PROJECT SUMMARY
The overall goal of this K01 award is to provide Gabriella McLoughlin, PhD, MS, with the training and
mentorship to establish an independent program of research focused on improving implementation of Policy,
Systems, and Environmental (PSE) interventions for childhood obesity and cardiovascular disease prevention.
Childhood obesity disparities have been exacerbated in recent years, such that children from racial/ethnic
minority and low-income backgrounds are most at risk. Multiple factors, such as increased food insecurity
resulting in a low-quality diet, contribute to this increased threat. Childhood obesity tracks into adulthood,
increasing the risk of cardiovascular disease, and warranting sustainable interventions for youth to address
social determinants of health. Since children and adolescents consume over half of their energy intake at
school, providing free nutrient-rich breakfast and lunch to low-income youth through Universal School Meals
(USM) is a key PSE approach to addressing obesity disparities. Adoption of USM is linked with reductions in
obesity risk for low-income students, improved diet quality, reduced food insecurity, and enhanced academic
achievement outcomes. Unfortunately, schools adopting USM report consistent challenges to its
implementation such as low student participation and financial difficulty in adhering to Federal nutrition
requirements. Programs and policies designed to mitigate health disparities for obesity cannot make the most
impact if they are not reaching their target population. Because the federal reimbursement rate for schools is
tied to the number of students receiving school meals, maintaining participation is critical to making USM
financially feasible. The purpose of this K01 award is to conduct an implementation mapping procedure with
the School District of Philadelphia (SDP), resulting in the development and testing of an equity-focused
implementation strategy for USM. This will be achieved through three aims: 1) Investigate determinants of
USM implementation through a health equity lens; 2) Develop and tailor a USM implementation strategy
through a community-engaged approach; and 3) Evaluate the implementation and student health outcomes of
the implementation strategy. To accomplish these aims and prepare for a larger implementation effectiveness
trial, the applicant will receive rigorous formal training in 1) assessing implementation determinants grounded
in health equity 2) community-engaged implementation mapping, 3) randomized controlled trials, and 4) cost
analysis of implementation under the mentorship of Drs. Jennifer Fisher, Omar Martinez, Resa Jones, Ross
Brownson, Alex Dopp, and Shiriki Kumanyika. Temple University is the ideal setting for this work given a
longstanding relationship with the local community, facilitating Dr. McLoughlin's collaboration with SDP and
completion of the study aims through a community-engaged approach. This K01 award holds significant
potential for public health impact and will enable Dr. McLoughlin to establish a rigorous program of research to
improve PSE implementation and reduce obesity and cardiovascular disease risk in vulnerable populations.