The purpose of this study was to compare the nutrient content and cost of current school lunches with school lunch menus revised according to the Nutrient Standard Planning Guidelines proposed by the USDA for the National School Lunch Program (NSLP). Menus were obtained from a selected elementary school for September 1994. School lunches selected by the students exceeded 1/3 of RDAs for all nutrients. Sodium and saturated fat for non-revised menus were in excess of the recommended amounts for school lunch. Dietary fiber was less than five grams per lunch. School lunch menus were revised by the investigator to lower total fat, saturated fat, and sodium and to increase dietary fiber. The cost for the revised meals was significantly higher (p>.05) than the popular choice meals. It appears that the increase in food cost occurs concomitantly with increased serving of fruits and vegetables.
The purpose of this study was to determine milk receiving, storage, and serving practices in public elementary schools in the United States and to compare these practices to recommendations for quality and safety. The study consisted of two parts. First, a national survey of 258 elementary school foodservice managers who were members of the American School Foodservice Association was administered. Respondents reported frequent milk deliveries with 81.6% relying on truck drivers to rotate milk thereby missing an opportunity for inspection. In 86.2% of schools, students retrieved milk directly from the milk refrigerator. The majority of respondents (97.0%) reported milk temperatures before lunch between 32E F to 41E F; only 66.3% did so after lunch. For the second part of the study, a Hazard Analysis Critical Control Point (HACCP) inspection was conducted in 32 central Texas public elementary schools focusing on milk receiving, storage and service procedures. There was a lack of delivery inspection with only 13.3% of cafeterias observing and recording milk arrival temperatures. A model HACCP system for milk service in individual serving portions was developed with sections for receiving, storage, and service of milk. School foodservice staff might benefit from additional training on the application of HACCP to milk.
Kim, T. (1998). A comparative study of effects of changing food production system on quality issues in a school foodservice operation. Unpublished doctoral dissertation, Kansas State University, Manhattan.
The purpose of this study was to investigate the effects of changing the food production system from a conventional to a cook-chill system on students' acceptance of a selected menu-item, time-temperature control, waste composition, foodservice employees’ job satisfaction, and the financial implications in a Midwest school district. One group pretest-posttest repeated measures design was used to test hypotheses. There was significantly less plate waste of the test menu-item in the cook-chill system than in the conventional system. There were wide variations in the reheating time and method, and also the holding time and temperature, among schools and between the two systems. Overall, employees’ job satisfaction significantly (p<.05) increased 1-½ years after the implementation of the cook-chill system. Significant savings in food cost and labor cost per meal were not observed with the installation of the cook-chill system during the first year of operation. Results of this study do not support some of the perceived benefits of a cook-chill system identified in the previous literature.
Yakawich, L. A. (1997). Effects of implementing Nu Menus on food cost and other operational variables. Unpublished master’s thesis, Kansas State University, Manhattan.
The purpose of this research was to investigate the effect of implementation of Nutrient Standard Menu Planning (Nu Menus) on food costs, nutrients, and procurement practices in two selected school foodservice operations. The research included two parts: (1) an evaluation of the differences in food costs and nutrients between planned menus using the Nu Menus system and actual menus served during two time periods in two selected school districts (Districts A and B); and (2) an analysis of the differences in food cost and nutrient composition for five days’ menus planned using two different menu planning options: Meal Pattern Planning, and Nu Menus in two school districts. Actual menus served in the two districts were different from the planned menus. Districts A and B experienced an average actual food cost increase of 1.5% and 3.5% respectively, when using planned menus compared to actual menus served during the two test periods. In District A, planned menus resulted in a decrease in calories. In District B, planned menus resulted in an increase in calories. This study illustrated that when schools deviated from planned menus, the meals served to children often did not comply with the current regulations. Implementing Nu Menus in school foodservice programs requires accurate forecasts, consistent use of standardized recipes, and changes to current procurement practices.
Yoon, H. (1997). Effect of preparation methods on total fat content, moisture content, and sensory characteristics of breaded chicken nuggets and beef steak fingers. Unpublished doctoral dissertation, Texas Woman’s University, Denton.
The purpose of this study was to determine the effect of frying methods and equipment on moisture content, total fat content, and sensory characteristics of breaded chicken nuggets and beef steak fingers, commonly served for school lunches. Three preparation methods, baking, hot-air frying, and deep-fat frying, were used to prepare chicken nugget and beef steak finger products. Hot-air frying resulted in the greatest decrease in fat content for both chicken nugget and beef steak fingers. Sensory evaluation showed that deep-fat frying was the preferred method compared to baking and hot-air frying for both chicken nugget and beef steak finger products. Regular and pectin-coated chicken nuggets were analyzed for moisture and fat content before and after deep-fat frying. Fat content of pectin-coated chicken nuggets was apparently lower than regular product after deep-fat frying.
Pickert, M. J. (1995). Forecasting in commercial and noncommercial foodservice operations. Unpublished master’s thesis, Kansas State University, Manhattan.
The purpose of this study was to determine forecasting techniques currently used by commercial and noncommercial foodservice operations. Information pertaining to operational demographics, menu complexity, and current forecasting techniques was obtained by interviewing 6 commercial and 12 noncommercial foodservice operation managers. One hundred percent of the interviewed managers forecast food production on a daily basis. The most heavily relied on information used to forecast in both types of operations is historical data. Commercial operations have been using computer systems to aid in forecasting an average of one year longer than noncommercial operations. All computer systems that are in use are capable of assisting in other managerial functions such as product ordering, employee scheduling, and recipe formulation.
The purpose of this study was twofold: to develop a decision model for serviceware and to determine the extent to which school foodservice directors make resource allocation decisions based on the concepts of pollution prevention, product stewardship, and sustainable development. Cost for labor, serviceware, chemicals, electricity, water, and solid waste removal and quantity of electricity and water used were measured for two serviceware systems in a middle school in a Midwestern city. Disposable serviceware used significantly less (p < .05) water, electricity, chemicals, and labor than permanent serviceware but generated significantly greater (p < .05) volume of solid waste. Labor and serviceware were the largest cost components of permanent and disposable serviceware, respectively. Total cost/meal for permanentware ($0.08122" .0105) and disposableware ($0.08414" .0108) were not significantly different (p> .05). Results indicated that a district’s environmental conditions influenced serviceware selection.
Smith, E. K. (1995). Qualitative program planning for school foodservice: Input from students, managers and principals. Unpublished master’s thesis, Texas Woman’s University, Denton.
School foodservice is competing with commercial establishments for the participation of high school students. In the past, school foodservices served a captive audience. Students now have the option of purchasing food in the cafeteria, bringing their lunch from home, or skipping lunch. The purpose of this study was to gain information from high school students, school foodservice managers, and high school principals concerning the quality of present school lunches and needed improvements. One hundred and eighty-six students from sixteen high schools participated in focus groups. Fourteen school foodservice managers and twenty-six high school principals completed surveys. The focus groups and surveys were designed to assess opinions about the present school lunch and needed improvements. The appearance of the cafeteria dining room and needed improvements were major issues. Long lines, poor menu choices, and the taste of the food were felt to prevent students from eating lunch.
A review of literature regarding issues of weight control for overweight children was completed and followed by a focus group with seven overweight children, aged 9-11 years, from the community. The focus group, with the specific topics of snacking, television viewing, exercise, and the children’s feelings regarding their size, was conducted in an effort to affirm findings and provide insight from the child’s perspective. Findings that were consistent with the review of literature included the most frequent snack choice (sweets), preferences for high-fat foods, lack of high-fiber foods, daily television viewing by all but one child, and lack of consistent participation in physical activity. These issues must be addressed to help prevent and treat childhood obesity.
Kramer, K. R. (1998). Childhood obesity: Predicting success in a behavior modification program. Unpublished master’s thesis, Texas Woman’s University, Houston.
The purpose of this study was to determine if a questionnaire designed to assess one’s beliefs about dieting could be used as a predictor of success in a weight-control program designed for children and adolescents. Pre-program weight and height, post-program weight and height, as well as the parents' and children's/adolescents' scores from the dieting belief questionnaires were collected from a total of 48 charts. The information was divided into two age groups: adolescents age 12-15 years and children age 6-9 years. The questionnaire was to be considered a useful tool in predicting success in the weight control program if a significant positive correlation was found between score on the dieting belief questionnaire and success in the program (positive change in % ideal body weight or relative weight). No significant relationships were found between the scores on the questionnaires (parents’ and children’s/adolescents’) and the children’s/adolescents’ success in program. Results of this study do not support the use of this questionnaire as a predictor of success in children’s weight control programs.
Aguirre, C. C. (1997). Fifth graders’ knowledge of the concepts of the food guide pyramid. Unpublished master’s thesis, Texas Woman’s University, Houston.
Numerous studies have demonstrated a disturbing trend of increasing weight among children. Overweight children have a higher risk of becoming overweight adults and, therefore, an increased risk of chronic disease later in life. For this reason, it is important to begin establishing healthy dietary and exercise patterns during the childhood years. In order to teach children these healthy patterns, it first seems beneficial to assess their current nutritional knowledge. The purpose of this study was to assess fifth-graders’ knowledge of the concepts portrayed in the Food Guide Pyramid. A questionnaire was developed to measure their knowledge and was completed by 138 fifth-grade students. Upon completion, the questionnaire was graded and descriptive statistics were used to interpret the results. The fifth graders displayed the most knowledge of food groupings and the least knowledge of the number of servings recommended. The mean score of 29.96 demonstrated inadequate knowledge of the concepts portrayed in the Food Guide Pyramid.
Miles, T. J. (1997). Differences between gains in weight-for-age and length-for-age of breast-fed infants in Delaware County, Indiana and the National Center for Health Statistics growth standards. Unpublished master’s thesis, Ball State University, Muncie, IN.
Breast-fed infants appear to grow less rapidly after the first three months of age when compared with current standards from the National Center for Health Statistics (NCHS). This study was undertaken to determine whether differences do exist between the growth patterns of breast-fed infants in Muncie, Indiana, and NCHS standards, and if so, at what age do the differences become apparent. For this study, growth data were gathered from 66 infants. Women who were free of chronic conditions were eligible to participate in the study. A 24-hour data-collection period was conducted one day each month for one calendar year or as long as the subjects remained in the study. Immediately before and after each nursing during the 24-hour time period, weight measurements were taken and recorded for the infants. Lengths were measured once at this time. The analysis of data from this study is similar to previous studies, and showed that weight gain in particular, but also length gain, of the breast-fed infant was slower after three months of age in comparison to NCHS standards. This supports the recommendations of others that the weight gain of breast-fed infants should not be compared to current NCHS standards and new growth charts based on breast-fed infants are needed.
Robertson, S. M. (1997). Caloric intake, physical activity, and obesity in three-to-seven year old children. Unpublished master’s thesis, Texas Woman’s University, Houston.
The present study was undertaken to determine the relationship between caloric intake, physical activity, and obesity in three- to seven-year-old children. Annual measures of caloric intake, physical activity level, height, and sum of seven skinfolds (SSS) were obtained from 125 children. Children whose SSS was greater than or equal to one and a half standard deviations above the mean were defined as the "take-off" group and were compared to children who were growing at a normal rate. Fifteen children were identified in the "take-off" group. The results indicated that the participants in the "take-off" group (n=15) had significantly higher caloric (p# .05) and fat intakes (p# .02) during the year of "take-off" compared to the participants in the "non-take-off" group when matched on age, ethnicity, and gender, (n=33). Physical activity was not found to be significantly different between the groups. The results also indicated that age is an important factor when matching case-controls.
Williams, P. (1997). The relationship between television viewing, the number of requests and purchases of calorically dense foods and BMI percentiles in 5th and 6th grade children. Unpublished master’s thesis, Texas Woman’s University, Houston.
Childhood obesity is growing at an alarming rate in the United States, with approximately 27% of children classified as obese. The increased incidence of childhood obesity during the past 20 years is thought to be the result of environmental influences. A random sample of 100 fifth- and sixth-grade children and their parent/guardian participated in the study. The parent was asked to complete a questionnaire, and each child was weighed and measured. The purpose of this study was to determine if a relationship exists between (a) television viewing and requests for calorically dense foods, (b) television viewing and purchases of calorically dense foods, (c) percentage of requested calorically dense foods purchased and BMI percentiles, and (d) hours spent weekly viewing television and BMI percentiles. Using Pearson r correlation, the researcher failed to reject the null hypotheses. There were no relationships between the four pairs of data.
Buchanan, S. J. (1996). Diet, demographics, and CHD risk factors in a school-aged population. Unpublished master’s thesis, New York Medical College.
The cross-sectional study facilitated a comparison of the dietary fat intake of National School Lunch Program (NSLP) participants (exposed group) and non-participants (unexposed group). Data were obtained from 196 parents/guardians using a self-administered "Survey" which included a brief, non-quantitative food frequency questionnaire. Participation in the NSLP appeared to have a protective effect on students’ dietary fat intake. Unadjusted and stratified analysis estimated that the exposed group was less likely to consume a high-fat diet than the unexposed group. It is anticipated that school-based nutrition education programs, as will be developed from the results of this study, in conjunction with healthful school meals, will further reduce dietary fat consumption by empowering students with the knowledge and skills to make informed food choices.
Markello, K. J. (1996). Does nutritional intake affect the academic achievement of elementary school students? Unpublished doctoral dissertation, Alfred University, Alfred, N Y.
This study investigated the effects of nutritional intake on elementary students’ academic achievement. One hundred seventy fourth- and fifth-grade students from a suburb of Buffalo, New York, were subjects. Using multiple regression, student achievement was regressed against four nutritional variables, (protein intake, carbohydrates intake, fat intake, and iron intake), ability, gender, age, size, and socioeconomic status (SES). The results indicated that ability and age have a positive effect on achievement, and age has a negative effect on the amount of protein consumed. The results indicate that specific amounts of nutrients in a child's diet do not directly affect achievement, but suggest that future research should investigate this area with a larger, more varied sample. These results are relevant to suburban, higher SES populations.
Fellows, L. A. (1996). Obesity in preadolescent children. Unpublished master’s thesis, Texas Woman’s University, Houston.
A comprehensive review of literature on childhood obesity and a focus group of five preadolescent children, ages 8-11 years old, enrolled in a weight-maintenance program, were performed. The questions addressed during the focus group were derived from the review of literature. These included issues that the children felt aided or hindered their weight maintenance. The findings of the focus group were compared with the review of literature. The children in the focus group felt they were able to lose or maintain weight by increasing their activity level, eating healthful snacks, and by decreasing the amount of time they watched television. The family support that the children received was a primary factor for successful weight maintenance. This concurred with the review of literature that active parent/family involvement by decreasing sedentary activity (e.g. television watching) while promoting physical activity and healthy eating is essential to the treatment and prevention of childhood obesity.
Dixit, S. (1994). Dietary intakes and their determinants in low-income elementary school children. Unpublished doctoral dissertation, Tufts University, School of Nutrition Science and Policy, Medford, MA.
This dissertation was composed of three separately-titled papers.
Meal and food consumption patterns of inner city, African-American, elementary school children.
This study assessed the food selection and meal patterns, dietary diversity, and fat intake of inner-city, low-income, elementary school children in East Orange, New Jersey. The sample consisted of 676 students attending grades 2 through 5. Dietary data were collected using a modified 24-hour recall procedure. About 85% of students consumed the three basic meals, breakfast, lunch, and dinner. While few students skipped lunch or dinner, 13% skipped breakfast. Overall, 89% of students consumed >30% of daily calories from fat, and 39% consumed >40% of calories from fat. Meat was the single largest contributor to the daily fat intakes, while snack foods and added fat contributed about 10% of the daily fat intake of students who consumed any snack. Substituting lean meats for high-fat meats and reducing the amount of meat consumed can result in significant reductions in children’s fat intakes.
Impact of school feeding programs on the nutrient intakes of low-income, African-American elementary school children
This study assessed the impact of SBP and NSLP participation on the diets of inner-city, low-income elementary school children in East Orange, New Jersey. The sample consisted of 676 students attending grades 2 through 5. Dietary data were collected using a modified 24-hour recall procedure. Students were classified as single (NSLP only) or dual-program (SBP + NSLP) participants or nonparticipants (alternate breakfast and lunch eaters). SBP and/or NSLP participation is associated with a greater likelihood of achieving daily vitamin and mineral adequacy, especially for milk related nutrients. Over the 24-hour period, significantly more dual-program participants than single-program participants or program nonparticipants consumed adequate amount of nutrients. Participation in school feeding programs is associated with a greater likelihood of achieving daily nutrient adequacy for most vitamins and minerals. School meals do not differ significantly from home meals in terms of their fat content, and efforts to reduce fat intakes should focus on reducing fat content of meals consumed both at home and at school.
Factors predicting school breakfast program participation of low-income, inner-city African-American elementary school children.
This study assessed (i) reliability of parents’ reports regarding their children’s School Breakfast Program (SBP) participation behavior, (ii) prevailing parents’ attitudes toward the SBP and their impact on SBP participation, and (iii) household and child level factors determining SBP participation. SBP attendance was recorded on 4 nonconsecutive weeks over a 3-month period for 639 students attending grades 2 through 5 in three public schools in East Orange, New Jersey. Interview administered surveys were conducted on a subsample of parents of study children. The results indicate that parents tend to over-report the number of days their child eats breakfast at school. Students who had a say in the decision regarding where they would eat breakfast were more likely to participate in the SBP than those who did not have a say. Parents did not report any stigma associated with participation in the SBP. Besides offering the SBP to all students at no cost, an increase in SBP participation rates can be achieved by offering the program after the school day has begun. Since students are more likely to participate in the SBP if they had a say in the decision regarding where they should eat breakfast, future research should focus on determining students’ attitudes and perceptions about the SBP.
The purpose of this study was to determine if there was a difference in nutrition knowledge of gymnasts taught nutrition education and those not taught nutrition education. Proper nutrition for young athletes is essential for quality performance. This study was conducted on 72 female gymnasts ages 10-13 at the United States Air Force Academy that included three days of nutrition education focusing on the Food Guide Pyramid. Statistically, a t-test concluded that there was a significant difference between the two groups at the p<.05 level.
Pierce, D. R. (1998). Effects of nutrition education accompanied by reinforcement on seventh grader’s food choices. Unpublished master’s thesis, Texas Woman’s University, Houston.
The purpose of this study was to increase adolescents’ calcium and iron intakes and decrease their intake of total fat, "junk food" items, and pre-sweetened beverages by utilizing topic-based lesson plans followed by reinforcement exercises. The experimental group was given a pre-test; their lunch choices were photographed for three days; they were exposed to the lesson plans and reinforcement exercises; they were given a posttest; and their lunch choices photographed again for three days. The control group was posttested, and their lunch choices were photographed for three days. They were not exposed to the lesson plans or reinforcement exercises. The nutrition knowledge test, photographs of the students’ lunch choices, and observations from the health instructor were the three instruments used to collect data. The experimental group’s nutrition knowledge and iron intake increased and consumption of presweetened beverages decreased, but their calcium, total fat, and "junk food" item intake did not change.
Schmidt, R. M. (1997). Perceptions of teachers about nutrition education in the team nutrition project. Unpublished master’s thesis, Oklahoma State University, Stillwater.
The purpose of this study was to compare elementary and middle school teachers’ perceptions on integrating nutrition education into a classroom curriculum. A questionnaire was distributed to teachers to obtain background information along with various other information on benefits and obstacles of nutrition education. A food intake form was included to obtain the teachers’ typical school day’s intake. This information gathered was calculated into an HEI (Healthy Eating Index) score and compared to responses on the questionnaire. This study revealed that teachers believe nutrition to be an important subject that should be introduced to children at the preschool to elementary age level. A significant difference was identified between elementary and middle school teachers’ perceptions on integrating nutrition education into the curriculum and also the grade level at which children should begin their nutrition education. When perceived benefits of nutrition education were correlated to HEI scores and total number of hours of nutrition taught, a significant difference was found. Teachers who perceived more barriers to teaching nutrition than benefits did not report teaching a greater number of hours than teachers who perceived more benefits to teaching nutrition than barriers.
Gamio, M.O. (1996). The influence of point-of-purchase cafeteria-based nutrition education program on high school students. Unpublished doctoral dissertation, University of Tennessee, Knoxville.
Male and female high-school students participated in an intervention designed to promote behavior change in food selection. The students were divided in two groups. Group I received the point-of-purchase cafeteria-based nutrition education program, and Group II received the point-of-purchase cafeteria-based nutrition education program plus a brief classroom nutrition education intervention. Evaluation included food practices, nutrition knowledge, attitudes and their perceptions about the school foodservice and the point-of-purchase intervention. For behavior change, there was a significant Time Effect for females in Group II with a significant decrease in both fat and vitamin C. Both genders in Group II had a significant decrease in energy intake. Males in Group II had a significant decrease in their fat intake and intakes of calcium and vitamin D. For nutrition knowledge there was no significant difference for Time Effect or for Group Effect for either gender. For nutrition attitudes there was a significant decrease in positive nutrition attitudes only for males Group II. Recommendations for greater changes in behavior, knowledge, and attitudes include a longer, more focused classroom nutrition education component and cafeteria serving styles which allow students more choices, especially among vegetables.
The purpose of this study was to determine the preferences for regular versus fat-modified food products among adolescents. A total of 109 students participated in the study. Four food pairs were taste tested over a period of two days. A five-point Likert-like scale (1=like extremely; 5=dislike extremely) was used to record the adolescents’ food preferences. Results were analyzed using a two-factor ANOVA. The whole milk (M =2.55, SD 1.35) was preferred over 1% milk (M =3.27, SD =1.50), indicating a statistically significant result, F (1,99) =19.53, p< .000. The regular potato chip (M =1.64, SD =.84) was also preferred over the fat-modified potato chip (M =1.91, SD =.78): again indicating a significant difference, F(1,101) =8.12, p<.005. The score of the remaining food pairs did not demonstrate a significant difference. Thus, the results indicated that there was a significant difference in adolescents’ degree of preference for regular versus fat-modified food products.
Gary, L. A. (1997). Children’s preferences for regular vs. fat-modified food products. Unpublished master’s thesis, Texas Woman’s University, Houston.
The purpose of this study was to determine if there is a difference in children’s degree of food preference for regular versus fat-modified food products. First-grade students were given eight food samples; four regular foods and four low-fat alternatives. Five-point facial hedonic scales were used for the children to record their reaction to each food sample (5=highest rating; 1= lowest rating). Results revealed that there was a significant difference in children’s degree of preference for two of the food pairs (p<.0005). Specifically, mean hedonic ratings indicated full-fat cheese (M =4.67, SD =0.87) was preferred over fat-free cheese (M =2.21, SD =1.38), and low-fat milk (M =4.71, SD =0.84) was preferred over full-fat milk (M =2.54, SD =1.41). No significant difference in children’s degree of preference was noted for potato chips or graham crackers. Overall, responses indicated that for three of the four food pairs, children showed equal or greater preference for the reduced-fat versions of food products.
Seelig, A. D. (1997). Preferences of seventh-grade students for low-fat school menu items. Unpublished master’s thesis, Texas Woman’s University, Denton.
The purpose of this study was to determine the feasibility of adding lower-fat foods to school lunch menus. The study compared the survey responses of seventh-grade students from selected middle schools. One hundred twenty-four students participated in the study. Results showed males and females differed in their beliefs about the importance of choosing foods low in fat and their willingness to eat more fruits, vegetables, and vegetarian foods. Taste was the most important factor to students when deciding to eat in the cafeteria and when selecting lunch menu items. Seventh-grade students preferred high-fat lunch menu items and chose sodas more than other beverages. Students were generally not aware which of their school lunch menu items were high in fat. While males ate snack foods and sodas in addition to their school lunches, females ate them in place of their school lunches.
Stalls, S. (1997). Sensory testing of reduced-fat bar cookies by fourth grade students. Unpublished master’s thesis, Texas Woman’s University, Denton.
The purpose of this study was to determine the level of acceptability of three different low-fat brownies compared to the USDA brownie recipe. Seventy-seven fourth-grade students obtained parental consent and took part in the sensory testing of four brownie samples (control, applesauce, plum/apple, and low-fat commercial mix). A nine-point hedonic and pictorial-face scale from "super good" to "super bad" (9-1) was used for each product. Higher values for acceptance scores indicate preference. The low-fat mix scored the highest mean of 8.052, compared to mean values for the control 7.195, the applesauce brownie 7.039, and the plum/apple 6.909. Preparation of low-fat brownies by use of a low-fat commercial mix or modification of a standard recipe with alternative ingredients for fat will assist institutions in meeting recommendations for lower fat school lunch menus.
This study hypothesized that feeding disorders in disabled children would be significantly more stressful to parents than other childhood disabilities; that pediatric feeding disorders would be more stressful in single-parent families than two-parent families; and that childhood feeding disorders would be less stressful to fathers than to mothers.
Forty-seven subjects representing 31 households responded to the Friedrich Questionnaire of Resources and Stress (QRS-F) and a demographic survey. Analysis of Variance of the QRS-F scores indicated significantly greater stress levels in families of disabled children who receive tube feedings, but not in families whose disabled children required special assistance with oral feedings. There was an inadequate number of responses from single-parent families to statistically compare their stress levels to two-parent families with feeding-disordered children. The comparison of fathers and mothers of disabled children with feeding disorders did not yield a statistically significant difference in stress levels. The greater stress levels found in parents of disabled children who received tube feedings show a need to provide improved education and training programs, as well as support after hospital discharge, to families with tube-fed children.
Breault, J. L. (1995). Development and evaluation of a training manual on feeding children with special needs, birth through age five. Unpublished master’s thesis, Kansas State University, Manhattan.
The purpose of this study was to develop a manual as a companion piece to a video focused on training childcare providers on feeding children with special needs. The manual was developed considering the needs of adult learners. The total package, Special Foods for Special Kids, (video and manual) was then evaluated using a preliminary expert panel, modified Delphi panel, and focus groups. Evaluation was completed on content, readability, and format of the manual. The addition of a glossary of terms, a section on autism, and a section on choking were incorporated in the revision of the final manual.
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