Amanda Linares, Sridharshi C Hewawitharana, Kaela Plank, Carolyn D Rider, Gail Woodward-Lopez, Miranda Westfall Brown
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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) <i>v</i>. 2·58 (0·11); <i>P</i> = 0·001) and fewer days/week with 60+ min of moderate-to-vigorous PA (MVPA) (Mean (se): 2·8 (0·10) <i>v</i>. 3·21 (0·12); <i>P</i> = 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 (<i>β</i> (95 % CI) = 0·67 (0·15, 1·20)), and greater increases in fruit consumption (<i>β</i> (95 % CI) = 0·37 (0·07, 0·66)) and in MVPA in higher FRPM schools (<i>β</i> (95 % CI) = 0·86 (0·33, 1·39)).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"e143"},"PeriodicalIF":3.0000,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Student and school characteristics modify the impact of SNAP-Ed on student dietary and physical activity outcomes.\",\"authors\":\"Amanda Linares, Sridharshi C Hewawitharana, Kaela Plank, Carolyn D Rider, Gail Woodward-Lopez, Miranda Westfall Brown\",\"doi\":\"10.1017/S136898002510092X\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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).</p><p><strong>Design: </strong>Quasi-experimental, two-group, pre-post, self-report.</p><p><strong>Setting: </strong>CFHL-eligible public schools (<i>n</i><sub>intervention</sub> = 51; <i>n</i><sub>comparison</sub> = 18).</p><p><strong>Participants: </strong>4th/5th grade students (<i>n</i><sub>intervention</sub> = 2115; <i>n</i><sub>comparison</sub> = 1102).</p><p><strong>Results: </strong>CFHL interventions were associated with an increase in consumption frequency of fruit (0·19 times/d (<i>P</i> = 0·015)) and vegetables (0·35 times/d (<i>P</i> = 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) <i>v</i>. 2·58 (0·11); <i>P</i> = 0·001) and fewer days/week with 60+ min of moderate-to-vigorous PA (MVPA) (Mean (se): 2·8 (0·10) <i>v</i>. 3·21 (0·12); <i>P</i> = 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 (<i>β</i> (95 % CI) = 0·67 (0·15, 1·20)), and greater increases in fruit consumption (<i>β</i> (95 % CI) = 0·37 (0·07, 0·66)) and in MVPA in higher FRPM schools (<i>β</i> (95 % CI) = 0·86 (0·33, 1·39)).</p><p><strong>Conclusions: </strong>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. 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引用次数: 0
摘要
目的:探讨基于学校的CalFresh健康生活(CFHL-California’s SNAP-Ed)干预措施在新冠肺炎相关学校关闭后的影响,以及学生和学校特征是否改变了干预措施对学生饮食和身体活动(PA)的影响。设计:准实验,两组,前后,自我报告。环境:符合CFHL条件的公立学校(未干预=51;对照=18)。参与者:4 /5年级学生(非干预=2115;非对照=1102)。结果:CFHL干预与水果(0.19次/天[p=0.015])和蔬菜(0.35次/天[p=0.006])消费频率的增加有关。根据学生的种族和性别,以及免费和减价餐(FRPM)合格学生的比例是否高于州平均水平,观察了基线饮食和PA行为的差异。值得注意的是,与FRPM等于或低于州平均水平的学校相比,FRPM高于州平均水平的学校的学生报告更频繁地饮用含糖饮料(平均[SE]: 3.18[0.10] vs 2.58[0.11];p=0.001),每周进行60分钟以上中高强度PA (MVPA)的天数更少(平均[SE]: 2.8[0.10] vs 3.21[0.12];p=0.020)。学生性别、学校城市化和学校FRPM改变了干预措施与某些饮食和/或PA结果之间的关系。干预措施与城市学校蔬菜摄入量增加(β[95% CI]=0.67[0.15,1.20])、水果摄入量增加(β[95% CI]= 0.37[0.07,0.66])和高FRPM学校MVPA增加(β[95% CI]=0.86[0.33,1.39])相关。结论:研究结果重申了以学校为基础的CFHL干预的有效性。我们确定了现有的学生和学校水平的差异,然后观察到在FRPM最高的学校中,干预措施与中度至重度PA的更大增加有关。调查结果可为以公平为中心的方法提供信息,以提供以学校为基础的干预措施,促进所有儿童获得终身健康的平等机会。
Student and school characteristics modify the impact of SNAP-Ed on student dietary and physical activity outcomes.
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.