Amanda Linares, Sridharshi C Hewawitharana, Kaela Plank, Carolyn D Rider, Gail Woodward-Lopez, Miranda Westfall Brown
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引用次数: 0
Abstract
Objective: To examine the impacts of school-based CalFresh Healthy Living (CFHL-California's SNAP-Ed) interventions post-COVID-19-related school closures and whether student and school characteristics modified intervention impacts on student diet and physical activity (PA).
Setting: CFHL-eligible public schools (nintervention = 51; ncomparison = 18).
Participants: 4th/5th grade students (nintervention = 2115; ncomparison = 1102).
Results: CFHL interventions were associated with an increase in consumption frequency of fruit (0·19 times/d (P = 0·015)) and vegetables (0·35 times/d (P = 0·006)). Differences in baseline diet and PA behaviours were observed by student race and gender and by whether the proportion of free and reduced-price meal (FRPM)-eligible students was above the state average. Notably, students in schools with FRPM above the state average reported more frequent consumption of sugar-sweetened beverages (Mean (se): 3·18 (0·10) v. 2·58 (0·11); P = 0·001) and fewer days/week with 60+ min of moderate-to-vigorous PA (MVPA) (Mean (se): 2·8 (0·10) v. 3·21 (0·12); P = 0·020) than those at schools with FRPM at/below the state average. Student gender, school urbanicity and school FRPM modified the relationship between the interventions and certain dietary and/or PA outcomes. Interventions were associated with greater increases in vegetable consumption in more urban schools (β (95 % CI) = 0·67 (0·15, 1·20)), and greater increases in fruit consumption (β (95 % CI) = 0·37 (0·07, 0·66)) and in MVPA in higher FRPM schools (β (95 % CI) = 0·86 (0·33, 1·39)).
Conclusions: Findings reaffirmed effectiveness of school-based CFHL interventions. We identified existing student and school-level disparities and then observed that interventions were associated with greater increases in MVPA in the highest FRPM schools. Findings can inform an equity-centred approach to delivery of school-based interventions that facilitate equal opportunity for all children to achieve lifelong health.
期刊介绍:
Public Health Nutrition provides an international peer-reviewed forum for the publication and dissemination of research and scholarship aimed at understanding the causes of, and approaches and solutions to nutrition-related public health achievements, situations and problems around the world. The journal publishes original and commissioned articles, commentaries and discussion papers for debate. The journal is of interest to epidemiologists and health promotion specialists interested in the role of nutrition in disease prevention; academics and those involved in fieldwork and the application of research to identify practical solutions to important public health problems.