The Impact of School Meal Delivery on Behavioral Disorders among Children in Health Disparity Populations

学校供餐对健康差异人群中儿童行为障碍的影响

• 批准号: 10728640
• 负责人: Michael R. Thomsen
• 金额: $ 39.89万
• 依托单位: UNIV OF ARKANSAS FOR MED SCIS
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-21 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10728640
• 关键词: Academic achievement; Address; Adolescent; Adopted; Adult; Affect; African American; Age; Arkansas; Attention deficit hyperactivity disorder; Behavior; Behavior Disorders; Behavioral; Behavioral Symptoms; Characteristics; Child; Child Development; Child Health; Child Nutrition; Childhood; Communities; Conduct Disorder; Criminal Justice; Data; Databases; Development; Diagnosis; Discipline; Disparity; Education; Educational Status; Eligibility Determination; Enrollment; Ethnic Origin; Event; Face; Food Policy; Gender; Household; Hunger; Impairment; Incidence; Intervention; Lead; Link; Low income; Medical; Minor; Mississippi; Neighborhoods; Not Hispanic or Latino; Oppositional Defiant Disorder; Outcome; Pathway interactions; Performance; Pharmaceutical Preparations; Policies; Population; Prevalence; Probability; Problem behavior; Prognosis; Public Health; Quasi-experiment; Race; Risk; Rural Population; Schools; Self-control as a personality trait; Socioeconomic Status; Suspensions; Symptoms; System; Testing; Variant; externalizing behavior; food insecurity; health care service utilization; health disparity populations; health related quality of life; human capital; improved; inattention; juvenile justice system; longitudinal database; medically underserved; novel; nutrition; prevent; programs; rurality; service utilization; underserved community

PROJECT SUMMARY Policies to facilitate participation in school nutrition programs could reduce diagnosis rate disparities in behavioral disorders, namely attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). Food insecurity predisposes children to these conditions and aggravates their symptoms. It impairs child development, contributes to inattention, and is associated with externalizing behaviors. Preliminary data show that two school meal delivery options could make a difference. One is the Community Eligibility Provision (CEP), which enables schools to provide free meals to all enrolled children, regardless of household socio-economic status. The other is making school breakfast available after classes begin (breakfast after the bell). There is growing evidence that these meal-delivery options reduce disciplinary incidents at school, but no studies have incorporated information on diagnosis or utilization of services for behavioral disorders. Our central hypothesis is that better access to school meals reduces the burden of behavioral disorders among children in underserved communities who face an elevated prevalence of food insecurity. There is evidence that exclusionary discipline (i.e., suspension or expulsion) contributes to an escalation of behavioral issues, which may predispose the child to an ODD or CD diagnoses and/or interactions with the juvenile justice system. Universal free meals and breakfast after the bell increase participation in school meals and are feasible meal delivery options for many schools but remain underutilized. Using a novel longitudinal all-payer claims database linked to educational achievement and disciplinary outcomes, three specific aims are proposed: 1. Describe variation in medical diagnoses for ADHD, ODD, and CD across schools by race, ethnicity, gender, age, rurality, and neighborhood characteristics. 2. Quantify the effect of school meal delivery policies and medical diagnoses on disciplinary outcomes and academic achievement by race/ethnicity, rurality, and socioeconomic status. 3. Determine the effect of universal meals and breakfast after the bell, alone and in combination, on the likelihood of diagnosed childhood behavioral disorders and subsequent service utilization overall and by race, ethnicity, and rurality. The study will draw from the population of Arkansas public schoolchildren. Arkansas ranks second in the nation for the percentage of children diagnosed with ADHD, third in the percentage of children taking ADHD medications, and second in the incidence of childhood food insecurity. Understanding whether policies to make meals more accessible prevent the medical diagnosis of behavioral disorders that can escalate into disciplinary events at school will have significant implications for improving health-related quality of life, human capital development, and fewer encounters with the juvenile and adult criminal justice systems.

项目摘要 促进参加学校营养计划的政策可以降低诊断率差异 行为障碍，即注意力缺陷多动症（ADHD），对立反抗疾病 （奇数）和行为障碍（CD）。粮食不安全感使儿童患有这些条件，并加重了 他们的症状。它会损害儿童发展，导致注意力不集中，并与外部化有关 行为。初步数据表明，两个学校餐点的选择可能会有所作为。一个是 社区资格规定（CEP），使学校能够为所有注册儿童提供免费餐点 无论家庭社会经济地位如何。另一个正在让学校早餐下课后可用 开始（钟声之后早餐）。越来越多的证据表明这些饮食选择减少了学科 学校发生的事件，但没有研究纳入有关诊断或利用服务的信息 行为障碍。我们的核心假设是，更好地获得学校餐会减轻 在服务不足的社区中，面临食物患病率高的儿童的行为障碍 不安全感。有证据表明，排除学科（即暂停或驱逐）有助于 行为问题的升级，这可能使孩子容易受到奇数或CD的诊断和/或 与少年司法系统的互动。钟声后，通用免费餐和早餐 参加学校用餐，是许多学校的可行餐饮选择，但仍未得到充分利用。 使用与教育成就和纪律相关的新型纵向全付款人主张数据库 结果，提出了三个具体目标： 1。描述跨种族，种族，种族，种族，奇数和CD的医学诊断变化 性别，年龄，农村和邻里特征。 2。量化学校用餐政策和医学诊断对纪律结果的影响 种族/种族，农业质量和社会经济地位的学术成就。 3。确定单独和组合钟声之后的通用餐和早餐对 诊断出儿童行为障碍的可能性以及随后的服务利用率总体上以及 种族，种族和乡村。 该研究将从阿肯色州的公立学童中汲取灵感。阿肯色州在 国家的诊断为多动症的儿童的百分比，在服用多动症的儿童百分比中排名第三 药物，第二个儿童粮食不安全的发生率。了解是否制定政策 进餐更容易获得，可以防止对行为障碍的医学诊断，这些疾病可能会升级为纪律处分 学校的活动将对改善与健康相关的生活质量，人力资本有重大影响 发展，与少年和成人刑事司法系统的相遇更少。