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Purpose/Objectives: Analyses were conducted to examine variations in fourth-grade children's participation in school-breakfast and school-lunch programs by weekday, month, socioeconomic status, absenteeism, gender, and school-breakfast location. Methods: Fourth-grade children were participants in a dietary-reporting validation study during either the 2005-2006 or 2006-2007 school years in 17 or 8 schools, respectively, in one South Carolina school district. For the two school years, the location of the school breakfast was the classroom for 6 and 7 schools, respectively, and the cafeteria for the remaining schools. District administrative records provided information about 180 possible days of participation in the school breakfast and lunch programs for each of 1,060 children (91% Black, 52% girls). The state's Office of Research and Statistics linked data on school-meal participation with information about individual children's socioeconomic status (eligibility for free or reduced-price school meals) and annual absenteeism from school. Results: For school-provided breakfast, logistic regression showed participation rate differences by weekday (smallest for Monday [56.1%], largest for Wednesday [57.8%], "p" < 0.001), month (smallest for April [53.5%], largest for September [60.8%], "p" < 0.001), socioeconomic status (smallest for full-price status [27.5%], largest for free-meal status [63.4%], "p" < 0.001), school-breakfast location (smaller for breakfast located in the cafeteria [38%] than classroom [71%], "p" < 0.001), and absenteeism ("p" < 0.001). For school-provided lunch, logistic regression showed participation rate differences by weekday (smallest for Friday [81.9%], largest for Thursday [83.3%], "p" < 0.001), month (smallest for May [78.7%], largest for August [86.0%], "p" < 0.001), socioeconomic status (smallest for full-price status [72.1%], largest for free-meal status [84.9%], "p" < 0.001), and absenteeism ("p" < 0.001). There were no differences in participation rate by gender. Applications for Child Nutrition Professionals: Administrative participation records are used for forecasting purchasing and production. Using such records in research studies may provide insight into factors influencing children's participation in school-provided meals. Districts and managers are encouraged to share administrative records of children's participation in school-provided meals with researchers.

Background: Research suggests significant health differences between rural dwelling youth and their urban counterparts with relation to cardiovascular risk factors. This study was conducted to (1) determine relationships between physical activity and markers of metabolic syndrome, and (2) to explore factors relating to physical activity in a diverse sample of rural youth. Methods: Data were collected from 4th, 6th, 8th, and 11th grade public school students in the rural Southeastern United States in the spring of 2002. Physiological data included anthropometrics, fasting glucose, lipids, hemodynamics, and skinfold measurements. Psychosocial data included parental support for physical activity, accessibility of physical activity facilities, and safety concerns for physical activity. Behavioral data included self-reported physical activity and sedentary behaviors. Results: After adjusting for sex, race, and age, subjects with low level of physical activity were 3 times more likely to be positive for metabolic syndrome compared to those reporting a high level of physical activity. Subjects reporting a low level of physical activity were 2.4 times more likely to be overweight compared to subjects reporting a high level of physical activity. Students with high levels of physical activity were more likely to have parents who provided money for physical activity lessons and sports teams. Conclusions: Rural youth with low levels of physical activity participation were at increased risks for metabolic syndrome and overweight. Effective physical activity promotions addressing supports for physical activity are urgently needed in rural America.

Objective: To compare reporting accuracy for breakfast and lunch in 2 studies. Design: Children were observed eating school meals and interviewed the following morning about the previous day. In Study 1, 104 children were each interviewed 1 to 3 times with [greater than or equal to] 25 days separating any 2 interviews. In Study 2, 121 children were each interviewed once in forward (morning-to-evening) and once in reverse (evening-to-morning) order, with these interviews separated by [greater than or equal to] 29 days. Setting: 12 schools. Participants: Fourth-grade children. Main Outcome Measures: For each meal, food-item variables (observed number, reported number, omission rate, intrusion rate, total inaccuracy) and kcal variables (observed, reported, correspondence rate, inflation ratio). Analysis: General linear mixed models. Results: For each study, observed and reported numbers of items and kcal, and correspondence rate (reporting accuracy), were greater for lunch than for breakfast; omission rate, intrusion rate, and inflation ratio (measures of reporting error) were greater for breakfast than for lunch. In Study 1, for each meal over interviews, total inaccuracy decreased and correspondence rate increased. In Study 2, for each meal for boys for reverse and for girls for forward order, omission rate was lower and correspondence rate was higher. Conclusions and Implications: Breakfast was reported less accurately than lunch. Despite improvement over interviews (Study 1) and differences for order x sex (Study 2), reporting accuracy was low for breakfast and lunch. Key Words: children, dietary recalls, reporting accuracy, school breakfast, school lunch, observation, validation

Objective Validation study data are used to illustrate that conclusions about children's reporting accuracy for energy and macronutrients over multiple interviews (ie, time) depend on the analytic approach for comparing reported and reference information--conventional, which disregards accuracy of reported items and amounts, or reporting-error-sensitive, which classifies reported items as matches (eaten) or intrusions (not eaten), and amounts as corresponding or overreported. Subjects and design Children were observed eating school meals on 1 day (n=12), or 2 (n=13) or 3 (n=79) nonconsecutive days separated by [greater than or equal to] 25 days, and interviewed in the morning after each observation day about intake the previous day. Reference (observed) and reported information were transformed to energy and macronutrients (ie, protein, carbohydrate, and fat), and compared. Main outcome measures For energy and each macronutrient: report rates (reported/reference), correspondence rates (genuine accuracy measures), and inflation ratios (error measures). Statistical analyses Mixed-model analyses. Results Using the conventional approach for analyzing energy and macronutrients, report rates did not vary systematically over interviews (all four P values >0.61). Using the reporting-error-sensitive approach for analyzing energy and macronutrients, correspondence rates increased over interviews (all four P values <0.04), indicating that reporting accuracy improved over time; inflation ratios decreased, although not significantly, over interviews, also suggesting that reporting accuracy improved over time. Correspondence rates were lower than report rates, indicating that reporting accuracy was worse than implied by conventional measures. Conclusions When analyzed using the reporting-error-sensitive approach, children's dietary reporting accuracy for energy and macronutrients improved over time, but the conventional approach masked improvements and overestimated accuracy. The reporting-error-sensitive approach is recommended when analyzing data from validation studies of dietary reporting accuracy for energy and macronutrients. J Am Diet Assoc. 2007;107:595-604.

The present analysis examined changes in the variability of overnight sodium excretion in 84 free-living adolescents (ages 15 to 19 years) on a 4-day sodium-controlled diet in which foods provided were selected by adolescents from an extensive list of menu items. The only selection criterion imposed was that foods selected for each day contain 4,000 [+ or -] 200 mg sodium. Adolescents collected overnight urine samples. Repeated measures analysis of variance tested the effect of diet day on overnight sodium excretion, overnight urinary sodium concentration, and overnight urinary volume. Variance ratio test evaluated changes in overnight sodium excretion variance across days. Day 4 overnight sodium excretion was statistically lower than days i to 3 (1.84 vs 6.54, 5.94, and 5.52 mEq/h [1.84 vs 6.54, 5.94, and 5.52 mmol/h]). Day 4 overnight urinary sodium concentration was lower than days 1 to 3 (32.16 vs 119.64, 109.61, and 111.32 mEq/L [32.16 vs 119.64, 109.61, and 111.32 mmol/L]). The variance of overnight sodium excretion from day 1 to day 4 was reduced 10-fold from 20.1 mEq/h (20.1 mmol/h) to 1.90 mEq/h (1.90 mmol/h). Daily overnight urine volumes remained constant, averaging 451.7 mL/day. The dietary protocol successfully reduced the variability of sodium intake as estimated by overnight sodium excretion in free-living adolescents. The protocol could be expanded to include baseline values, additional days of sodium control, and varying levels of dietary sodium intake.

This pilot study investigated body mass index (BMI; calculated as kg/[m.sup.2]), sex, interview protocol, and children's accuracy for reporting kilocalories. Forty 4th-grade children (20 low-BMI: [greater than or equal to] 5th and <50th percentiles, 10 boys, 15 African American; 20 high-BMI: [greater than or equal to] 85th percentile, 10 boys, 15 African American) were observed eating school meals (breakfast, lunch) and interviewed either that evening about the prior 24 hours or the next morning about the previous day, with 10 low-BMI (5 boys) and 10 high-BMI (5 boys) children per interview protocol. Five kilocalorie variables were analyzed using separate four-factor (BMI group, sex, race, interview protocol) analyses of variance. No effects were found for reported or matched kilocalories. More kilocalories were observed (P<0.02) and omitted (P<0.05) by high-BMI than low-BMI children. For intruded kilocalories, means were smaller (better) for high-BMI girls than high-BMI boys, but larger for low-BMI girls than low-BMI boys (interaction P<0.04); low-BMI girls intruded the most while high-BMI girls intruded the least. For interview protocol, omitted and intruded kilocalories were higher (worse), although not significantly so (P values <0.11), for interviews about the previous day than the prior 24 hours. These results illuminate relations of BMI, sex, interview protocol, and children's reporting accuracy, and are consistent with results concerning BMI and sex from studies with adults.

Quality control is an important aspect of a study because the quality of data collected provides a foundation for the conclusions drawn from the study. For studies that include interviews, establishing quality control for interviews is critical in ascertaining whether interviews are conducted according to protocol. Despite the importance of quality control for interviews, few studies adequately document the quality control procedures used during data collection. This article reviews quality control for interviews and describes methods and results of quality control for interviews from two of our studies regarding the accuracy of children's dietary recalls; the focus is on quality control regarding interviewer performance during the interview, and examples are provided from studies with children. For our two studies, every interview was audio recorded and transcribed. The audio recording and typed transcript from one interview conducted by each research dietitian either weekly or daily were randomly selected and reviewed by another research dietitian, who completed a standardized quality control for interviews checklist. Major strengths of the methods of quality control for interviews in our two studies include: (a) interviews obtained for data collection were randomly selected for quality control for interviews, and (b) quality control for interviews was assessed on a regular basis throughout data collection. The methods of quality control for interviews described may help researchers design appropriate methods of quality control for interviews for future studies.

This article (a) provides a general review of interobserver reliability (IOR) and (b) describes our method for assessing IOR for items and amounts consumed during school meals for a series of studies regarding the accuracy of fourth-grade children's dietary recalls validated with direct observation of school meals. A widely used validation method for dietary assessment is direct observation of meals. Although many studies utilize several people to conduct direct observations, few published studies indicate whether IOR was assessed. Assessment of IOR is necessary to determine that the information collected does not depend on who conducted the observation. Two strengths of our method for assessing IOR are that IOR was assessed regularly throughout the data collection period and that IOR was assessed for foods at the item and amount level instead of at the nutrient level. Adequate agreement among observers is essential to the reasoning behind using observation as a validation tool. Readers are encouraged to question the results of studies that fail to mention and/or to include the results for assessment of IOR when multiple people have conducted observations. J Am Diet Assoc. 2004;104:1385-1392.

We investigated telephone administration of the Children's Social Desirability (CSD) scale and our adaptation for children of the Social Desirability for Food scale (C-SDF). Each of 100 4th-graders completed 2 telephone interviews 28 days apart. CSD scores had adequate internal consistency and test-retest reliability, and a 14-item subset was identified that sufficiently measures the same construct. Our C-SDF scale performed less well in terms of internal consistency and test-retest reliability; factor analysis revealed 2 factors, 1 of which was moderately related to the CSD. The 14-item subset of the CSD scale may help researchers understand error in children's dietary reports. KEY WORDS: children, social desirability, dietary reports

Objective: To investigate the accuracy of children's dietary recalls of school breakfast and school lunch validated with observations and obtained during in-person versus telephone interviews. Design: Each child was observed eating school breakfast and school lunch and was interviewed that evening about that day's intake. Setting: Ten elementary schools. Participants: A sample of fourth-graders was randomly selected within race (black, white) and gender strata, observed, and interviewed in person (n = 33) or by telephone (n = 36). Main Outcomes Measured: Rates for omissions (items observed but not reported) and intrusions (items reported but not observed) were calculated to determine accuracy for reporting items. A measure of total inaccuracy was calculated to determine inaccuracy for reporting items and amounts combined. Analysis: Analysis of variance; chi-square. Results: Interview type (in person, telephone) did not significantly affect recall accuracy. For omission rate, intrusion rate, and total inaccuracy, means were 34%, 19%, and 4.6 servings for in-person recalls and 32%, 16%, and 4.3 servings for telephone recalls of school breakfast and school lunch. Conclusions and Implications: The accuracy of children's recalls of school breakfast and school lunch is not significantly different whether obtained in person or by telephone. Whether interviewed in person or by telephone, children reported only 67% of items observed; furthermore, 17% of items reported were not observed. KEY WORDS: children, dietary recalls, observations, validity, in person, telephone

Objective: To use data from observations and interviews to document fourth-graders' preferences for, and consumption of, fruits compared to vegetables available as part of school lunches. Design: Observations and interviews were conducted for studies regarding the impact of time interval between eating and reporting on the accuracy of children's school lunch recalls. Subjects/Settings: Children were recruited from up to 4 schools in one district during 3 school years; 63% agreed to participate. Randomly selected children (n = 237) were each observed eating school lunch once and were interviewed (regarding items eaten and preferences for items eaten) within 1 1/2 hours or the next morning. Main Outcome Measures: Observed consumption of servings of items available as part of school lunch was recorded as none, taste, little bit, half, most, and all. Response options for preferences for items available as part of school lunch were liked not at all, a little, and a lot. Statistical Analyses Performed: Mixed-model analysis of variance. Results: Preferences were higher for fruits than vegetables. As preferences increased, consumption increased (P < .0001). Consumption of fruits compared to vegetables was similar after adjusting for preferences. Implications: Research is needed to understand how to increase children's preferences for vegetables as a means of increasing consumption. Key Words: fruits, vegetables, school lunch, preferences, consumption (J Nutr Educ Behav. 2002;34:166-171.)

Objective: To explore fourth-graders' school breakfast participation by gender and race (black, white) and examine the extent to which parents' responses to 'Does this child usually eat school breakfast?' reflected their children's participation. Design: Parents answered 'yes' or 'no' to the questions printed on consent forms. Observers documented which children participated in school breakfast on 26 to 51 randomly selected days per school during 24 weeks in the 1999-2000 school year. Subjects: 357 children recruited from all 22 fourth-grade classes from 6 schools in 1 public school district. Variables Measured: Participation rate, participation rate grouping [usually participated ([greater than or equal to] 50% of days observed), did not usually participate (< 50% of days observed)]. Statistical Analyses Performed: Komolgorov-Smirnov tests, McNemar's test. Results: Median participation rate was 37.5% overall. Distribution of participation rates differed significantly by race (K-S test, P < .001) but not gender. There was a significant difference in the percentage of parents who said 'yes' or 'no' compared to children's usual participation grouping (McNemar test, P < .001). Of parents who said 'yes,' 66% of children usually participated; of parents who said 'no,' 92% of children did not usually participate. Implications: Children, not parents, must be the source for learning about what children eat at school. Key Words: children, parents, School Breakfast Program participation (J Nutr Educ Behav. 2002;34:159-165)

ABSTRACT Objective To determine the accuracy and consistency of fourth-graders' school breakfast and school lunch recalls obtained during 24-hour recalls and compared with observed intake. Design Children were interviewed using [...]

This commentary addresses the role of behavior and learning in children's liking and eating of vegetables and candy, discussing the results from research with preschool children concerning their development of food preferences and the social context of eating. Practical applications of the research results for schools are presented. (SM)

Objective To validate fourth-graders' self-reports of school lunch by comparing their reports to lunch observations, and to determine the impact on accuracy of gender, ethnicity, meal component, and time interval between eating and reporting. Design Students were randomly selected, observed eating lunch, and interviewed the same day, next day, or Monday regarding Friday's lunch. Accuracy of reporting items was determined by tallying matched foods (items reported and observed), phantom foods (items reported but not observed), and omitted foods (items not reported but observed). Accuracy of reporting amount eaten was determined by calculating absolute and arithmetic differences. Subjects Subjects were 260 students: 89 same-day, 148 next-day, and 23 Monday recalls; 59 whites (30 boys) and 201 blacks (103 boys) from four schools. Statistical analyses Rates for matched, phantom, and omitted foods; analysis of variance; Friedman's nonparametric analog of analysis of variance; Student-Newman-Keuls' post hoc comparisons. Results In regard to reporting items, the respective rates for matched, phantom, and omitted foods were 84%, 5%, and 16% for same-day recalls; 68%, 13%, and 32% for next-day recalls; and 38%, 48%, and 62% for Monday recalls. Rates for omitted and phantom foods were higher for Monday recalls than for next-day recalls, which were higher than for same-day recalls (P, Nutrition studies concerning children often require them to provide dietary self-reports; however, validated dietary assessment methods for children are needed (1-6). Validity is the degree to which a method measures [...]

Objective To develop and validate a consensus set of retrieval categories for how children remember what they have eaten, and to relate retrieval categories to accuracy of reporting items eaten during school lunch. Design A Delphi technique study was conducted using 10 psychologists. The subject matter consisted of responses transcribed from interviews conducted with 89 randomly selected fourth graders within 90 minutes of eating. Retrieval categories were evaluated for accuracy by comparing students' self-reported lunch intake with observation. Statistical analyses For round 1, a centroid hierarchical cluster analysis was used to identify common sets of rating pairs to propose categories for reaching consensus. For rounds 2 and 3, percent of agreement was calculated. Accuracy was tabulated across meal items and student use by retrieval category. Results After round 3, we found that 23 'near-consensus' categories were used by at least eight raters. Six categories were used 60% of the time, 4 were used 20% of the time, and 5 were used 15% of the time. Less frequently used categories were combined with similar, more frequently used categories for a total of 16 categories. Students used a large variety of retrieval categories when accurately reporting consumption. Of the 16 categories, 12 were used similarly by both accurate and inaccurate students. Where there were differences in accuracy by retrieval category, the more accurate students used 'taste/smell/texture' and 'visual' in deference to 'order items consumed' and 'oral cue still present.' Applications These categories provide insight into the broad range of retrieval categories that children use and provide direction for researchers to design and study specific cues to enhance the accuracy of children's self-reports of diet., Survey researchers are aware that memory for autobiographical information is not dependable, and that inference, which helps to fill in the details that respondents cannot recall, is inexact and often [...]

Background: Qualitative methods were used to better understand how to obtain interviewer-administered recalls of physical activity from children. Methods: Subjects were 24 third- and fifth-grade children from 1 school in Columbia, South Carolina. Cognitive interviews targeted different retention intervals (about the same or previous school day). Round 1 's protocols used an open format and had 4 phases (obtain free recall, review free recall, obtain details, review details). Round 2's protocols used a chronological format and had 3 phases (obtain free recall, obtain details, review details). Trained coders identified discrepancies across interview phases in children's recalls of physical activity at physical education (PE) and recess. Based on the school's schedule, children's reports of PE and recess were classified as omissions (scheduled but unreported) or intrusions (unscheduled but reported). Results: Across interview phases, there were numerous discrepancies for Round 1 (regardless of grade, sex, or retention interval) but few discrepancies for Round 2. For Rounds 1 and 2, respectively, 0% and 0% of children omitted PE, while 33% and 0% intruded PE; 44% and 56% of children omitted recess, while 33% and 0% intruded recess. Conclusions: Results provide important information for facilitating interviewer-administered recalls of physical activity with elementary-age children. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives To evaluate the feasibility of implementing 3 specific prompting methods among students in the first and fourth grades (mean age=7.2 and 10.1 years, respectively), to validate recall accuracy [...]