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: 10475834
• 负责人: Juliana FW Cohen
• 金额: $ 57.1万
• 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 2026-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10475834
• 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.

项目摘要 改善儿童饮食和体育锻炼水平是降低肥胖风险的关键策略。然而， 大多数孩子不符合饮食或体育锻炼建议，以及来自家庭的孩子 由于社会经济的缺点和/或种族/族裔少数民族的缺点不成比例 肥胖率，阿拉斯加原住民/美洲印第安儿童在全国范围内的率最高。学校 可以是促进更健康习惯的理想场所，因为孩子们花了很大一部分时间 上学，经常在那里消耗多达一半的日常能量摄入量。两个承诺，成本效益的学校 政策是较长的午餐时间，并且PA的集成机会更长，但严格的证据是 缺乏。在这个时间敏感的建议中，我们建议评估阿拉斯加安克雷奇的自然实验 在小学中实施一项健康计划，其中包括30分钟的午餐时间和54 每天的PA分钟（包括教室运动活动外30分钟的休息时间）。 在四年的时间里，健康倡议将在学校的交流中分错。我们的研究将收集 来自K-4年级的4,000名学生的纵向数据用于评估使用板的学校用餐的变化 废物方法学（目标1）。身体活动水平也将在儿童的子样本中进行评估（n = 2,000 K-4年级的学生使用加速度计测量值（AIM 2）。结果将在基线时测量 下一个学年的实施后（在每个时间点同一个月收集）。 此外，BMI，睡眠时间和质量以及与学习成绩有关的其他因素（即变化 在学生的颠覆性课堂行为中[在基准时和实施后一年衡量] 纪律转介给校长，与饥饿相关的访问，对学校护士和标准化的考试成绩 [实施后的基线和最多四年]）将被评估。实施保真度将被评估 通过现场访问，环境扫描和教师调查通过研究期。安克雷奇学校 地区计划从2021-22学年开始实施该计划的交错实施。那，时间 - 敏感资金对于确保足够的基线数据收集时间至关重要。该提议的意义 这是我们提供第一个经验证据的能力，证明了更长午餐的学校政策 时期和综合体育锻炼机会会影响学生的饮食摄入量，体育活动水平， 体重状况和与学习成绩有关的因素。这项严格，创新和时间敏感的研究 将有助于开发有关学校潜在有效性的全面证据 营养和体育锻炼政策，可以帮助解决儿童的健康分配，包括 服务不足和理解的阿拉斯加本地人口。研究结果还将提供基本证据 告知当地，州和联邦决策者关于学校营养和体育锻炼的决定 政策以及具有更广泛影响儿童健康的强大潜力。