Food Deprivation, Obesity, Childhood
Conditions
Brief summary
The purpose of this study is to assess the impact of an implementation strategy on participation in Universal School Meals (USM).
Detailed description
The purpose of this cluster randomized trial is to test the effectiveness of an implementation strategy on implementation and student health outcomes of universal school meals (USM). This will be completed by developing and tailoring of an implementation strategy and testing its effectiveness though a cluster randomized design. Primary implementation outcomes of this trial are acceptability, cost, feasibility, penetration, and sustainability. Secondary student health outcomes are changes in diet quality (district-wide survey for students), food insecurity (USDA 6-item screener), and weight status. Exploratory descriptive models will be run to assess differences between intervention and control schools. To provide evidence for approaches in adolescents at highest risk for poor dietary intake, food security, and obesity risk, racial and ethnic minority adolescents from the School District of Philadelphia will comprise the majority of the sample. The principal investigator has just completed a year-long needs assessment with 8 schools across the district. We will aim to recruit 4 schools to be randomized to 1 of 2 conditions. Recruitment is underway, final recruitment details will be added once randomization is complete. From these schools, we aim to randomize (2 intervention; 2 waitlist comparison) for the development and tailoring of an implementation strategy. At baseline and throughout the 2-year trial period, we aim to collect interview data and surveys, and analyze data on diet quality, food security, and weight status.
Interventions
OTHERImplementation Mapping
Implementation mapping is a stakeholder-driven process whereby researchers and practitioners work together to develop an implementation strategy.
OTHERWaitlist Comparison - Implementation Mapping
Implementation mapping is a stakeholder-driven process whereby researchers and practitioners work together to develop an implementation strategy. Participating schools receiving this treatment will wait one year before developing an implementation strategy for testing.
Sponsors
The School District of Philadelphia
National Heart, Lung, and Blood Institute (NHLBI)
Temple University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
11 Years to 99 Years
Healthy volunteers
Yes
Inclusion criteria
* An elementary/middle or high school within the School District of Philadelphia (SDP) that provides free breakfast and lunch to students * School is willing to be randomized to either a treatment or waitlist comparison condition * School has a team of teachers, administration, and food service staff who are willing to complete interviews and surveys for data collection * School has valid data for student Body Mass Index, meal participation, and food insecurity (parent reported). * Students currently enrolled in a SDP elementary/middle/high school * Students willing to participate in an interview and complete surveys * Students have participated in school meals in the last year.
Exclusion criteria
* Charter schools and private schools * Students not enrolled in school full time; students under 11 years of age.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Implementation Outcomes Surveys | 1 Year | Implementation outcomes of perceived acceptability, feasibility, and sustainability of the implementation strategy will be assessed through surveys completed by school stakeholders |
| School Meal Participation | Throughout study completion | Counts to calculate number of students who participate in breakfast and lunch each day will be generated and totaled for each school. |
| Qualitative Interviews | 1 year | Focus group interviews with students, parents, teachers, administration, and food service staff. |
| Implementation Mapping Self-Assessment | 1 year | Self-assessment to document fidelity to implementation mapping procedures. |
| Implementation Cost Measure | 1 Year | A survey developed through stakeholder interviews to calculate costs of implementation will be completed by schools. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Food Insecurity | Baseline and 1 year | The United States Department of Agriculture (USDA) 6-item food screening questionnaire is administered to parents across the district. These data are a secondary outcome to implementation outcomes. |
| Dietary Behaviors | Baseline and 1 year | Students complete a survey each year which records their nutrition behaviors such as fruit and vegetable consumption, sugar-sweetened beverages, and other key behaviors. These data are a secondary outcome to implementation outcomes. |
| Student Weight | Baseline and 1 year | Student weight (pounds) is collected by school nurses and other professionals in the school district. These data are a secondary outcome to implementation outcomes. |
| Height | Baseline and 1 year | Student height (feet, inches) is collected by school nurses and other professionals in the school district. These data are a secondary outcome to implementation outcomes. |
Countries
United States
Outcome results
None listed