Evaluation of a District-Wide Initiative to Improve School Meal Consumption and Physical Activity Levels among Elementary Students in Anchorage, Alaska

对提高阿拉斯加州安克雷奇小学生学校膳食消耗和身体活动水平的全区举措进行评估

• 批准号: 10728348
• 负责人: Juliana FW Cohen
• 金额: $ 10.35万
• 依托单位: MERRIMACK COLLEGE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-26 至 2023-08-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10728348
• 关键词: Academy; Accelerometer; Address; Adoption; Alaska; Alaska Native; American Indians; Area; Behavior; Behavioral; Body mass index; Child; Child Health; Consumption; Data; Data Collection; Development; Diet; Dietary intake; Disparity; Effectiveness; Energy Intake; Ensure; Evaluation; Family; Fruit; Funding; Habits; Health; Healthy Eating; Human Resources; Hunger; Instruction; Knowledge; Length; Light; Location; Low income; Measurement; Measures; Medicine; Methodology; Milk; Minority Groups; Movement; Natural experiment; Obesity; Outcome; Outcome Assessment; Performance; Physical activity; Policies; Policy Maker; Population; Public Health; Recommendation; Research; Research Design; Risk; Risk Factors; Risk Reduction; Scanning; School Nursing; Schools; Site Visit; Sleep; Specialist; Standardization; Strenuous Exercise; Students; Surveys; Testing; Time; Unhealthy Diet; Vegetables; Visit; Weight; Work; cost effective; dietary; elementary school; ethnic diversity; ethnic minority; evidence base; experience; federal policy; follow-up; fourth grade; health disparity; implementation fidelity; improved; innovation; moderate-to-vigorous physical activity; nutrition; obesity in children; obesity prevention; obesity risk; post implementation; racial diversity; racial minority; school district; sedentary; socioeconomic disadvantage; socioeconomics; student participation; teacher; wasting

PROJECT SUMMARY Improving children’s diets and physical activity levels are key strategies to reduce the risk of obesity. However, most children do not meet dietary or physical activity recommendations, and children who are from families with socioeconomic disadvantages and/or who are racial/ethnic minorities experience disproportionately higher rates of obesity, with Alaska Native/American Indian children experiencing the highest rates nationally. Schools can be an ideal location to promote healthier habits as children spend a substantial portion of their time in school and often consume up to half their daily energy intake there. Two promising, cost-effective school policies are longer lunch periods and longer recess with integrated PA opportunities, but rigorous evidence is lacking. In this time-sensitive proposal, we propose to evaluate a natural experiment in Anchorage, Alaska of the implementation of a wellness initiative in elementary schools that includes 30 minute lunch periods and 54 minutes of PA daily (including 30 minutes of recess in addition to classroom movement activities). The wellness initiative will have a staggered rollout in schools over the span of four years. Our study will collect longitudinal data from 4,000 students in K-4th grade to assess changes in school meal consumption using plate waste methodology (Aim 1). Physical activity levels will also be assessed in a subsample of children (n=2,000 students in grades K-4) using accelerometer measurements (Aim 2). Outcomes will be measured at baseline and post-implementation the following school year (collected during the same month at each time point). Additionally, BMI, sleep duration and quality, and other factors related to academic performance (i.e., changes in students’ disruptive classroom behaviors [measured at baseline and one year post-implementation], disciplinary referrals to the principal, hunger-related visits to the school nurse, and standardized test scores [baseline and up to four years post-implementation]) will be evaluated. Implementation fidelity will be assessed throughout the study period via site visits, environmental scans, and teacher surveys. Anchorage School District plans the staggered implementation of the initiative to begin in the 2021-22 school year. Thus, time- sensitive funding is critical to ensure adequate time for baseline data collection. The proposal’s significance lies in our ability to provide the first empirical evidence of the degree to which school policies for longer lunch periods and integrated physical activity opportunities influence students’ dietary intakes, physical activity levels, weight status, and factors related to academic performance. This rigorous, innovative, and time-sensitive study will contribute to the development of a comprehensive evidence base on the potential effectiveness of school nutrition and physical activity policies, which can help to address health disparities in children, including among an underserved and understudied Alaska Native population. Study results will also provide essential evidence to inform local, state, and federal policymakers’ decisions regarding school nutrition and physical activity policies as well as have the strong potential to impact children’s health more broadly.

项目概要 改善儿童的饮食和身体活动水平是降低肥胖风险的关键策略。 大多数儿童不符合饮食或身体活动建议，并且来自家庭的儿童 具有社会经济劣势和/或少数种族/族裔的人的经历不成比例地更高 肥胖率，阿拉斯加原住民/美洲印第安人儿童的肥胖率是全国最高的。 可以成为促进健康习惯的理想场所，因为孩子们大部分时间都花在 两所有前途、具有成本效益的学校。 政策是更长的午餐时间和更长的休息时间以及综合的 PA 机会，但严格的证据表明 在这个时间敏感的提案中，我们建议评估阿拉斯加州安克雷奇的自然实验。 在小学实施健康倡议，其中包括 30 分钟午餐时间和 54 分钟午餐时间 每天几分钟的 PA（除了课堂活动外还包括 30 分钟的课间休息）。 我们的研究将在四年内逐步在学校推出健康计划。 来自 4,000 名 K-4 年级学生的纵向数据，用于使用餐盘评估学校膳食消费的变化 废物方法（目标 1）也将在儿童子样本中进行评估（n=2,000）。 K-4 年级的学生）使用加速度计测量（目标 2）。 以及实施后的下一学年（在每个时间点的同月收集）。 此外，BMI、睡眠持续时间和质量以及与学业成绩相关的其他因素（即睡眠变化） 学生的破坏性课堂行为[在基线和实施后一年进行测量]， 向校长提出纪律处分、对学校护士进行与饥饿有关的拜访以及标准化考试成绩 [基线和实施后四年]）将被评估实施保真度。 在整个研究期间，通过实地考察、环境扫描和安克雷奇学校教师调查。 学区计划从 2021-22 学年开始分阶段实施该举措。 敏感资金对于确保有足够的时间收集基线数据至关重要。 关键在于我们有能力提供第一个经验证据，证明学校延长午餐政策的程度 时期和综合体育活动机会影响学生的饮食摄入量、体育活动水平、 这项严格、创新且时间敏感的研究。 将有助于建立一个关于学校潜在有效性的综合证据库 营养和身体活动政策，有助于解决儿童的健康差距，包括儿童之间的健康差距 服务不足和研究不足的阿拉斯加原住民研究结果也将提供重要的证据。 为地方、州和联邦决策者做出有关学校营养和体育活动的决定提供信息 政策并具有更广泛影响儿童健康的强大潜力。