School Wellness Policy: RCT to Implement & Evaluate Impact on Childhood Obesity

描述(由申请人提供)：与NIH的优先事项一致，我们的长期目标是通过以学校为基础的营养和体力活动政策来降低儿童肥胖率和风险。我们建议监测和评估康涅狄格州纽黑文公立学区排名第一的学校健康政策是如何实施的，并确定其对儿童肥胖行为、体重结果和学校表现的影响。我们将使用随机设计对12所目标学校的实施战略进行评估。我们建议使用生态模型作为指导框架，对可能影响儿童肥胖的因素进行多层次评估。这个雄心勃勃的项目之所以有可能，是因为纽黑文公立学校与两个耶鲁大学研究中心之间的专业知识和强大的合作伙伴关系：陆克文食品政策和肥胖与护理中心：社区研究与参与联盟。这项研究旨在通过有针对性的实施和对学生健康的可衡量影响，显著推进学校健康政策的实证研究。具体目标是：(1)跟踪和评估有针对性的学校实施地区健康政策的战略；(2)确定促进或阻碍地区健康政策实施的因素；以及(3)评估学校健康政策的实施对肥胖行为和健康结果以及学校表现的影响。我们将采用随机2×2研究设计，在12所学校实施营养和体育锻炼政策。这将允许比较营养和体育活动政策对学生行为和健康结果的独特和协同影响。我们将每年跟踪一组5年级学生(NH700)，为期4年，以评估学生饮食行为、体力活动水平和BMI的潜在变化。我们使用多种方法收集数据，并从生态框架中检验这些结果的预测因素：学生变量、家庭特征、学校政策和社区特征(例如，通过环境地图和美国人口普查局的统计数据)。这一多学科建议与计划公告(PA-10-052)中阐明的研究目标同步，即学校营养和体力活动政策、肥胖行为和体重结果。我们直接针对学校中与保健有关的政策的执行和影响；我们有一个积极的跟踪系统来监测政策；我们把重点放在传统上易受伤害和服务不足的少数群体。正如国立卫生研究院所说，存在以政策为基础的方法，以应对学校中的肥胖问题；然而，在关于最佳政策、这些政策的关键实施战略以及这些政策对重要的健康和社会成果的影响等关键领域，缺乏知识。拟议的项目将促进科学知识和理解，为指导学校和社区未来的干预措施提供重要证据--将科学转化为改善公众健康。 公共卫生相关性：我们的长期目标是通过以学校为基础的营养和体育活动政策来降低儿童肥胖率和风险。使用随机设计，我们建议监测和评估纽黑文公立学校地区康涅狄格州排名第一的地区健康政策的实施情况，并确定其对儿童肥胖行为、体重结果和学校表现的影响。这项研究旨在显著推进学校健康政策的实证研究，并提供重要证据，指导学校和社区未来的干预措施--将科学转化为改善公众健康的措施。

DESCRIPTION (provided by applicant): Consistent with NIH priorities, our long-term objective is to reduce the rates and risk of childhood obesity via school-based nutrition and physical activity policies. We propose to monitor and evaluate how Connecticut's first-ranked School Wellness Policy, in the New Haven Public School district, is implemented and determine its impact on children's obesogenic behaviors, weight outcomes, and school performance. We will evaluate a strategy of implementation at 12 targeted schools using a randomized design. We propose a multi-level assessment of factors that may influence childhood obesity using the Ecological Model as a guiding framework. This ambitious project is possible because of the expertise and strong collaborative partnerships between The New Haven Public Schools and two Yale University research centers: The Rudd Center for Food Policy and Obesity and CARE: Community Alliance for Research and Engagement. This study is designed to significantly advance empirical research on school wellness policies through targeted implementation and measurable impact on student health. Specific Aims are to: (1) track and evaluate a strategy of targeted school implementation of a District Wellness Policy; (2) identify factors that facilitate or impede implementation of The District Wellness Policy; and (3) evaluate the impact of implementation of The School Wellness Policy on obesogenic behaviors and health outcomes as well as school performance. We will implement nutrition and physical activity policies in 12 schools using a randomized 2 x 2 research design. This will permit comparison of unique and synergistic effects of nutrition and physical activity policies on student behaviors and health outcomes. We will follow a cohort of 5th grade students (NH700) annually for 4 years to assess potential changes in student eating behaviors, physical activity levels, and BMI. We use a multi-method approach to collect data and examine predictors of these outcomes from across the ecological framework: student variables, family characteristics, school policies, and neighborhood features (e.g., via environmental mapping and US Census Bureau statistics). This multidisciplinary proposal is synchronous with research objectives articulated in Program Announcement (PA-10-052) School Nutrition and Physical Activity Policies, Obesogenic Behaviors and Weight Outcomes. We directly target implementation and impact of health-related policies in schools; we have an active tracking system to monitor policies; and we focus on minority populations traditionally vulnerable and underserved. As stated by NIH, policy-based approaches to combat obesity in schools exist; however, knowledge is lacking in key areas concerning the optimal policies, key implementation strategies for such policies, and the impact of these policies on important health and social outcomes. The proposed project will advance scientific knowledge and understanding provide important evidence to guide future interventions in schools and communities - translating science to improved health of the public. PUBLIC HEALTH RELEVANCE: Our long-term objective is to reduce the rates and risk of childhood obesity via school-based nutrition and physical activity policies. Using a randomized design, we propose to monitor and evaluate how Connecticut's first-ranked District Wellness Policy, in the New Haven Public School district, is implemented and determine its impact on children's obesogenic behaviors, weight outcomes, and school performance. This study is designed to significantly advance empirical research on school wellness policies and to provide important evidence to guide future interventions in schools and communities - translating science to improved health of the public.