Categories associated with best practice:
Determinants of Health: Food security
To prevent an increase in obesity rates in elementary school students in a low-income school district, the intervention aims are to: 1) eliminate unhealthy foods and beverages on campus; 2) develop nutrition services as the main source for healthful eating (HE), and promote school staff to model healthy eating. The intervention is a two-year quasi-experimental research project (not a natural experiment) that adapts a rapid improvement process and uses participatory principles in order to build school capacity and sustain change. A change team was created in each intervention school (n=4). Outcome measures were behavioral observation (reflects consumption of healthy and unhealthy foods) and BMI. Compared to control schools (n=4), the total outside food and beverage items per child per week decreased in intervention schools (of both healthy and unhealthy foods). No intervention effect was reported for obesity rates (which increased slightly in both intervention and control schools).
Primary Source Document
KJ Coleman, M Shorden, SL Caparosa, ME Pomichowski, and DA Dzewaltowski, The healthy options for nutrition environments in schools (Healthy ONES) group randomized trial: Using implementation models to change nutrition policy and environments in low income schools International Journal of Behavioral Nutrition and Physical Activity
Contact information of developer(s) and/or implementer(s)
Partnerships of organizations, Kareen.J.Coleman@pg.org
|Intervention Goal / Objective||Level(s) Targeted||Equity Focus|
|Promote school staff modeling of HE||People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.|
|Develop nutrition services as the main source on campus for healthful eating (HE)||People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.|
|Eliminate unhealthy foods and beverages on campus||People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.|
Health Issue(s) that is/are addressed by the Intervention
- Healthy Eating
- Obesity Prevention
Specific Activities of the Intervention
Priority/Target Population for Intervention Delivery
- Children (age 6-12 years)
- Elementary school
|Outcomes and Impact Chart|
|Level of Impact||Description of Outcome||Equity Focus|
|Individual Level||BMI: Regardless of group or gender, all children increased significantly in BMI Z scores over time (p<.001). Changes in rates of obesity were similar between intervention and control groups.||Outcomes are reported for people living in conditions of disadvantage, and are not compared to people living in more advantaged conditions.|
|Individual Level||Healthy food and beverage items per child per week (ANOVA: F(4,13)=4.74, p=0.01): decreased in intervention schools (p=0.03); and no change in control schools. Varied by school environment.||Outcomes are reported for people living in conditions of disadvantage, and are not compared to people living in more advantaged conditions.|
|Individual Level||Unhealthy food and beverage items per child per week (ANOVA: F(4,13)=4.96, p=0.01): decreased in intervention schools (p<0.001); and increased in control schools (p=0.02). Varied by school environment.||Outcomes are reported for people living in conditions of disadvantage, and are not compared to people living in more advantaged conditions.|
|Individual Level||Total outside food and beverage items per child per week (consumption) (ANOVA: F(4,13)=3.43; p =0.04); decreased in intervention schools (p=0.005); and increased in control schools (p=0.04). Varied by school environment (lunch/recess).|
- Implemented once (could be a pilot) - The intervention has been implemented once and is theoretically replicable elsewhere.
Expertise Required for Implementation within the Context of the Intervention
- Specialized skills training provided as part of the Intervention - The intervention does not require individuals or groups with highly specialized training, but requires that individuals or groups be trained as part of the implementation of the intervention.
Are there supports available for implementation
Are there resources and/or products associated with the interventions
Yes. The IHI website offers resources on the rapid improvement process that was used in intervention schools (http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx).