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Barriers and Facilitators to High School Meal Program Participation: A Qualitative Study of Students and Their Caregivers.

BACKGROUND
The school food environment is a critically important area to target the health of millions of students, especially those experiencing food insecurity. However, both students and caregivers have noted significant barriers to participation in the school meal program, including taste, lunchroom experience, and limited availability of fresh, healthy foods. There is a lack of qualitative research which considers both caregiver and adolescent perspectives, particularly among youth of color.


METHODS
Forty-seven students (77% Black) and 24 caregivers across 4 midwestern high schools participated in focus groups and key informant interviews assessing barriers and facilitators to school meal participation. We conducted thematic analysis of the data using matrix intersection queries and reviewing frequencies of relevant nodes to identify themes.


RESULTS
Themes about the importance of freshness and quality of the foods served in the lunchroom emerged from both students and caregivers.


CONCLUSIONS
Future research may explore differences in meal participation depending on types of vender, farm to school program status, and other local variations in public schools and determine whether they increase participation, reduce food insecurity, and increase diet quality.