Effectiveness of population level interventions in schools and academic performance

学校人口水平干预措施和学业成绩的有效性

• 批准号: 10515687
• 负责人: Brisa N Sanchez
• 金额: $ 65.87万
• 依托单位: DREXEL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-21 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10515687
• 关键词: Adult; Affect; African American; Beverages; California; Characteristics; Child; Childhood; Cognition; Color; Communities; Data; Diet; Diet and Nutrition; Dietary Intervention; Dietary intake; Education; Effectiveness; English Language; Environment; Evaluation; Exposure to; Fatty acid glycerol esters; Food; Geography; Goals; Health; Hunger; Individual; Inequality; Infrastructure; Intake; Intervention; Language Arts; Latino; Latino Population; Link; Longitudinal Studies; Low income; Mathematics; Methodology; Natural experiment; Neighborhoods; Neurobiology; Nutrition Policy; Nutritional; Outcome; Pathway interactions; Performance; Play; Policies; Population; Population Heterogeneity; Price; Process; Reduce health disparities; Research; Schools; Series; Standardization; Students; Subgroup; Testing; United States Department of Agriculture; United States National Institutes of Health; community intervention; community-level factor; design; disparity reduction; environmental intervention; ethnic diversity; ethnic health disparity; evidence base; food environment; food standard; good diet; health disparity; improved; longitudinal design; nutrition; peer; public health relevance; racial and ethnic; racial and ethnic disparities; school environment; social determinants; social health determinants; sugar

PROJECT SUMMARY African American and Latino populations have worse adult health than their White peers (hereafter “health disparities”). These health gaps often begin in childhood, and have persisted, in part, because of continuing inequalities in the social determinants of health. Far less research has identified population-level interventions that level the playing field on the social determinants of health across population subgroups. The scant evidence on effective population-level interventions is a significant barrier to reducing health gaps. Rigorous prior studies have revealed the plausibility for large-scale nutrition policies to reduce racial/ethnic gaps in children’s academic performance—a strong predictor of adult educational attainment, which is one of the most fundamental determinants of health. These studies have illuminated the intermediary mechanisms in the pathway between school nutrition policies, (junk) food availability in communities near schools and children’s academic performance. No longitudinal studies have thoroughly investigated the population-level influences on academic performance of nutrition policies together with modifiable characteristics of nearby-school neighborhoods. This longitudinal study capitalizes on a series of natural experiments generated by California’s policies to improve nutrition standards for foods and drinks sold to children in schools, and the changes in nutrition standards for school meals put in place by the Healthy, Hunger Free Kids Act of 2010. The study will determine (a) the effectiveness of population-level school nutrition policy interventions in improving children’s academic performance and reducing related gaps among African American and Latino vs. White peers; (b) the extent to which modifiable, food-related factors in communities near schools influence longitudinal changes in academic performance disparities; and (c) if school nutrition policy effectiveness varies by those community factors. To generate valid inferences about the population-level effectiveness of these policies on academic performance, this study uses the strongest possible approach to evaluate non-randomized exposures: a difference-in-differences analysis that includes within-child change in exposures. Difference in difference analyses will also examine the effects of child-level changes in modifiable characteristics of communities near their schools and changes in academic performance (and disparities). This study is unparalleled because we use powerful longitudinal data on academic performance among a diverse population of 11.8 million children. Policy and community interventions in and around schools hold potential to reduce disparities given their community-oriented focus, existing infrastructures and networks that facilitate their large-scale implementation and broad reach. Given its robust design, the study will have a significant impact on evidence-based nutrition policy and population-level interventions to mitigate racial/ethnic health gaps; identify opportunities to enhance educational attainment; and broaden the scope of interventions to improve fundamental determinants of health.

项目摘要 非裔美国人和拉丁裔人口的成人健康状况要比白人同龄人差（“健康 差异”）。这些健康差距通常始于童年，并在某种程度上持续存在 社会决定者的不平等。较少的研究确定了人群级干预措施 这将跨种群子组的社会决定者的竞争环境水平。很少 有效人口水平干预措施的证据是减少健康差距的重大障碍。严格的 先前的研究揭示了大规模营养政策的合理性，以减少种族/种族差距 儿童的学习成绩 - 成人教育成就的有力预测指标，这是最重要的 健康的基本决定者。这些研究阐明了中介机制 学校营养政策之间的途径，（垃圾）学校和儿童附近社区的粮食供应 学业表现。没有纵向研究彻底研究了人口水平的影响 关于营养政策的学业表现以及近学校的可修改特征 社区。这项纵向研究利用了加利福尼亚州产生的一系列自然实验 改善学校中出售给儿童食品和饮料的营养标准的政策，以及变化 由2010年健康，饥饿儿童法案制定的学校用餐营养标准。研究将 确定（a）人口水平的学校营养政策干预措施在改善儿童方面的有效性 在非洲裔美国人和拉丁美洲人与白人同伴之间的学习成绩以及减少相关差距； （b） 学校附近社区中可修改的食物相关因素的范围影响了纵向变化 学术绩效差异； （c）如果这些社区的学校营养政策有效性变化 因素。为这些政策对学术的人口水平有效性产生有效的推论 性能，本研究使用强大的方法来评估非随机暴露： 差异分析包括暴露的孩子内变化。差异差异 分析还将检查儿童级变化在附近社区的可修改特征的影响 他们的学校以及学业表现（和差异）的变化。这项研究是无与伦比的，因为我们 在1,180万儿童中，使用有关学术表现的强大纵向数据。 鉴于他们 面向社区的重点，现有的基础架构和网络，促进其大规模实施 和广泛的范围。鉴于其强大的设计，该研究将对基于证据的营养产生重大影响 减轻种族/族裔健康差距的政策和人口水平的干预措施；确定增强的机会 教育成就；并扩大干预措施的范围，以改善健康的基本决定。