CERP3 contributors: Jason Jabbari.
Moreland-Russell, S., Jabbari, J., Allen, P. et al. Understanding multi-level policy implementation in the national school lunch and breakfast programs: a mixed-methods and agent-based modeling protocol. Implement Sci Commun 7, 37 (2026). https://doi.org/10.1186/s43058-025-00843-5
The Healthy, Hunger-Free Kids Act (2010) improved the nutritional quality of school meals in the U.S. by aligning the National School Lunch and Breakfast Programs with updated dietary guidelines. However, 2018 federal flexibilities in sodium, whole grains, and milk standards shifted key implementation decisions to local school districts. This created variability in uptake and potential inequities in diet quality and health outcomes, particularly among students from low-resource settings. Key drivers of differential uptake, and decision-making by local districts, is not well understood.