The Impact of School Meal Delivery on Behavioral Disorders among Children in Health Disparity Populations

学校供餐对健康差异人群中儿童行为障碍的影响

• 批准号: 10728640
• 负责人: Michael R. Thomsen
• 金额: $ 39.89万
• 依托单位: UNIV OF ARKANSAS FOR MED SCIS
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-21 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10728640
• 关键词: Academic achievement; Address; Adolescent; Adopted; Adult; Affect; African American; Age; Arkansas; Attention deficit hyperactivity disorder; Behavior; Behavior Disorders; Behavioral; Behavioral Symptoms; Characteristics; Child; Child Development; Child Health; Child Nutrition; Childhood; Communities; Conduct Disorder; Criminal Justice; Data; Databases; Development; Diagnosis; Discipline; Disparity; Education; Educational Status; Eligibility Determination; Enrollment; Ethnic Origin; Event; Face; Food Policy; Gender; Household; Hunger; Impairment; Incidence; Intervention; Lead; Link; Low income; Medical; Minor; Mississippi; Neighborhoods; Not Hispanic or Latino; Oppositional Defiant Disorder; Outcome; Pathway interactions; Performance; Pharmaceutical Preparations; Policies; Population; Prevalence; Probability; Problem behavior; Prognosis; Public Health; Quasi-experiment; Race; Risk; Rural Population; Schools; Self-control as a personality trait; Socioeconomic Status; Suspensions; Symptoms; System; Testing; Variant; externalizing behavior; food insecurity; health care service utilization; health disparity populations; health related quality of life; human capital; improved; inattention; juvenile justice system; longitudinal database; medically underserved; novel; nutrition; prevent; programs; rurality; service utilization; underserved community

PROJECT SUMMARY Policies to facilitate participation in school nutrition programs could reduce diagnosis rate disparities in behavioral disorders, namely attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). Food insecurity predisposes children to these conditions and aggravates their symptoms. It impairs child development, contributes to inattention, and is associated with externalizing behaviors. Preliminary data show that two school meal delivery options could make a difference. One is the Community Eligibility Provision (CEP), which enables schools to provide free meals to all enrolled children, regardless of household socio-economic status. The other is making school breakfast available after classes begin (breakfast after the bell). There is growing evidence that these meal-delivery options reduce disciplinary incidents at school, but no studies have incorporated information on diagnosis or utilization of services for behavioral disorders. Our central hypothesis is that better access to school meals reduces the burden of behavioral disorders among children in underserved communities who face an elevated prevalence of food insecurity. There is evidence that exclusionary discipline (i.e., suspension or expulsion) contributes to an escalation of behavioral issues, which may predispose the child to an ODD or CD diagnoses and/or interactions with the juvenile justice system. Universal free meals and breakfast after the bell increase participation in school meals and are feasible meal delivery options for many schools but remain underutilized. Using a novel longitudinal all-payer claims database linked to educational achievement and disciplinary outcomes, three specific aims are proposed: 1. Describe variation in medical diagnoses for ADHD, ODD, and CD across schools by race, ethnicity, gender, age, rurality, and neighborhood characteristics. 2. Quantify the effect of school meal delivery policies and medical diagnoses on disciplinary outcomes and academic achievement by race/ethnicity, rurality, and socioeconomic status. 3. Determine the effect of universal meals and breakfast after the bell, alone and in combination, on the likelihood of diagnosed childhood behavioral disorders and subsequent service utilization overall and by race, ethnicity, and rurality. The study will draw from the population of Arkansas public schoolchildren. Arkansas ranks second in the nation for the percentage of children diagnosed with ADHD, third in the percentage of children taking ADHD medications, and second in the incidence of childhood food insecurity. Understanding whether policies to make meals more accessible prevent the medical diagnosis of behavioral disorders that can escalate into disciplinary events at school will have significant implications for improving health-related quality of life, human capital development, and fewer encounters with the juvenile and adult criminal justice systems.

项目摘要 促进参与学校营养计划的政策可以减少以下方面的诊断率差异： 行为障碍，即注意力缺陷多动障碍（ADHD）、对立违抗性障碍 (ODD)行为障碍（CD）。粮食无保障使儿童易患这些疾病， 他们的症状。它损害儿童的发展，有助于注意力不集中，并与外化有关 行为。初步数据显示，两种学校供餐方案可能会有所不同。一是 社区资格规定（CEP），使学校能够为所有入学儿童提供免费膳食， 无论家庭的社会经济地位如何。另一个是在课后提供学校早餐 开始（铃响后吃早饭）。越来越多的证据表明，这些送餐方式减少了纪律处分。 学校发生的事件，但没有研究纳入诊断或利用服务的信息， 行为障碍我们的核心假设是，更好地获得学校膳食可以减轻学生的负担。 在缺乏服务的社区中，儿童面临食物流行率上升的行为障碍 不安全感有证据表明，排除性纪律（即，暂停或开除）有助于 行为问题的升级，这可能使孩子容易被诊断为ODD或CD和/或 与少年司法系统的互动。普遍免费餐和早餐后，贝尔增加 参与学校供餐，对许多学校来说是可行的供餐选择，但仍未得到充分利用。 使用一个新的纵向所有付款人索赔数据库链接到教育成就和纪律 根据这些成果，提出了三个具体目标： 1.描述不同种族、民族、学校中ADHD、ODD和CD的医学诊断差异， 性别、年龄、农村和邻里特征。 2.量化学校供餐政策和医学诊断对学科成果的影响， 按种族/民族、农村和社会经济地位分列的学业成绩。 3.确定铃声后的通用餐和早餐单独和组合对 被诊断为儿童期行为障碍的可能性和随后的总体服务利用率， 种族、民族和乡村性。 这项研究将从阿肯色州公立学校的学生中抽取样本。阿肯色州排名第二， 在被诊断患有ADHD的儿童比例方面， 第二是儿童粮食不安全。了解是否要制定政策 更容易获得的膳食可以防止对行为障碍的医学诊断， 学校的活动将对改善与健康有关的生活质量、人力资本 发展，与少年和成人刑事司法系统的接触较少。