Effectiveness of population level interventions in schools and academic performance

学校人口水平干预措施和学业成绩的有效性

• 批准号: 10687919
• 负责人: Brisa N Sanchez
• 金额: $ 64.14万
• 依托单位: DREXEL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-21 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10687919
• 关键词: Adult; Affect; African American; Beverages; California; Characteristics; Child; Childhood; Cognition; Color; Communities; Data; Diet; Diet and Nutrition; Dietary Intervention; Dietary intake; Disparity; Education; Effectiveness; English Language; Environment; Equity; Ethnic Origin; Evaluation; Exposure to; Fatty acid glycerol esters; Food; Geography; Goals; Health; Hunger; Individual; Inequality; Infrastructure; Intake; Intervention; Latino; Latino Population; Link; Longitudinal Studies; Low income; Mathematics; Methodology; Natural experiment; Neighborhoods; Neurobiology; Nutrition Policy; Nutritional; Pathway interactions; Performance; Play; Policies; Population; Population Heterogeneity; Price; Process; Race; Reduce health disparities; Research; Schools; Series; Shapes; Standardization; Students; Subgroup; Testing; Time; United States Department of Agriculture; United States National Institutes of Health; community intervention; community-level factor; design; disparity reduction; environmental intervention; ethnic disparity; ethnic diversity; ethnic health disparity; evidence base; food environment; food standard; good diet; health determinants; health disparity; improved; longitudinal design; nutrition; peer; poor health outcome; public health relevance; racial disparity; racial health disparity; school environment; social determinants; social health determinants; sugar

PROJECT SUMMARY African American and Latino populations have worse adult health than their White peers (hereafter “health disparities”). These health gaps often begin in childhood, and have persisted, in part, because of continuing inequalities in the social determinants of health. Far less research has identified population-level interventions that level the playing field on the social determinants of health across population subgroups. The scant evidence on effective population-level interventions is a significant barrier to reducing health gaps. Rigorous prior studies have revealed the plausibility for large-scale nutrition policies to reduce racial/ethnic gaps in children’s academic performance—a strong predictor of adult educational attainment, which is one of the most fundamental determinants of health. These studies have illuminated the intermediary mechanisms in the pathway between school nutrition policies, (junk) food availability in communities near schools and children’s academic performance. No longitudinal studies have thoroughly investigated the population-level influences on academic performance of nutrition policies together with modifiable characteristics of nearby-school neighborhoods. This longitudinal study capitalizes on a series of natural experiments generated by California’s policies to improve nutrition standards for foods and drinks sold to children in schools, and the changes in nutrition standards for school meals put in place by the Healthy, Hunger Free Kids Act of 2010. The study will determine (a) the effectiveness of population-level school nutrition policy interventions in improving children’s academic performance and reducing related gaps among African American and Latino vs. White peers; (b) the extent to which modifiable, food-related factors in communities near schools influence longitudinal changes in academic performance disparities; and (c) if school nutrition policy effectiveness varies by those community factors. To generate valid inferences about the population-level effectiveness of these policies on academic performance, this study uses the strongest possible approach to evaluate non-randomized exposures: a difference-in-differences analysis that includes within-child change in exposures. Difference in difference analyses will also examine the effects of child-level changes in modifiable characteristics of communities near their schools and changes in academic performance (and disparities). This study is unparalleled because we use powerful longitudinal data on academic performance among a diverse population of 11.8 million children. Policy and community interventions in and around schools hold potential to reduce disparities given their community-oriented focus, existing infrastructures and networks that facilitate their large-scale implementation and broad reach. Given its robust design, the study will have a significant impact on evidence-based nutrition policy and population-level interventions to mitigate racial/ethnic health gaps; identify opportunities to enhance educational attainment; and broaden the scope of interventions to improve fundamental determinants of health.

项目概要 非裔美国人和拉丁裔人口的成年健康状况比白人同龄人更差（以下简称“健康状况”） 这些健康差距往往始于童年，并且一直持续存在，部分原因是持续存在的 健康问题社会决定因素中的不平等。确定人口层面干预措施的研究要少得多 为不同人群的健康问题社会决定因素提供公平的竞争环境。所剩无几 关于有效人口一级干预措施的证据是缩小健康差距的重大障碍。严格的 先前的研究表明，采取大规模营养政策来缩小种族/族裔差距是合理的。 儿童的学业成绩——成人受教育程度的有力预测指标，也是最重要的指标之一 健康的基本决定因素。这些研究阐明了这一过程中的中介机制。 学校营养政策、学校附近社区的（垃圾）食品供应和儿童的营养之间的路径 学习成绩。没有纵向研究彻底调查人口层面的影响 营养政策的学术表现以及附近学校可改变的特征 社区。这项纵向研究利用了加利福尼亚州进行的一系列自然实验 提高向学校儿童出售的食品和饮料的营养标准的政策，以及 2010 年《健康、无饥饿儿童法案》制定的学校膳食营养标准。该研究将 确定 (a) 人口层面学校营养政策干预措施在改善儿童健康状况方面的有效性 学术表现并缩小非裔美国人和拉丁裔与白人同龄人之间的相关差距； （二） 学校附近社区中与食品相关的可改变因素在多大程度上影响纵向变化 学业成绩差异； (c) 学校营养政策的有效性是否因社区而异 因素。就这些学术政策在人口层面的有效性产生有效的推论 性能，本研究使用尽可能最强的方法来评估非随机暴露： 多重差异分析，包括儿童内部暴露变化。差异中的差异 分析还将检验附近社区可改变特征的儿童层面变化的影响 他们的学校和学业成绩的变化（和差异）。这项研究是无与伦比的，因为我们 使用 1180 万不同人群的学习成绩的强大纵向数据。 鉴于学校内部和周围的政策和社区干预措施有可能减少差异 以社区为导向的重点，现有的基础设施和网络有利于其大规模实施 和广泛的影响力。鉴于其稳健的设计，该研究将对循证营养产生重大影响 缩小种族/族裔健康差距的政策和人口干预措施；找出加强的机会 教育程度；扩大干预措施的范围，以改善健康的基本决定因素。