9, GO TO Q11]

Q11. As you have implemented changes, can you think of any people in the following categories who gave assistance, input, or who would be aware of student/parent perceptions related to sodium changes in school meals:

	Yes	No
School employees (such as principals, nurses, administrators, administrators who are a member of a local school wellness committee, or teachers)	☐	☐
Food suppliers (such as local manufacturers, distributors, local farmers, or local food hubs that supply your operation with food products and ingredients)	☐	☐
Community stakeholders (such as parents, community members, school board members, or non-employee members of a school wellness committee)	☐	☐

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Thank you for your participation. We may contact you again to participate in an in-depth interview with our research team. You will be notified in March 2017 if you have been selected.

We thank you in advance for your important contribution to this research.