title: Use of environmental change strategies to facilitate sodium reduction: a case study in a rural California school district.
abstract: BACKGROUND
  Excess sodium consumption increases the risk for hypertension, which is a leading risk factor for cardiovascular disease. For children and teenagers, school meals are a significant source of sodium consumption.
  
  
  OBJECTIVE
  To describe the environmental change strategies that were implemented to reduce sodium in the school meals of a rural California school district.
  
  
  METHODS
  Descriptions of the environmental strategies, with an emphasis on staff training and infrastructure improvements.
  
  
  METHODS
  School district of approximately two thousand 9th- to 12th-grade students in rural, northern California.
  
  
  METHODS
  School administration and food service staff at the 5 high schools in Anderson Union High School District.
  
  
  METHODS
  Shasta County Public Health partnered with Anderson Union High School District to (1) facilitate changes to meal preparation practices, (2) improve cafeteria infrastructure, and (3) provide training and technical assistance to improve procurement strategies.
  
  
  RESULTS
  Environmental strategies to reduce sodium in school meals were implemented in 2011. Anderson Union High School District has continued to successfully implement scratch cooking and improve procurement strategies to reduce sodium in school meals.
  
  
  CONCLUSIONS
  Using an approach that includes environmental change strategies can lead to sodium reduction in a school setting.
authors: Outcomes, Planning, and Evaluation Division (Ms Taylor) and Healthy Communities Division, Public Health Branch (Mss Tibbett and Bishop), Shasta County Health and Human Services Agency, Redding, California; and Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Patel).
authors: Stephanie
authors: S
authors: Taylor
authors: Theresa
authors: T
authors: Tibbett
authors: Deesha
authors: D
authors: Patel
authors: Ereka
authors: E
authors: Bishop
mesh_terms: D002140:California; D003296:Cooking / Q000379:methods; D004777:Environment; D005522:Food Services / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007318:Inservice Training; D019982:Organizational Case Studies; D012424:Rural Population; D012574:Schools