Performing Department
(N/A)
Non Technical Summary
This proposal is designed to address the CSREES broad goal of "4. Improving the Nation's nutrition and health", as well as the more specific goal of `1. Improve our understanding of the behavioral and environmental factors that influence obesity and lead to the development and evaluation of effective interventions for obesity prevention". The overarching goal of this proposal is to design and evaluate a dissemination package that can be used by the USDA Cooperative Extension and other high capacity systems to assist schools around the nation in implementing environmental changes for child obesity prevention. The dissemination package developed as part of this proposal will tackle the most pervasive issues in school nutrition which we have found to undermine the success of any healthy school environment. These include vending machine contents, availability, and location; food sales by any school or affiliated organization on campus to raise money; food rewards in or outside the classroom; sales of unhealthy snacks by the school cafeteria to achieve and maintain profitability; and poor eating habits modeled by school staff. We will use extensive process and outcome measures make the following changes to all school nutrition environments: change all school revenue practices to nonfood alternatives; change items in vending machines to only healthy foods and beverages; change reward systems in the classroom to nonfood reinforcers; and to reward modeled health behaviors in school staff. The only stipulation for the control schools will be that they not engage in the changes we enact for the environmental schools during the period of the grant. Extensive process evaluation efforts will include tracking the changes in sales and revenue associated with the new food environment, assessing the influence of the intervention on school staff's, students', and parents' attitudes towards the environmental changes, and documenting the barriers and solutions to these barriers. We plan to have a collaborative process of change with school district nutrition services, as well as administration at each school. Children will also have a role in deciding what should change and how this can be communicated to their parents and communities.
Animal Health Component
(N/A)
Research Effort Categories
Basic
50%
Applied
50%
Developmental
(N/A)
Goals / Objectives
The overarching goal of this proposal is to design and evaluate a "dissemination package" that can be used by the USDA Cooperative Extension and other high capacity systems (such as school boards, National 5 a Day campaigns, etc.) to assist schools around the nation in implementing environmental changes to prevent obesity in children. We have developed two objectives to meet this goal: the design and evaluation of a package for system-wide change in school food environments, and the dissemination of this system-wide change strategy with evaluation tools to the USDA Cooperative Extension and other high capacity systems. Objective 1: To design and evaluate a "package" for system-wide change in school food environments. We will create this package with the use of extensive process evaluation efforts including: 1) tracking the changes in sales and revenue associated with the new food environment, 2) assessing the influence of the intervention on school staff's, student's, and parent's attitudes towards the environmental changes, and 3) documenting the barriers and solutions as the program progresses. As part of this objective, we will test two hypotheses using a quasiexperimental, longitudinal research design: 1. Boys and girls in control schools will become progressively more at risk for overweight as compared to boys and girls in the environmental intervention schools who will demonstrate no changes in risk for overweight. 2. There will be a dose response relationship in the rates of risk for overweight in children, such that the reduction in risk for overweight will be more pronounced as more aspects of the school nutrition environment are successfully changed (healthy food options in vending machines, non-food fundraising, non-food reinforcers in classrooms, and school staff modeling). Objective 2: To disseminate this "package" for system-wide change in school food environments with evaluation tools to the USDA Cooperative Extension, collaborative partners in San Diego County, California Five a Day, and other high capacity systems.
Project Methods
To achieve the first objective of the study (to design and evaluate a "package" for system-wide change in school food environments), we will use a quasi-experimental, longitudinal design to test the effects of changing the school nutrition environment to reduce risk for overweight in second and third (elementary) and sixth (middle school) grade boys and girls. The second and third grade boys and girls will be followed into the fourth and fifth grades, and the sixth grade boys and girls will be followed into eighth grade to determine the longitudinal impact of these changes. After a baseline year of assessment, three elementary schools and one middle school will be assigned to the environmental intervention, while the remaining three elementary and one middle school will be assigned to the control group which will continue with the status quo nutritional policies already in place (if any). The intervention will entail changing all school revenue practices to nonfood alternatives with the exception of vending which will contain healthy food and beverage options; changing reward systems in the classroom to nonfood reinforcers; and rewarding modeled health behaviors in school staff. The only stipulation for the control schools will be that they not engage in the changes we enact for the environmental schools during the period of the grant. As with the national and El Paso CATCH interventions, Healthy Places interventions, and various other school interventions, the statistical design of the present study will be complicated by the lack of independence of data. Pre- and post-intervention assessments are associated within students and student data is associated with other student data within school sites. To adjust for the clustered data structure and determine the impact of the primary outcome measures, a mixed model ANOVA will be conducted. Outcome measures with continuous data will be analyzed using Proc Mixed (SAS version 6.12, SAS Institute Inc., Cary, NC). Outcome measures with dichotomous data will be analyzed using Proc GLIMMIX (SAS version 6.12, SAS Institute Inc., Cary, NC). Since this is a repeated measures design, the correlation structure among the repeated measurements will be modeled as part of the analysis before the analyses of the fixed effects are carried out. We have used this strategy successfully to demonstrate changes in individual child data with a school level intervention.