Background: Pediatric obesity is escalating and predisposes children to a multiple of health risks. These risks are magnified in the poor and predominantly Hispanic population residing along the US-Mexico border where health disparities are rampant. Foreground: Many low-income families rely on school meals – breakfast, lunch, and after-school snacks – to feed their children. An analysis of a typical lunch at a local charter school (EPCS) found unacceptable low vegetable, fruit, and whole grain. Because children eat what is available, healthier school meals will help build life-long eating habits and school-age children receiving school meals are prepared onsite. Methods: The administrator of the community organization that ran the charter school and associated clinic championed the change project. Healthier school meals were implemented by a multidisciplinary team of stakeholders, including parents and children. Clinic staff measured indices of weight pre- and post-implementation. EBP Framework: An integrative model was utilized to guide this change process. The Prochaska model for change enhanced Team Strategies and Toold for Enhancement Performance and Patient Safety (TSTEPPS) by identifying behaviors over the change process that influenced outcome. Findings/Results: External funding provided the means to build a state-of-the-art kitchen at the school. Faculty and students from a local community college culinary arts program staffed the kitchen. Students, parents, and team members enjoyed the taste of school meals prepared on-site using AHA guidelines. No difference in indices of obesity changed over the 14-week school meal program. As expected, weight circumference-to-height ratio predicted central adiposity across all grades. The rate of obesity tripled between pre-kindergarten and third grade. Conclusion/Recommendations: Continued monitoring of the EPCS students BMI and wc:ht needs to occur to document future changes in the overweight and obese percentages, especially with the addition of increased physical activity. In addition, continuing to utilize wc:ht ratios will assist in establishing pediatric standards for the measurement. One school, one meal at a time is a small but important step toward reducing pediatric obesity rates.
