BACKGROUND Rural children consume more calories per day on average than urban children, and they are less likely to consume fruit. Self-service salad bars have been proposed as an effective approach to better meet the National School Lunch Program's fruit and vegetable recommendations. No studies have examined how rural and urban schools differ in the implementation of school salad bars. OBJECTIVE To compare the prevalence of school-lunch salad bars and differences in implementation between urban and rural Arizona schools. DESIGN Secondary analysis of a cross-sectional web-based survey. PARTICIPANTS/SETTING School nutrition managers (N=596) in the state of Arizona. MAIN OUTCOMES MEASURED National Center for Education Statistics locale codes defined rural and urban classifications. Barriers to salad bar implementation were examined among schools that have never had, once had, and currently have a school salad bar. Promotional practices were examined among schools that once had and currently have a school salad bar. STATISTICAL ANALYSES PERFORMED Generalized estimating equation models were used to compare urban and rural differences in presence and implementation of salad bars, adjusting for school-level demographics and the clustering of schools within districts. RESULTS After adjustment, the prevalence of salad bars did not differ between urban and rural schools (46.9%±4.3% vs 46.8%±8.5%, respectively). Rural schools without salad bars more often reported perceived food waste and cost of produce as barriers to implementing salad bars, and funding was a necessary resource for offering a salad bar in the future, as compared with urban schools (P<0.05). No other geographic differences were observed in reported salad bar promotion, challenges, or resources among schools that currently have or once had a salad bar. CONCLUSIONS After adjustment, salad bar prevalence, implementation practices, and concerns are similar across geographic settings. Future research is needed to investigate methods to address cost and food waste concerns in rural areas.

中文翻译：

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亚利桑那州农村学校与城市学校沙拉吧实施的普遍性和差异

背景技术农村儿童平均每天消耗的卡路里比城市儿童多，他们不太可能吃水果。自助沙拉吧已被提议作为一种有效方法，以更好地满足国家学校午餐计划的水果和蔬菜建议。没有研究调查农村和城市学校在学校沙拉吧的实施方面有何不同。目的 比较学校午餐沙拉吧的流行情况以及亚利桑那州城乡学校之间实施的差异。设计 基于网络的横断面调查的二次分析。参与者/环境 亚利桑那州的学校营养经理 (N=596)。测量的主要结果 国家教育统计中心区域代码定义了农村和城市分类。在从未有过、曾经有过和目前有学校沙拉吧的学校中检查了沙拉吧实施的障碍。在曾经和现在有学校沙拉吧的学校中检查了促销做法。执行的统计分析 使用广义估计方程模型来比较城市和农村在沙拉吧的存在和实施方面的差异，根据学校人口统计数据和地区内学校的集群进行调整。结果 调整后，城乡学校沙拉吧的流行率没有差异（分别为46.9%±4.3%和46.8%±8.5%）。没有沙拉吧的农村学校更经常报告认为食物浪费和生产成本是实施沙拉吧的障碍，资金是未来提供沙拉吧的必要资源，与城市学校相比（P<0.05）。在报告的沙拉吧促销、挑战或资源方面，目前或曾经拥有沙拉吧的学校之间没有观察到其他地域差异。结论 调整后，沙拉吧流行、实施实践和关注点在不同地理环境中是相似的。未来的研究需要调查解决农村地区成本和食物浪费问题的方法。