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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control | No Intervention | These schools did not receive the intervention. | |
| Students for Nutrition and eXercise | Experimental | 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 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Students for Nutrition and eXercise | Behavioral | 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 |
| 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 |
| 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 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Mark A. Schuster, MD, PhD | Boston Children's Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| RAND Corporation | Santa Monica | California | 90401 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24784545 | Derived | Bogart LM, Cowgill BO, Elliott MN, Klein DJ, Hawes-Dawson J, Uyeda K, Elijah J, Binkle DG, Schuster MA. A randomized controlled trial of students for nutrition and eXercise: a community-based participatory research study. J Adolesc Health. 2014 Sep;55(3):415-22. doi: 10.1016/j.jadohealth.2014.03.003. Epub 2014 Apr 29. |
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| ID | Term |
|---|---|
| D009765 | Obesity |
| ID | Term |
|---|---|
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| D009752 | Nutritional Status |
| D015444 | Exercise |
| ID | Term |
|---|---|
| D009747 | Nutritional Physiological Phenomena |
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |
| D006304 | Health Status |
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|
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 |
| D001835 |
| Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D003710 | Demography |
| D011154 | Population Characteristics |
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |