Improving Participation in Universal School Meals (USM)
- Conditions
- Food DeprivationObesity, Childhood
- Interventions
- Other: Implementation MappingOther: Waitlist Control - Implementation Mapping
- Registration Number
- NCT06579079
- Lead Sponsor
- Temple University
- 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.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 1000
- 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.
- Charter schools and private schools
- Students not enrolled in school full time; students under 11 years of age.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Implementation Strategy - Intervention Condition Implementation Mapping Schools in the intervention condition will be assigned to receive coaching and logistical support to develop and tailor an implementation strategy across 1 academic year. This strategy will then be implemented in the following academic years (2- year pilot). Waitlist Control Waitlist Control - Implementation Mapping Schools in the waitlist control will wait 1 academic year before developing and testing an implementation strategy (1-year pilot)
- Primary Outcome Measures
Name Time Method 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.
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
- Secondary Outcome Measures
Name Time Method 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.
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.
Trial Locations
- Locations (1)
Temple University
🇺🇸Philadelphia, Pennsylvania, United States