Vegetarian meals in the national school lunch program: Emploring the barrriers and facilitators

Background: The school food environment is critical in demonstrating and encouraging a healthy dietary pattern among children. Incorporating vegetarian options into school lunch menus is an under-examined aspect of the school food environment, but has the potential to help achieve federal nutrition standards and introduce students to diverse foods. The purpose of this research was to explore the barriers and facilitators to serving meat alternates and vegetarian meals in the school lunch program. Methods: Peer-reviewed literature, grey literature, and federal documents were reviewed to summarize the current state of research and federal guidelines on meat alternates and vegetarian meals in schools. Qualitative data collection to explore school personnel perspectives on serving vegetarian options took place between November 2011 and June 2012. At the district level, 19 semi-structured interviews were completed with food service personnel in school districts across the United States representing various geographical regions, district sizes, and student demographics. At the school level, 18 semi-structured interviews with school personnel, 5 observations, and review of 10 school lunch menus took place in the Baltimore City Public School district, chosen based on its emphasis on the availability of vegetarian meals through district-wide implementation of Meatless Monday. Interview participants, schools, and districts were selected based on convenience and purposive sampling. Interview transcriptions and observation notes were coded and reviewed for key themes using ATLAS.ti 6.2. Results: Key barriers to serving vegetarian options were students' food preferences, greater food waste and drop in school lunch participation rates, negative public opinion, and negative parent and personnel attitudes. Key facilitators to serving vegetarian options were demand for vegetarian meals, community support and involvement in school nutrition, providing choice and variety of well-presented vegetarian options, and flexibility of school meal guidelines. Conclusions: This research demonstrates how federal school meal guidelines have evolved to provide increased flexibility in providing vegetarian options; however, achieving acceptance among some students, school personnel, and families is a challenge. Multi-level strategies involving schools, families, communities, and policy makers are needed to create and sustain a school environment that is supportive of offering vegetarian options. Future research should explore student and family perspectives