Reduce Sodium - SLT

Appendix B4.

School Administrator In-Depth Interview Guide

Introduction: Thank you for agreeing to speak with us today. My name is [name of interviewer] and I’m a researcher from [2M Research Services or abt associates]. This is [name of note taker], also a researcher from [2M Research Services or abt associates], and s/he will be taking notes during our conversation to ensure that we accurately capture all of the opinions and insights you provide us. 2M Research Services and Abt Associates were contracted by U.S. Department of Agriculture (USDA) Food and Nutrition Service, referred to as FNS, to conduct an assessment of the challenges and successes your school and school district have experienced while working to meet the sodium standards. As a school employee, the opinions and information that you provide are critical to this effort.

In order to ensure that we fully and accurately capture the points raised during today’s discussion, we would like to digitally record this conversation. Please note that this interview will remain private. There is a small risk of loss of privacy, but the research team has taken many steps to reduce this risk. Your identity and any information attributable to you will not be released to anyone outside of the research team. The recording will NOT be shared with FNS, your school district, or anyone outside the research team. We will only use the recording to ensure accuracy of the transcription. Any identifying information, such as your name or anyone else’s name that may be mentioned, will be omitted from the final transcript. The recording of your interview will be deleted at the end of the study, after all data have been analyzed.

Do we have your permission to record this interview?

Yes  Great. Thank you. Do you have any questions before we begin?

No  Okay. That is not a problem at all. We would like to ask for your patience, as we will need a little more time to note your responses by hand to ensure we accurately capture your insights. Do you have any questions before we begin?

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, 60 minutes to complete this interview.

USDA’s updated school meal nutrition standards established three sodium targets to be phased in over a 10-year period, with specific levels for students in three grade ranges. The Target 1 sodium standards became effective for school year 2014–2015 and set limits on sodium for breakfast and lunch offerings between 540 milligrams and 1,420 milligrams, depending on the grade level.

USDA is interested in gaining a better understanding of the challenges and successes your school has experienced while working toward meeting the sodium standards, and to hear what your strongest recommendations are for other schools striving to meet sodium Target 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
1 Baseline of sodium levels offered in foods for the School Breakfast Program were 573 mg (elementary schools), 629 mg (middle/junior high schools), and 686 mg (high schools). 2 Baseline of sodium levels offered in foods for the National School Lunch Program were 1,377 mg (elementary schools), 1,520 mg (middle/junior schools), and 1,588 mg (high schools). Source: U.S. President Final Rule. Nutrition Standards in the National School Lunch and School Breakfast Programs. Federal Register 77, no. 17, (January 26, 2012). https://www.gpo.gov/fdsys/pkg/FR-2012-01-26/pdf/2012-1010.pdf

Background

These first few questions focus on the characteristics of you and your school/school district.

Q1. How long have you been a [position title]?

Q1A. Has that time always been with this [SCHOOL/SCHOOL DISTRICT], or were you with another [SCHOOL/SCHOOL DISTRICT] prior to this? [PROBE FOR: Other school level; within the same district, etc.]

Q1B. Other than being a [POSITION TITLE], have you been involved in your [SCHOOL/SCHOOL DISTRICT] in other ways? If yes, how so? [Probe: involvement in school wellness committee, school wellness initiatives, etc.]

Q2. Are general nutrition changes in school meals communicated to you? Can you describe the changes that you know about? [Probe for sodium.]

Q2A. Who communicates these nutrition changes in school meals?

Q2B. When were these changes communicated to you? [Probe for when they heard about sodium targets.]

Q2C. How are changes in nutrition standards communicated to you? How often is this communication done?

Q3. Do you have any direct involvement with your [SCHOOL/SCHOOL DISTRICT]’s nutrition program? If yes, how have you been involved in supporting the changes in school meals?

Q4. What do you think about the updated standards for healthier school meals and in particular, sodium reduction?

Now we would like to discuss your [SCHOOL/SCHOOL DISTRICT]’s success in achieving the Target 1 sodium standards.

Approaches to Reduce Sodium

Q5. Are you aware of any strategies your [SCHOOL/SCHOOL DISTRICT] uses to address changes in nutrition standards in school meals? What about strategies to reduce sodium? Can you describe these strategies? [Probe for: conducting taste tests, scratch cooking, working with manufacturers, changing recipes, incorporating more fresh fruit and vegetables, school vegetable garden, including information related to the changes in curriculum, etc.]

Successes and Lessons Learned

Q5A. Of the strategies your [SCHOOL/SCHOOL DISTRICT] has implemented to reduce sodium in school meals, which do you think was the most effective strategy? Which strategy was most widely accepted? [PROBE FOR: REASONS WHY]

Q5B. Did your [SCHOOL/SCHOOL DISTRICT] engage [SCHOOL/SCHOOL DISTRICT] staff members to help support changes to and gain acceptance of school meals? What about efforts to reduce sodium? How did you or other school staff support this? [PROBE for: how school staff supported the effort; how acceptance was achieved]

Challenges

Q6. What do you think has been the biggest barrier for your [SCHOOL/SCHOOL DISTRICT] in their efforts to address changes in school meal nutrition standards? Any specific barriers to reducing sodium in school meals? [Probe for: resistance from staff, parents, and/or students.]

Q6A. [ask if barriers are cited] How did [SCHOOL/SCHOOL DISTRICT] overcome these barriers/challenges? Has the community helped your school overcome these barriers? How so? Do any barriers/challenges still exist?

Q7. Based on our information, your [SCHOOL/SCHOOL DISTRICT] is located in a/an [rural, urban, or suburban] area. Do you feel that your [SCHOOL/SCHOOL DISTRICT]’s location plays a role in the ability to meet the sodium standards? Why or why not? [PROBE FOR: AVAILABILITY/ACCESSIBILITY OF DESIRED PRODUCTS, POPULATION SIZE RELATED TO DEMAND, ETC.]

Q7A. Do you think that being located in the [Northeast, Northwest, Midwest, Southwest, Southeast, etc.] region of the U.S. influences your ability to reduce sodium in school meals? Why or why not?

[PROBE FOR:

• ACCESS TO Desired, LOWer SODIUM PRODUCTS AND/OR FOODS

• ABILITY TO LOCALLY PURCHASE LOWER SODIUM FOOD PRODUCTS

• CHALLENGES WITH PARENT INVOLVEMENT

• CHALLENGES WITH STUDENT ACCEPTANCE

• COMMUNITY ATTITUDES/SUPPORT FOR REDUCED SODIUM MEALS

  • Regional Cuisines and Cultures]

Q7B. Do you feel that the size of your [SCHOOL/SCHOOL DISTRICT] plays a role in your [SCHOOL/SCHOOL DISTRICT]’s ability to meet the sodium standards? [PROBE FOR: AVAILABILITY/ACCESSIBILITY OF DESIRED PRODUCTS, POPULATION SIZE RELATED TO DEMAND, ETC.]

Q7C. Do you think that the school level of your campus (elementary, middle, or high school) plays a role in meeting and/or acceptance of the sodium standards for school meals? [PROBE FOR: REASONS WHY]

Acceptance

Q8. In your opinion, are students at [SCHOOL/SCHOOL DISTRICT] aware of the nutrition changes in school meals? Why or why not? If yes, do you think they are supportive of the changes? What the about changes in sodium levels? Why or why not? How do you know?

Q8A. Have you heard feedback from students about the changes in school meals? What have you heard? Any particular foods that they like most or least? Why? Is any of the feedback related to changes in sodium?

Q8B. From what you have observed, which items gain the most acceptance? Least acceptance? Why do you think so? Has this changed with changes in school meals and nutrition standards?

Q8C. Did your [SCHOOL/SCHOOL DISTRICT] encourage student input or feedback when changes were being made to school meals? Why or why not? What other steps were taken by the school to support acceptance by students?

[PROBE FOR:

• MARKETING METHODS (ON-SITE SIGNAGE, STUDENT EDUCATIONAL MATERIALS, PARENT HANDOUTS, PUBLIC ENDORSEMENT, etc.)

• STUDENT INVOLVEMENT IN PLANNING SCHOOL MEAL MENUS, GETTING STUDENT INPUT about LOWER SODIUM OFFERINGS IN SCHOOL MEALS

• TASTE TESTS

• PRESENTATIONS TO A PARENT-TEACHER ASSOCIATION/PARENT ORGANIZATION, OR OTHER PARENT GROUP MEETING TO DISCUSS SCHOOL MEALS

• CONDUCTING A NUTRITION EDUCATION ACTIVITY related to sodium IN THE CLASSROOM OR FOOD SERVICE AREA

• SETTING UP A BOOTH AT A SCHOOL EVENT TO PROVIDE INFORMATION ABOUT THE LOWER SODIUM STANDARDS (SUCH AS AT A FAMILY NIGHT OR PARENT-TEACHER CONFERENCE)

• ANYTHING ELSE?]

Q8D. Which of these do you think had the most impact on student acceptance of lower sodium foods? Why? [allow a response of don’t know after probing for a response.]

Q9. Did your [SCHOOL/SCHOOL DISTRICT] encourage staff input when changes were being made to school meals? Why or why not? Are there other approaches that your [SCHOOL/SCHOOL DISTRICT] took to gain acceptance of the changes to school meals from school staff? Can you describe what your [SCHOOL/SCHOOL DISTRICT] has tried?

Q10. Does your [SCHOOL/SCHOOL DISTRICT] work with the community members such as parents or a wellness committee to support healthier school meals? How so? Do they help with efforts specific to reducing sodium? What role have they played?

Q11. What ideas or suggestions do you have for other schools to gain support for the changes that [SCHOOL/SCHOOL DISTRICT] is making to school meals they serve? How about to help increase acceptance for lower sodium in school meals? Are there key strategies that you would recommend? If yes, what are they?

We appreciate the time you’ve taken to answer our questions. Your input is very valuable. Do you have any questions for us before we end [if site visit: this portion of] the interview?

[if telephone interview:] If you have additional questions following this interview, you may contact us at [contact information]. Thank you again.

[if site visit:] Next, if available, we would like to take a look at any posters or signs you may have displayed in the cafeteria, letters that may have been sent to parents, agendas or notes from meetings with community stakeholders, and any other related materials. Do you have any of these materials that you would be willing to share with us?

Yes  We will be documenting what we see using a checklist but, with your permission, we would also like to take photographs of these items. We will not photograph any children or school personnel. Do we have your permission to photograph?

Yes  Thank you. Do you have any questions before we begin? [note to interviewer: proceed to Site Visit Observational Instrument]

No  Okay. No problem. We will not take photographs, but would like to take notes about the content of the signage related to sodium reduction. [note to interviewer: proceed to Site Visit Observational Instrument] Reason: ___________________________________________

Thank you again for your time. If you have additional questions following this interview, you may contact us at: [contact information].