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A variety of policies and practices have been implemented to increase participation in the National School Breakfast Program (SBP) and the impact of these initiatives on SBP participation is not known. The purpose of this study was to determine whether new SBP policies and practices implemented in North Carolina were associated with an improvement in SBP participation. A mixed modeling approach was used to assess longitudinal patterns of change in district-level and school-level SBP participation rates between 2007 and 2015. Most of the policy initiatives implemented in NC were associated with an increase in participation either at the school or district level.

State-wide School Breakfast Promotion Initiatives and Trends in School Breakfast Participation