Author ORCID Identifier

Date Available


Year of Publication


Degree Name

Doctor of Education (EdD)

Document Type

Doctoral Dissertation




Kinesiology and Health Promotion

First Advisor

Dr. Melinda Ickes


Rural adolescents suffer from poor nutrition, increasing their risk for obesity and other chronic diseases. The Summer Food Service Program (SFSP), an off-shoot of the National School Lunch Program, provides meals to qualifying children, including low-income, rural adolescents, under the age of 18. The purpose of this study was to: 1) examine the impact of the SFSP on the nutrition–related knowledge, self-reported fruit and vegetable (SRFV) consumption, and the constructs of the Theory of Planned Behavior (attitudes, subjective norms, perceived behavioral control, and behavioral intentions) of rural, low-income adolescents; and 2) examine the relationship between nutrition behaviors (quality food selection and consumption) and participation in the SFSP using digital photography.

The participants (N = 78) were recruited from those enrolled in the Upward Bound (UB) Summer Program at a mid-sized university that utilized the SFSP. The UB, a federally funded program, provided the opportunity to reach high school students from low-income, rural areas to study the aforementioned effects of the SFSP. The quasi-experimental pre- post-intervention design used a survey (n = 57) to determine predictors of positive nutrition behaviors and digital photography (n = 43) to determine actual food selection and consumption of those enrolled in the SFSP. A nutrition quality scale (0-6, with 6 indicating higher quality) was developed in order to categorize food items within food groups according to their nutritional value, and aided in determining quality of foods selected and consumed.

Paired samples t-test showed a significant increase in knowledge (t(56) = -8.09, p = .000) and SRFV consumption (t(56) = -3.20, p = .002) from pre- to post-intervention. Regression analysis demonstrated that all constructs of the Theory of Planned Behavior (TPB) were significant (F(4, 52) = 14.56, p < .001 with an R2of .53) for predicting behavior intentions, with perceived behavioral control (PBC) being the most salient predictor of intentions to increase fruit and vegetable consumption. A one-way repeated measures MANOVA was not significant for the comparison of pre- and post- survey scores for knowledge, SRFV consumption, and the constructs of the TPB, F (4, 53) = .604, p = .660. Digital photography showed a significant increase in consumption from week 1 (baseline) to week 5 (program completion) for fruit (t(42) = -2.04, p = .048) and milk (t(42) = -3.13, p = .003) at lunch, for milk (t(42) = -3.01, p = .003) at supper, and for milk overall (all three meals combined), t(42) = -3.08, p = .004. Vegetable consumption decreased significantly from week 1 to week 5 t(42) = 2.47, p = .018 at supper and overall (all three meals combined) t(42) = 2.65, p = .011. Two proportion z tests showed a statistically significant decrease in the selection of food items at quality level 2 from week 1 (.34) to week 5, z = 3.11, p = .002, and statistically significant increases in the selection of quality level 3 (.20), z = -2.15, p = .031, and quality level 5 (.17), z = -3.33, p < .000, item. Two proportion z tests showed a statistically significant decrease in the consumption of food items at quality level 5 from week 1 (.62) to week 5, z = 2.94, p = .003. However, the analysis showed no consistent increase in the quality of foods selected or consumed from week 1 to week 5.

Opportunities for shaping adolescent nutrient intake and eating behaviors during and outside of enrollment in the SFSP exist. Reinforcing positive attitudes, subjective norms and perceived behavioral control while participants are enrolled in the SFSP may help to increase nutrition behavioral intentions and therefore, nutrition behaviors. Opportunities also exist for offering healthier food options for those participating in the SFSP. SFSP participants are a captive, impressionable group, and providing a supportive social and physical environment, and high nutritional quality choices in the SFSP more often may provide the potential for behavior change that may lead to an increase in healthy nutritious habits for adolescents from rural areas.

Digital Object Identifier (DOI)

Funding Information

Arvle and Ellen Turner Thacker Research Fund -- $687.18

Included in

Food Studies Commons