School Site Visits for Community-Based Participatory Research on Healthy Eating


      School nutrition policies are gaining support as a means of addressing childhood obesity. Community-based participatory research (CBPR) offers an approach for academic and community partners to collaborate to translate obesity-related school policies into practice. Site visits, in which trained observers visit settings to collect multilevel data (e.g., observation, qualitative interviews), may complement other methods that inform health promotion efforts. This paper demonstrates the utility of site visits in the development of an intervention to implement obesity-related policies in Los Angeles Unified School District (LAUSD) middle schools.


      In 2006, trained observers visited four LAUSD middle schools. Observers mapped cafeteria layout; observed food/beverage offerings, student consumption, waste patterns, and duration of cafeteria lines; spoke with school staff and students; and collected relevant documents. Data were examined for common themes and patterns.


      Food and beverages sold in study schools met LAUSD nutritional guidelines, and nearly all observed students had time to eat most or all of their meal. Some LAUSD policies were not implemented, including posting nutritional information for cafeteria food, marketing school meals to improve student participation in the National School Lunch Program, and serving a variety of fruits and vegetables. Cafeteria understaffing and costs were obstacles to policy implementation.


      Site visits were a valuable methodology for evaluating the implementation of school district obesity-related policies and contributed to the development of a CBPR intervention to translate school food policies into practice. Future CBPR studies may consider site visits in their toolbox of formative research methods.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Flegal K.M.
        • Carroll M.D.
        • Kuczmarski R.J.
        • Johnson C.L.
        Overweight and obesity in the U.S.: prevalence and trends, 1960–1994.
        Int J Obes. 1998; 22: 39-47
        • IOM
        Schools can play a role in preventing childhood obesity.
        • Briefel R.R.
        • Crepinsek M.K.
        • Cabili C.
        • Wilson A.
        • Gleason P.M.
        School food environments and practices affect dietary behaviors of U.S. public school children.
        J Am Diet Assoc. 2009; 109: S91-S107
        • Story M.
        • Kaphingst K.M.
        • French S.
        The role of schools in obesity prevention.
        Future Child. 2006; 16: 109-142
      1. U.S. Department of Agriculture. Child Nutrition and WIC Reauthorization Act of 2004, Pub. L. No. 108–265, Sect. 204 (2004).

        • National Conference of State Legislatures
        Childhood obesity—an overview of policy options for 2003–2004.
        • Los Angeles Unified School District
        Los Angeles School District Healthy Beverage Motion.
        • Los Angeles Unified School District
        Los Angeles School District Obesity Prevention Motion.
        • U.S. Government Accountability Office
        School lunch program: efforts needed to improve nutrition and encourage healthy eating.
        General Accounting Office, Washington DC2003
        • California Project Lean
        School wellness policy development, implementation, and evaluation.
        • U.S. Department of Agriculture
        Foods sold in competition with USDA school meal programs: a report to Congress.
        USDA, Washington DC2001
      2. Community-Based Participatory Research Conference summary, Agency for Healthcare Research and Quality, November 27–28, 2001, Rockville MD.

        • Israel B.A.
        • Eng E.
        • Schulz A.J.
        • Parker E.A.
        Methods in community-based participatory research for health.
        John Wiley & Sons, San Francisco2005
        • Singleton R.A.
        • Straits B.C.
        Approaches to social research.
        4th ed. Oxford University Press, New York2005
        • Farquar S.A.
        • Parker E.A.
        • Schulz A.J.
        • Israel B.A.
        Application of qualitative methods in program planning for health promotion interventions.
        Health Promot Pract. 2006; 7: 234-242
        • Lawrenz F.
        • Keiser N.
        • Lavoie B.
        Evaluative site visits: a methodological review.
        Am J Eval. 2003; 24: 341-352
        • Nightingale D.
        • Rossman S.
        Managing field data collection from start to finish.
        in: Wholey J. Hatry H. Newcomer K. Handbook of practical program evaluation. Jossey-Bass, San Francisco1994
        • Chung P.J.
        • Borneo H.
        • Kilpatrick S.D.
        • et al.
        Parent–adolescent communication about sex in Filipino American families: a demonstration of community-based participatory research.
        Ambul Pediatr. 2005; 5: 50-55
        • Goh Y.Y.
        • Bogart L.M.
        • Sipple-Asher B.
        • et al.
        Using community-based participatory research to identify potential interventions to overcome barriers to adolescents' healthy eating and physical activity.
        J Behav Med. 2009; 32: 491-502
        • Los Angeles Unified School District
        Los Angeles school district profile 2006–2007.
        • Los Angeles Unified School District
        Los Angeles Unified School District Food Service Branch Monthly Newsletter 2008, January.
        • Los Angeles Unified School District
        Los Angeles School District Cafeteria Improvement Motion.
        • Educational Data Partnership
        District information.
        • Uyeda K.
        • Bogart L.M.
        • Hawes-Dawson J.
        • Schuster M.A.
        Development and implementation of a school-based obesity prevention intervention: lessons learned from community-based participatory research.
        Prog Community Health Partnersh. 2008; 3: 249-255
        • Fishbein M.
        A reasoned action approach to health promotion.
        Med Decis Making. 2008; 28: 834-844
        • Landis J.R.
        • Koch G.G.
        The measurement of observer agreement for categorical data.
        Biometrics. 1977; 33: 159-174
        • Shrout P.E.
        • Fleiss J.L.
        Intraclass correlations: uses in assessing rater reliability.
        Psychol Bull. 1979; 86: 420-428
        • MacVean M.
        LA Unified schools violate junk food ban.
        (LA Times 2009, May 9)
        • Gates D.
        • Brehm B.
        • Hutton S.
        • Singler M.
        • Poeppelman A.
        Changing the work environment to promote wellness: a focus group study.
        AAOHN J. 2006; 54: 515-520
        • Polacsek M.
        • O'Brien L.M.
        • Lagasse W.
        • Hammar N.
        Move & Improve: a worksite wellness program in Maine.
        Prev Chronic Dis. 2006; 3: A101
        • Quandt S.A.
        • Arcury T.A.
        • Austin C.K.
        • Cabrera L.F.
        Prevention occupational exposure to pesticides: using participatory research with Latino farmworkers to develop an intervention.
        J Immigr Health. 2001; 3: 85-96
        • Hersey J.
        • Williams-Piehota P.
        • Sparling P.B.
        • et al.
        Promising practices in promotion of healthy weight at small and medium-sized U.S. worksites.
        Prev Chronic Dis. 2008; 5: A122