Alternative Breakfast Service Models Are Associated With Greater Student School Breakfast Participation. Evidence From Middle and High School Students Across 8 States

Background Eating school breakfast has benefits for students, yet participation remains lower than that of school lunch. This study examined associations between school breakfast service models, self‐reported participation, and perceived participation barriers, and whether these associations differed by school level (middle vs. high) and universal school meals policy (with vs. without). Methods One thousand ninety‐seven middle and high school students were surveyed. Data were analyzed using multilevel logistic regression. Results Most students (67%) reported access only to traditional before‐school breakfast. Higher odds of participation and lower odds of time‐related barriers were found for breakfast in the classroom (OR 3.88; 95% CI 2.49, 6.03) and “second chance” breakfast (OR 2.07; 95% CI 1.43, 3.00) compared to traditional before‐school breakfast only. Grab‐and‐go options were associated with modestly higher odds of participation (OR 1.29; 95% CI 1.01, 1.67) and fewer barriers among high school students. Implications for School Health Policy, Practice, and Equity Breakfast after the bell approaches is associated with higher participation and fewer barriers. These strategies can help ensure more students have reliable access to school breakfast. Conclusions Alternative school breakfast service models, particularly breakfast in the classroom and “second chance” breakfast, may increase participation and support student nutrition, health, and academic performance.