Intervention effects on kindergarten and first-grade teachers' classroom food practices and food-related beliefs in American Indian reservation schools.

Prevalence of obesity among American Indian children is higher than the general US population. The school environment and teachers play important roles in helping students develop healthy eating habits. The aim of this prospective study was to examine teachers' classroom and school food practices and beliefs and the effect of teacher training on these practices and beliefs. Data were used from the Bright Start study, a group-randomized, school-based trial that took place on the Pine Ridge American Indian reservation (fall 2005 to spring 2008). Kindergarten and first-grade teachers (n=75) from 14 schools completed a survey at the beginning and end of the school year. Thirty-seven survey items were evaluated using mixed-model analysis of variance to examine the intervention effect for each teacher-practice and belief item (adjusting for teacher type and school as random effect). At baseline, some teachers reported classroom and school food practices and beliefs that supported health and some that did not. The intervention was significantly associated with lower classroom use of candy as a treat (P=0.0005) and fast-food rewards (P=0.008); more intervention teachers disagreed that fast food should be offered as school lunch alternatives (P=0.019), that it would be acceptable to sell unhealthy foods as part of school fundraising (P=0.006), and that it would not make sense to limit students' food choices in school (P=0.035). School-based interventions involving teacher training can result in positive changes in teachers' classroom food practices and beliefs about the influence of the school food environment in schools serving American Indian children on reservations.