Unhealthful middle school students eating patterns have contributed to the dramatic rise in adolescent obesity rates. The rates have risen the fastest in lower income communities of color. While much has been accomplished to improve school food practices in some school sites, important barriers still remain to disseminate promising school food practices widely, especially in ethnically diverse lower income communities.

The purpose of this action research case study is to illuminate how promising middle school food practices can be improved and how school stakeholders can use their existing capacity to make those improvements. The school site represents pioneering efforts in advancing healthful middle school food practices in this ethnically diverse kindergarten through 8th grade public school. The school is located in a diverse working class San Francisco neighborhood with extensive access to unhealthful food.

This study draws conceptual guidance from the Interactive Systems Framework for Dissemination and Implementation (ISF), which provides a comprehensive way to consider the improvements and capacities needed to disseminate promising prevention practices. Although the school food practices in this case represent improvements in providing healthier food to middle school students, the unappealing nature of school lunches worked in tandem with the unhealthful neighborhood foods and peer and family influences to increase the appeal of unhealthy foods. Middle school students, teachers, and foodservice representatives combined their capacities to make incremental improvements to the promising school food practices, despite the inadequate level of public funding to provide healthful and appealing school lunch meals.

Stakeholders in similar settings can consider applying the strategies used by school stakeholders in this case to make incremental improvements to their school practices in order to improve the eating patterns of middle school students. Future research that identifies the capacities used by school stakeholders in working class communities of color to improve school food practices can help confirm or disconfirm this study's findings and add practice-based evidence to this research area.