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

描述（由申请人提供）：符合美国国立卫生研究院的优先事项，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，以减少儿童肥胖率和风险。我们建议监测和评估康涅狄格州排名第一的学校健康政策，在纽黑文公立学区，是如何实施的，并确定其对儿童的肥胖行为，体重结果和学校表现的影响。我们将使用随机设计评估12所目标学校的实施策略。我们提出了一个多层次的评估因素，可能会影响儿童肥胖的生态模型作为指导框架。这个雄心勃勃的项目是可能的，因为纽黑文公立学校和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：陆克文中心食品政策和肥胖和关怀：研究和参与社区联盟。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，显着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;（3）评估学校健康政策对肥胖行为和健康结果以及学校表现的影响。我们将在12所学校实施营养和体育活动政策，采用随机2x2研究设计。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效应。我们将每年跟踪一组五年级学生（NH 700）4年，以评估学生饮食行为，身体活动水平和BMI的潜在变化。我们使用多方法方法来收集数据，并从整个生态框架中检查这些结果的预测因素：学生变量，家庭特征，学校政策和邻里特征（例如，通过环境测绘和美国人口普查局的统计数据）。该多学科提案与计划公告（PA-10-052）学校营养和体育活动政策，致胖行为和体重结果中阐述的研究目标同步。我们直接针对学校卫生相关政策的实施和影响;我们有一个积极的跟踪系统来监测政策;我们关注传统上脆弱和得不到充分服务的少数群体。正如美国国立卫生研究院所指出的，存在以政策为基础的方法来防治学校肥胖症;然而，在有关最佳政策的关键领域缺乏知识，这些政策的关键实施战略，以及这些政策对重要健康和社会成果的影响。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如何康涅狄格州的排名第一的地区健康政策，在纽黑文公立学校区，实施并确定其对儿童的致肥胖行为，体重结果和学校表现的影响。这项研究的目的是显着推进学校健康政策的实证研究，并提供重要的证据，以指导未来的干预措施，在学校和社区-翻译科学，以改善公众的健康。

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.