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.

项目总结 非洲裔美国人和拉美裔美国人的成年健康状况比他们的白人同龄人差(以下简称健康 差异“)。这些健康差距往往从儿童时期就开始了，并且之所以持续存在，部分原因是 健康的社会决定因素中的不平等。确定人口水平干预措施的研究要少得多 这为不同人口亚群之间健康的社会决定因素创造了公平的竞争环境。不足之处 人口一级有效干预措施的证据是缩小健康差距的重大障碍。严谨 先前的研究已经揭示了大规模营养政策缩小种族/民族差距的可能性 儿童的学习成绩是成人教育程度的有力预测指标，这是最重要的 健康的基本决定因素。这些研究阐明了在金融市场中的中介机制 学校营养政策、学校附近社区的(垃圾)食品供应与儿童健康之间的途径 学业成绩。没有纵向研究彻底调查人口水平的影响 论营养政策的学术绩效与就近学校的可调性 邻里关系。这项纵向研究利用了加州的一系列自然实验 改善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》制定了学校膳食的营养标准。这项研究将 确定(A)人口一级学校营养政策干预措施在改善儿童营养状况方面的有效性 学习成绩和缩小非洲裔和拉丁裔与白人同龄人之间的相关差距；(B) 学校附近社区中可改变的与食物有关的因素影响纵向变化的程度 学业成绩差异；以及(C)学校营养政策的有效性是否因社区而异 各种因素。对这些政策在人口层面上的有效性进行有效的推论 表现，这项研究使用尽可能强的方法来评估非随机暴露：a 差异中的差异分析，包括儿童内部暴露的变化。差异中的差异 分析还将检查儿童层面的变化对附近社区可修改特征的影响 他们的学校和学习成绩的变化(和差距)。这项研究是无与伦比的，因为我们 使用关于1180万不同人口中学习成绩的强有力的纵向数据。 学校内部和周围的政策和社区干预具有缩小差距的潜力，因为 以社区为重点，现有基础设施和网络，促进其大规模实施 和广阔的触角。鉴于其强有力的设计，这项研究将对循证营养学产生重大影响 政策和人口一级的干预措施，以缩小种族/族裔健康差距；确定机会，以加强 教育程度；并扩大干预范围，以改善健康的基本决定因素。