Student BMI z-score: BMI z-score was calculated using the World Health Organization (WHO) growth reference standards. The z-score represents the number of standard deviations a child's BMI is from the population mean for age and sex. A z-score of 0 corresponds to the median BMI of the reference population. Positive values indicate a BMI higher than the reference median, while negative values indicate a BMI lower than the reference median. Higher z-scores generally indicate increased adiposity, with standard clinical thresholds defining overweight as a BMI z-score ≥ 1 and obesity as a BMI z-score ≥ 2.

Caregiver BMI was calculated from height and weight data using the following equation: kg/m^2

Overall health rating is a Single item question asking to rate general overall health and scored on a 5-point Likert scale from 1=poor to 5=excellent.

Using validated scoring procedures, an unhealthy days score was computed by adding the number of physically and mentally unhealthy days within the past 30 days, with a minimum score of 0 and maximum score of 30 days. Higher scores indicate worse quality of life.

School-related quality of life (QOL) was assessed with the 5-item school functioning subscale of the Pediatric QOL Inventory which used a 5-point Likert scale (i.e., 1 = never a problem, 5 = almost always a problem). Applying validated scoring procedures, items were reverse-scored and linearly transformed to a 0 to 100 scale with higher scores indicating higher school-related QOL.

Control arm receives no intervention

Total of all reporting groups

Total number includes Student and Caregiver participants numbers combined

Total number of participants includes the combination of student and caregiver participants within each arm of the study.

Total number includes Student and Caregiver participants numbers combined

BMI percentile for children is a standardized measure used to assess body weight relative to height, adjusted for age and sex. It is calculated by deriving the Body Mass Index (BMI) from weight (kg) divided by height squared (m²) and then comparing the value to age- and sex-specific growth charts established by the Center for Disease Control.

Caregiver BMI was calculated from height and weight data using the following equation: kg/m^2

Total number includes Student and Caregiver participants numbers combined

BMI z-score was calculated using the World Health Organization (WHO) growth reference standards. The z-score represents the number of standard deviations a child's BMI is from the population mean for age and sex. A z-score of 0 corresponds to the median BMI of the reference population. Positive values indicate a BMI higher than the reference median, while negative values indicate a BMI lower than the reference median. Higher z-scores generally indicate increased adiposity, with standard clinical thresholds defining overweight as a BMI z-score ≥ 1 and obesity as a BMI z-score ≥ 2.

BMIz-scores are only calculated for the student sample. A total of 11 KSS student participants and 19 control student participants were not weighed and therefore are not in the sample.

BMI percentile for children is a standardized measure used to assess body weight relative to height, adjusted for age and sex. It is calculated by deriving the Body Mass Index (BMI) from weight (kg) divided by height squared (m²) and then comparing the value to age- and sex-specific growth charts established by the CDC.

BMI percentiles are only calculated for the student sample. A total of 11 KSS student participants and 19 control student participants were not weighed and therefore are not in the sample.

Only caregivers are asked for their educational attainment.

Only caregivers are asked to report their family's annual household income

Only caregivers weight and height were calculated into a BMI. Additionally, a total of 10 KSS caregiver participants and 7 caregiver control participants did not report their weights and heights so BMI could not be calculated for them.

Change in ounces of sugar sweetened beverage consumption from Baseline to 7-months as measured via the validated Beverage Intake Questionnaire (BEVQ-15). Participants were asked to report how often and how much of the following sugary drinks they consumed in the past 30 days: regular soft drinks, sweetened juice beverage/drink, sweetened tea, coffee with sugar, energy/sports drinks. Using standardized and validated scoring procedures, daily totals for each of the sugary beverages were determined by multiplying intake frequency by portion size. These daily total intakes were then summed across the five sugary drink types to obtain a total daily intake, in fluid ounces, of all sugary drinks. Change scores were calculated by subtracting the baseline sugary drink intake from the 7 month follow-up.

This analysis only includes caregiver participants. While students were analyzed for change in SSB, student SSB change was a primary outcome and therefore they are not reported here. Overall participants analyzed includes caregivers who completed both the baseline and 7 month follow up items for the BEVQ-15.

Student BMI z-score: BMI z-score was calculated using the World Health Organization (WHO) growth reference standards. The z-score represents the number of standard deviations a child's BMI is from the population mean for age and sex. A z-score of 0 corresponds to the median BMI of the reference population. Positive values indicate a BMI higher than the reference median, while negative values indicate a BMI lower than the reference median. Higher z-scores generally indicate increased adiposity, with standard clinical thresholds defining overweight as a BMI z-score ≥ 1 and obesity as a BMI z-score ≥ 2.

Because BMI is calculated differently for adults, this analysis only includes student participants. Caregiver BMI changes are reported separately. Overall participants analyzed includes students who completed both the baseline and 7 month height and weight measures.

Caregiver BMI was calculated from height and weight data using the following equation: kg/m^2

Because BMI is calculated differently for children, this analysis only includes caregiver participants. Student BMI changes are reported separately. Overall participants analyzed includes caregivers who reported their baseline and 7 month height and weight measures.

Overall health rating is a Single item question asking to rate general overall health and scored on a 5-point Likert scale from 1=poor to 5=excellent.

Overall participants analyzed includes students and caregivers who completed both the baseline and 7 month overall health rating item.

Using validated scoring procedures, an unhealthy days score was computed by adding the number of physically and mentally unhealthy days within the past 30 days, with a minimum score of 0 and maximum score of 30 days. Higher scores indicate worse quality of life.

Questions were only asked of caregiver and students are not included in the analysis. Overall participants analyzed includes caregivers who completed both the baseline and 7-month follow up items for the quality of life scale.

School-related quality of life (QOL) was assessed with the 5-item school functioning subscale of the Pediatric QOL Inventory which used a 5-point Likert scale (i.e., 1 = never a problem, 5 = almost always a problem). Applying validated scoring procedures, items were reverse-scored and linearly transformed to a 0 to 100 scale with higher scores indicating higher school-related QOL.

This analysis only includes student participants. Caregiver quality of life measures are reported separately. Overall participants analyzed includes students who completed both the baseline and 7 month school related function items.

Change in ounces of sugar sweetened beverage consumption from Baseline to 7-months as measured via the validated Beverage Intake Questionnaire (BEVQ-15). Participants were asked to report how often and how much of the following sugary drinks they consumed in the past 30 days: regular soft drinks, sweetened juice beverage/drink, sweetened tea, coffee with sugar, energy/sports drinks. Using standardized and validated scoring procedures, daily totals for each of the sugary beverages were determined by multiplying intake frequency by portion size. These daily total intakes were then summed across the five sugary drink types to obtain a total daily intake, in fluid ounces, of all sugary drinks. Change scores were calculated by subtracting the baseline sugary drink intake from the 7 month follow-up.

This analysis only includes caregiver participants who consumed > 24 fluid ounces of SSB at Baseline AND who completed both the Baseline and 7 month SSB items for the BEVQ-15. While students were analyzed similarly, student SSB change across Baseline SSB intake was a primary outcome and therefore they are not reported here.

Change in ounces of sugar sweetened beverage consumption from Baseline to 7-months as measured via the validated Beverage Intake Questionnaire (BEVQ-15). Participants were asked to report how often and how much of the following sugary drinks they consumed in the past 30 days: regular soft drinks, sweetened juice beverage/drink, sweetened tea, coffee with sugar, energy/sports drinks. Using standardized and validated scoring procedures, daily totals for each of the sugary beverages were determined by multiplying intake frequency by portion size. These daily total intakes were then summed across the five sugary drink types to obtain a total daily intake, in fluid ounces, of all sugary drinks. Change scores were calculated by subtracting the baseline sugary drink intake from the 7 month follow-up.

This analysis only includes caregiver participants who consumed > 12 fluid ounces of SSB at Baseline AND who completed both the Baseline and 7 month SSB items for the BEVQ-15. While students were analyzed similarly, student SSB change across Baseline SSB intake was a primary outcome and therefore they are not reported here.

Change in ounces of sugar sweetened beverage consumption from Baseline to 7-months as measured via the validated Beverage Intake Questionnaire (BEVQ-15). Participants were asked to report how often and how much of the following sugary drinks they consumed in the past 30 days: regular soft drinks, sweetened juice beverage/drink, sweetened tea, coffee with sugar, energy/sports drinks. Using standardized and validated scoring procedures, daily totals for each of the sugary beverages were determined by multiplying intake frequency by portion size. These daily total intakes were then summed across the five sugary drink types to obtain a total daily intake, in fluid ounces, of all sugary drinks. Change scores were calculated by subtracting the baseline sugary drink intake from the 7 month follow-up.

This analysis only includes caregiver participants who consumed > 8 fluid ounces of SSB at Baseline AND who completed both the Baseline and 7 month SSB items for the BEVQ-15. While students were analyzed similarly, student SSB change across Baseline SSB intake was a primary outcome and therefore they are not reported here.

Change in ounces of sugar sweetened beverage consumption from Baseline to 7-months as measured via the validated Beverage Intake Questionnaire (BEVQ-15). Participants were asked to report how often and how much of the following sugary drinks they consumed in the past 30 days: regular soft drinks, sweetened juice beverage/drink, sweetened tea, coffee with sugar, energy/sports drinks. Using standardized and validated scoring procedures, daily totals for each of the sugary beverages were determined by multiplying intake frequency by portion size. These daily total intakes were then summed across the five sugary drink types to obtain a total daily intake, in fluid ounces, of all sugary drinks. Change scores were calculated by subtracting the baseline sugary drink intake from the 7 month follow-up.

This analysis only includes student participants who consumed > 24 fluid ounces of SSB at Baseline AND who completed both the Baseline and 7 month SSB items for the BEVQ-15. While caregivers were analyzed similarly, caregiver SSB change across Baseline SSB intake was a secondary outcome and therefore they are not reported here.

Change in ounces of sugar sweetened beverage consumption from Baseline to 7-months as measured via the validated Beverage Intake Questionnaire (BEVQ-15). Participants were asked to report how often and how much of the following sugary drinks they consumed in the past 30 days: regular soft drinks, sweetened juice beverage/drink, sweetened tea, coffee with sugar, energy/sports drinks. Using standardized and validated scoring procedures, daily totals for each of the sugary beverages were determined by multiplying intake frequency by portion size. These daily total intakes were then summed across the five sugary drink types to obtain a total daily intake, in fluid ounces, of all sugary drinks. Change scores were calculated by subtracting the baseline sugary drink intake from the 7 month follow-up.

This analysis only includes student participants who consumed > 12 fluid ounces of SSB at Baseline AND who completed both the Baseline and 7 month SSB items for the BEVQ-15. While caregivers were analyzed similarly, caregiver SSB change across Baseline SSB intake was a secondary outcome and therefore they are not reported here.

Change in ounces of sugar sweetened beverage consumption from Baseline to 7-months as measured via the validated Beverage Intake Questionnaire (BEVQ-15). Participants were asked to report how often and how much of the following sugary drinks they consumed in the past 30 days: regular soft drinks, sweetened juice beverage/drink, sweetened tea, coffee with sugar, energy/sports drinks. Using standardized and validated scoring procedures, daily totals for each of the sugary beverages were determined by multiplying intake frequency by portion size. These daily total intakes were then summed across the five sugary drink types to obtain a total daily intake, in fluid ounces, of all sugary drinks. Change scores were calculated by subtracting the baseline sugary drink intake from the 7 month follow-up.

This analysis only includes student participants who consumed > 8 fluid ounces of SSB at Baseline AND who completed both the Baseline and 7 month SSB items for the BEVQ-15. While caregivers were analyzed similarly, caregiver SSB change across Baseline SSB intake was a secondary outcome and therefore they are not reported here.

Control arm receives no intervention