Improving High School Breakfast Environments

Study Overview
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Brief Summary
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The goals of this intervention study are to implement best practice strategies to expand and promote the school breakfast program and test the impact upon student participation rates among a) all 10th and 11th grade students and among a randomly selected cohort of 800 students b) total diet and body mass index and percent body fat inin 16 rural Minnesota school districts. School-wide Primary Aim: Improve participation in the school breakfast program among high school students. Hypothesis: School-wide school breakfast program participation will be higher in the intervention versus comparison group.

Detailed Description
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We will accomplish the following secondary aims using a random subsample of 800 incoming 10th and11th grade students. Student-level Secondary Aims Secondary Aim 1: High school students in the intervention condition will decrease their rate of weight gain relative to height gain as measured by change in body mass index and percent body fat compared to students in the control condition. Hypothesis: Body mass index and percent body fat will be maintained or reduced in the treatment versus control group. Secondary Aim 2: High school students in the intervention condition will maintain or decrease their energy intake while improving dietary intakes of low fat dairy, whole grains and fresh fruits compared to the control students. Hypothesis: Energy intake (measured by 3, 24-hour recalls) will be maintained or reduced and intakes of low fat dairy, whole grains and fresh fruits will increase more in the intervention groups. Secondary Aim 3: Compared to students in the control condition, high school students in the intervention condition will report receiving more support to eat school breakfast. Support will be social (increased peer and school support) or related to the school environment (satisfaction with serving locations and times, eating locations, foods and increased availability of low fat dairy, fruits and whole grains for breakfast). Hypothesis: The treatment group will report receiving more social and school environment support for eating school breakfast than the comparison group (measured by a student survey).

Official Title
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Improving High School Breakfast Environments

Conditions
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Obesity

Intervention / Treatment
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* Behavioral: Improve access to the school breakfast program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Must be in 10th or 11th grade in school year 2013-14 Must have access to the internet Must have access to a phone Exclusion Criteria for the Cohort: Unable to read English Unable to speak English Pregnant Plan to move out of the school district within school year Not in school most mornings Eat breakfast 4 or more days a week
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention arm<br>The role of the intervention arm (schools) is to improve access to the school breakfast program | Behavioral: Improve access to the school breakfast program<br>* Access to the school breakfast program is defined as implementation of a grab-n-go cart outside of the school cafeteria, policy change allowing students to eat in the hallway and marketing of the program. in rural high schools.<br>* Other names: improve access to school breakfast;|
| No Intervention: Comparison arm<br>the role of the comparison arm (schools) is to maintain usual breakfast program at school | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change From Baseline in Percent Students Eating the School Breakfast Per School | Change in participation in the reimbursable school breakfast program will be evaluated from school provided objective participation data from baseline (SY1) to the end of one school year (SY2) | Change from baseline (SY1) in average school year school-level breakfast participation at the end of one school year (SY2). | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change From Baseline in Body Mass Index | Change from baseline to the end of one school year (SY2) in body mass index. | Change from baseline (SY1) in student body mass index at the end of one school year (SY2). | 
| Change From Baseline in Percent Body Fat | Student percent body fat will be measured by trained research staff | Change from baseline in student body fat at the end of the school year (SY2) |