The purpose of this study is to assess the impact of an implementation strategy on participation in Universal School Meals (USM).
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
1,000
Implementation mapping is a stakeholder-driven process whereby researchers and practitioners work together to develop an implementation strategy.
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.
Temple University
Philadelphia, Pennsylvania, United States
School Meal Participation
Counts to calculate number of students who participate in breakfast and lunch each day will be generated and totaled for each school.
Time frame: Throughout study completion
Qualitative Interviews
Focus group interviews with students, parents, teachers, administration, and food service staff.
Time frame: 1 year
Implementation Mapping Self-Assessment
Self-assessment to document fidelity to implementation mapping procedures.
Time frame: 1 year
Implementation Cost Measure
A survey developed through stakeholder interviews to calculate costs of implementation will be completed by schools.
Time frame: 1 Year
Implementation Outcomes Surveys
Implementation outcomes of perceived acceptability, feasibility, and sustainability of the implementation strategy will be assessed through surveys completed by school stakeholders
Time frame: 1 Year
Height
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.
Time frame: Baseline and 1 year
Food Insecurity
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.
Time frame: Baseline and 1 year
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Dietary Behaviors
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.
Time frame: Baseline and 1 year
Student Weight
Student weight (pounds) is collected by school nurses and other professionals in the school district. These data are a secondary outcome to implementation outcomes.
Time frame: Baseline and 1 year