Yailine De La Cerda

HLTH 309

December 7, 2020

Methodological Lit Review

Dr. Dixon

Healthy, Hunger Free Kids Act of 2010

Introduction

The Healthy, Hunger Free Kids Act of 2010 was put into place while I was still in middle

school. It is something that actually affected me and the people around me. The Healthy,

Hunger Free Kids Act of 2010 was singled into law by President Obama back in December 2010.

This authorized funding and set policy for the USDA’s core child nutrition programs. For the first

time in over 30 years there was an opportunity to make real reforms to the school lunch and

breakfast programs by improving nutrition and hunger safety for millions of children (Au et al.,

2020, Berger et al., 2020, Mansfield, 2017, Martinelli, 2020, Mozer, 2019). I will analyze articles

about the Healthy, Hunger Free Kids Act of 2010 to see what the impact has been on these

children. The independent variable is the program that brought in healthier options of school

lunches. The dependent variable are the children themselves and if it actually benefited them.

Sampling

The article by Au et al. used cross-sectional sampling of 130 communities. This means

they samples different groups at the same time. Hispanic, African American and low-income

communities were sampled and two elementary and two middle schools were randomly

selected withing each community. The article by Mansfield used systematic reviews and meta-
analysis to get research from PubMed, Web of Science and Science direct using the term

“national school lunch program”. The article by Martinelli obtained their data from the NJCHS,

it was a longitudinal study that examines the impact of the food and physical activity

environment on children’s weight and health outcomes (Martinelli,2020). The study was on a

child and their parent that lived in a predominantly low-income urban city. The article by Mozer

uses secondary data analysis of research that was conducted by the University of Washington’s

Center for Public Health and Nutrition to examine the changes in the school lunch quality. The

analysis was descriptive and longitudinal. The article by Berger et al. got data from the public

files of the 2007-2016 waves of NHANES, which was a repeated cross-sectional survey of the

civilian noninstitutionalized population of the U.S ( Berger et al., 2020). It seems most of the

articles got their data from other studies that have been done prior and most of the data was

longitudinal.

Methodology

The articles that actually collected the data used surveys (Au et al., 2020,

Martinelli,2020). These surveys were qualitative because they used open ended questions and

did phone interviews and had a focus group. The other three articles used secondary data from

other websites or studies so that make their data quantitative (Mansfield, 2017, Mozer, 2019,

Berger et al., 2020). These three articles all used surveys in the secondary data. Surveys are the

easiest and fastest way to gather data, but it may not have the best outcome in terms of

results. Having one on one interviews is probably the best way to get accurate data like the first
two articles did over the phone. It shows that they went that extra step to get information on

the topic they are researching.

Data Collection

Only two of the articles collected their own data (Au et al., 2020, Martinelli,2020). They

collected this data by conducting surveys. Surveys are an easy way to collect data because it is

quick and low cost. Collecting your own data makes it easier to collect the data you need

because you are the one that decides what the questions are going to be. The other three

articles used secondary data for their research (Mansfield, 2017, Mozer, 2019, Berger et al.,

2020). Unlike the other two articles that conducted their own survey, they do not get to tailor

their questions and get the exact information they may need. However, both ways are still

great to get the data you may need because they are both quick. Many of these articles had a

control group because they were not just sampling from one group. They collected data from

many other groups, and they did not have the same people retake the same surveys over and

over.

Analysis

One of the articles did a comparison of indices of pre- and post-implantation nutritional

quality using a combination of Wilcoxon two sample test with t approximation and a two sides

alternative t test (Mozer, 2019). This article (Martinelli,2020) used multivariable logistic

regression modes 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 (Martinelli,2020). This

article (Au et al., 2020) used descriptive statistics and multivariate regression were used.

Differences were examined by school poverty level and region, adjusting for other school- and

community-level covariates. This article (Mansfield, 2017) categorized the studies that were

secondary studies and categorized them as one-time observation studies, longitudinal

observations studies, or intervention studies. The last article used repeated measures fixed

effect analysis assuming that the differences in dietary quality between the two days could be

attributed to the substitution of school foods for other foods (Berger et al., 2020).

Conclusion

All five articles show that implementing the HHFKA improved the total dietary quality of

U.S. school students (Au et al., 2020, Berger et al., 2020, Mansfield, 2017, Martinelli, 2020,

Mozer, 2019). These students benefit from eating school lunch meals in the post HHFKA era. All

articles agree that this act has improved school lunches and are feasible across a wide variety of

schools and that these schools have successfully implemented reimbursable school meal

nutrition standards regardless of the school poverty level. Now kids have healthier options to

choose from that actually have good nutritional value and that they easily have access to. The

HHFKA is something that has benefited children statewide and it will continue to do so. It was a

huge thing to be passed since nothing had been changed about school lunches in over 30 years.
References:

Au, L. E., Ritchie, L. D., Gurzo, K., Nhan, L. A., Woodward-Lopez, G., Kao, J., . . . Gosliner, W.

(2020). Post–Healthy, Hunger-Free Kids Act Adherence to Select School Nutrition

Standards by Region and Poverty Level: The Healthy Communities Study. Journal of

Nutrition Education and Behavior, 52(3), 249-258. doi:10.1016/j.jneb.2019.10.016

Berger, A. T., Widome, R., Erickson, D. J., Laska, M. N., & Harnack, L. J. (2020). Changes in

association between school foods and child and adolescent dietary quality during

implementation of the Healthy, Hunger-Free Kids Act of 2010. Annals of Epidemiology, 47,

30-36. doi:10.1016/j.annepidem.2020.05.013

Mansfield, J. L., & Savaiano, D. A. (2017). Effect of school wellness policies and the Healthy,

Hunger-Free Kids Act on food-consumption behaviors of students, 2006-2016: a

systematic review. Nutrition reviews, 75(7), 533–552.

https://doi.org/10.1093/nutrit/nux020

Martinelli, S., Acciai, F., Au, L. E., Yedidia, M. J., & Ohri-Vachaspati, P. (2020). Parental

Perceptions of the Nutritional Quality of School Meals and Student Meal Participation:

Before and After the Healthy Hunger-Free Kids Act. Journal of Nutrition Education and

Behavior, 52(11), 1018-1025. doi:10.1016/j.jneb.2020.05.003

Mozer, L., Johnson, D. B., Podrabsky, M., & Rocha, A. (2019). School Lunch Entrées Before and

After Implementation of the Healthy, Hunger-Free Kids Act of 2010. Journal of the

Academy of Nutrition and Dietetics, 119(3), 490-499. doi:10.1016/j.jand.2018.09.009