A Randomized Controlled Trial of Students for Nutrition and eXercise

Study Overview
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Brief Summary
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Objectives: We conducted a randomized controlled trial (RCT) of Students for Nutrition and eXercise (SNaX), a middle-school-based obesity-prevention intervention combining school-wide environmental changes, multimedia, encouragement to eat healthy school cafeteria foods, and peer-led education and marketing. Methods: We randomly selected schools from the Los Angeles Unified School District (LAUSD) and assigned five to the intervention group and five to a wait-list control group. School records were obtained for number of fruits and vegetables served, students served lunch, and snacks sold per attending student. Pre- and post-intervention surveys assessed psychosocial variables among 2,997 seventh-graders (75% of all seventh-graders across schools). Hypotheses: For the RCT of SNaX, we hypothesized that SNaX would lead to increases in the proportion of students served in the cafeteria (because SNaX markets cafeterias' healthy foods); increased fruit and vegetable servings (because SNaX increases access to sliced/bite-sized fruits and vegetables); decreased school store snack sales; and greater water consumption. We also hypothesized that SNaX would lead to more positive attitudes about the cafeteria and water, improve obesity-prevention knowledge, and increase intentions to drink water.

Official Title
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A Community-Academic Partnership to Address Disparities in Obesity Among Youth

Conditions
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Obesity

Intervention / Treatment
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* Behavioral: Students for Nutrition and eXercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: schools with >50% NSLP-eligible students (a proxy for low-income) and <900 - seventh-graders Exclusion Criteria: schools with <50% NSLP-eligible students and >900 seventh-graders

Ages Eligible for Study
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Minimum Age: 11 Years

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: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control<br>These schools did not receive the intervention. | |
| Experimental: Students for Nutrition and eXercise<br>These schools received the entirety of Students for Nutrition and eXercise, a middle-school-based obesity-prevention intervention combining school-wide environmental changes, multimedia, encouragement to eat healthy school cafeteria foods, and peer-led education and marketing | Behavioral: Students for Nutrition and eXercise<br>* These schools received the entirety of Students for Nutrition and eXercise, a middle-school-based obesity-prevention intervention combining school-wide environmental changes, multimedia, encouragement to eat healthy school cafeteria foods, and peer-led education and marketing<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of students obtaining lunch per day by National School Lunch Program (NSLP) eligibility | We obtained the number of students obtaining lunch per day (by National School Lunch Program (NSLP) eligibility) from schools. | 5 months | 
| Number of fruits and vegetables served per day | We obtained the number of fruits and vegetables served per day from the school cafeterias. | 5 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Attitudes about the cafeteria | Attitudes about the cafeteria were calculated by survey data using the mean of two 7-point scales representing attitudes about the cafeteria: unsatisfying/satisfying and bad for my health/good for my health. | 5 months | 
| Attitudes about water | Attitudes about water were measured with a survey including an 11-point scale (very negatively/very positively). | 5 months | 
| Knowledge about healthy eating and physical activity | Knowledge about healthy eating and physical activity was measured with a survey containing 6 true/false items. | 5 months | 
| Intentions to drink water | Intentions to drink water were assessed with two survey items, How likely is it that you will drink water [or drink water from a refillable water bottle] the next day you are in school? with 5-point scales (extremely likely/extremely unlikely). | 5 months | 
| Water consumption frequency | Water consumption frequency was assessed by survey with, How often do you usually drink tap water? and How often do you usually use a refillable water bottle to drink water? (every day, a few times a week, once a week, twice a month, once a month, less than once a month, never). | 5 months | 
| Number of snacks sold per day | We obtained the data on the number of snacks sold per day from the school store. | 5 months |