Evaluation of a District-Wide Initiative to Improve School Meal Consumption and Physical Activity Levels among Elementary Students in Anchorage, Alaska

对提高阿拉斯加州安克雷奇小学生学校膳食消耗和身体活动水平的全区举措进行评估

• 批准号: 10728348
• 负责人: Juliana FW Cohen
• 金额: $ 10.35万
• 依托单位: MERRIMACK COLLEGE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-26 至 2023-08-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10728348
• 关键词: Academy; Accelerometer; Address; Adoption; Alaska; Alaska Native; American Indians; Area; Behavior; Behavioral; Body mass index; Child; Child Health; Consumption; Data; Data Collection; Development; Diet; Dietary intake; Disparity; Effectiveness; Energy Intake; Ensure; Evaluation; Family; Fruit; Funding; Habits; Health; Healthy Eating; Human Resources; Hunger; Instruction; Knowledge; Length; Light; Location; Low income; Measurement; Measures; Medicine; Methodology; Milk; Minority Groups; Movement; Natural experiment; Obesity; Outcome; Outcome Assessment; Performance; Physical activity; Policies; Policy Maker; Population; Public Health; Recommendation; Research; Research Design; Risk; Risk Factors; Risk Reduction; Scanning; School Nursing; Schools; Site Visit; Sleep; Specialist; Standardization; Strenuous Exercise; Students; Surveys; Testing; Time; Unhealthy Diet; Vegetables; Visit; Weight; Work; cost effective; dietary; elementary school; ethnic diversity; ethnic minority; evidence base; experience; federal policy; follow-up; fourth grade; health disparity; implementation fidelity; improved; innovation; moderate-to-vigorous physical activity; nutrition; obesity in children; obesity prevention; obesity risk; post implementation; racial diversity; racial minority; school district; sedentary; socioeconomic disadvantage; socioeconomics; student participation; teacher; wasting

PROJECT SUMMARY Improving children’s diets and physical activity levels are key strategies to reduce the risk of obesity. However, most children do not meet dietary or physical activity recommendations, and children who are from families with socioeconomic disadvantages and/or who are racial/ethnic minorities experience disproportionately higher rates of obesity, with Alaska Native/American Indian children experiencing the highest rates nationally. Schools can be an ideal location to promote healthier habits as children spend a substantial portion of their time in school and often consume up to half their daily energy intake there. Two promising, cost-effective school policies are longer lunch periods and longer recess with integrated PA opportunities, but rigorous evidence is lacking. In this time-sensitive proposal, we propose to evaluate a natural experiment in Anchorage, Alaska of the implementation of a wellness initiative in elementary schools that includes 30 minute lunch periods and 54 minutes of PA daily (including 30 minutes of recess in addition to classroom movement activities). The wellness initiative will have a staggered rollout in schools over the span of four years. Our study will collect longitudinal data from 4,000 students in K-4th grade to assess changes in school meal consumption using plate waste methodology (Aim 1). Physical activity levels will also be assessed in a subsample of children (n=2,000 students in grades K-4) using accelerometer measurements (Aim 2). Outcomes will be measured at baseline and post-implementation the following school year (collected during the same month at each time point). Additionally, BMI, sleep duration and quality, and other factors related to academic performance (i.e., changes in students’ disruptive classroom behaviors [measured at baseline and one year post-implementation], disciplinary referrals to the principal, hunger-related visits to the school nurse, and standardized test scores [baseline and up to four years post-implementation]) will be evaluated. Implementation fidelity will be assessed throughout the study period via site visits, environmental scans, and teacher surveys. Anchorage School District plans the staggered implementation of the initiative to begin in the 2021-22 school year. Thus, time- sensitive funding is critical to ensure adequate time for baseline data collection. The proposal’s significance lies in our ability to provide the first empirical evidence of the degree to which school policies for longer lunch periods and integrated physical activity opportunities influence students’ dietary intakes, physical activity levels, weight status, and factors related to academic performance. This rigorous, innovative, and time-sensitive study will contribute to the development of a comprehensive evidence base on the potential effectiveness of school nutrition and physical activity policies, which can help to address health disparities in children, including among an underserved and understudied Alaska Native population. Study results will also provide essential evidence to inform local, state, and federal policymakers’ decisions regarding school nutrition and physical activity policies as well as have the strong potential to impact children’s health more broadly.

项目总结 改善儿童饮食和体力活动水平是降低肥胖风险的关键策略。然而， 大多数儿童不符合饮食或体力活动建议，来自家庭的儿童 有社会经济劣势和/或是种族/民族少数群体的人患上不成比例的高风险 肥胖率，阿拉斯加原住民/美洲印第安人儿童经历了全国最高的肥胖率。学校 可能是推广更健康习惯的理想场所，因为孩子们大部分时间都花在 在学校，他们每天摄入的能量往往高达一半。两所前景光明、性价比高的学校 政策是更长的午餐时间和更长的休息时间，以及综合PA机会，但严格的证据是 缺乏。在这个时间敏感的提案中，我们建议对阿拉斯加安克雷奇的一个自然实验进行评估。 在小学实施健康倡议，包括30分钟的午餐时间和54分钟的午餐时间 每天PA分钟(除课堂活动外还包括30分钟的课间休息时间)。这个 健康计划将在四年内在学校交错推出。我们的研究将收集 4,000名K-4年级学生使用餐盘评估学校膳食消费变化的纵向数据 废物方法(目标1)。体力活动水平也将在一组儿童(n=2,000)中进行评估 K-4年级学生)使用加速度计测量(目标2)。结果将在基线上进行衡量 并在下一学年实施后(在同一个月的每个时间点收集)。 此外，BMI、睡眠时间和质量，以及其他与学习成绩有关的因素(即，变化 在学生的破坏性课堂行为中[在基线和实施一年后测量]， 将纪律转介给校长，与饥饿有关的探访学校护士，以及标准化考试成绩 将对[基线和实施后最多四年]进行评估。将评估实施的保真度 在整个研究期间，通过现场访问、环境扫描和教师调查。安克雷奇学校 学区计划在2021-22学年开始交错实施这一倡议。因此，时间- 敏感的资金对于确保有足够的时间收集基线数据至关重要。这项提议的意义 在于我们有能力提供第一个经验证据，证明学校的政策在多大程度上会延长午餐时间 课时和综合体育活动机会影响学生的膳食摄入量、体育活动水平、 体重状况，以及与学业成绩相关的因素。这项严谨、创新且对时间敏感的研究 将有助于开发关于学校潜在有效性的全面证据基础 营养和体力活动政策，可帮助解决儿童的健康差距，包括 服务不足、研究不足的阿拉斯加原住民。研究结果也将提供必要的证据 为地方、州和联邦政策制定者关于学校营养和体育活动的决策提供信息 这些政策也有可能在更广泛的范围内影响儿童的健康。