Inventory versus checklist approach to assess middle school à la carte food availability

Background: The purpose of this research is to evaluate 2 methods of assessing foods available on school à la carte lines for schools' ability to assess the proportion of foods that are healthful options. Methods: This observational study used data collected at 38 middle schools, October 2006-May 2007. An inventory method was used to collect detailed information of items available on each school's à la carte line, followed by a simplified checklist form. Using the detailed inventory method, the proportion of items meeting the Institute of Medicine's (IOM) nutrition standards for foods available at each school was calculated. From the checklists, we calculated the proportion of categories representing more healthful foods. Schools were independently ranked according to the percentage of items meeting the IOM criteria, (inventory data) and the percentage of food categories considered "healthy" (checklist data). Wilcoxon rank sum test was used to compare school rankings. Results: The inventory and checklist approaches showed a good level of agreement when both methods were independently used to rank the level of healthy foods available on à la carte (Wilcoxon rank sum = 32.5, p =.62). Conclusion: For purposes of ranking schools along a continuum of "healthfulness of foods on à la carte lines," especially when resources are limited, a checklist approach appears to be satisfactory. This method may also be useful to school stakeholders needing an inexpensive à la carte assessment tool.