Evaluation of a District-Wide Initiative to Improve School Meal Consumption and Physical Activity Levels among Elementary Students in Anchorage, Alaska - PROJECT SUMMARY Improving children’s diets and physical activity levels are key strategies to reduce the risk of obesity. However, most children do not meet dietary or physical activity recommendations, and children who are from families with socioeconomic disadvantages and/or who are racial/ethnic minorities experience disproportionately higher rates of obesity, with Alaska Native/American Indian children experiencing the highest rates nationally. Schools can be an ideal location to promote healthier habits as children spend a substantial portion of their time in school and often consume up to half their daily energy intake there. Two promising, cost-effective school policies are longer lunch periods and longer recess with integrated PA opportunities, but rigorous evidence is lacking. In this time-sensitive proposal, we propose to evaluate a natural experiment in Anchorage, Alaska of the implementation of a wellness initiative in elementary schools that includes 30 minute lunch periods and 54 minutes of PA daily (including 30 minutes of recess in addition to classroom movement activities). The wellness initiative will have a staggered rollout in schools over the span of four years. Our study will collect longitudinal data from 4,000 students in K-4th grade to assess changes in school meal consumption using plate waste methodology (Aim 1). Physical activity levels will also be assessed in a subsample of children (n=2,000 students in grades K-4) using accelerometer measurements (Aim 2). Outcomes will be measured at baseline and post-implementation the following school year (collected during the same month at each time point). Additionally, BMI, sleep duration and quality, and other factors related to academic performance (i.e., changes in students’ disruptive classroom behaviors [measured at baseline and one year post-implementation], disciplinary referrals to the principal, hunger-related visits to the school nurse, and standardized test scores [baseline and up to four years post-implementation]) will be evaluated. Implementation fidelity will be assessed throughout the study period via site visits, environmental scans, and teacher surveys. Anchorage School District plans the staggered implementation of the initiative to begin in the 2021-22 school year. Thus, time- sensitive funding is critical to ensure adequate time for baseline data collection. The proposal’s significance lies in our ability to provide the first empirical evidence of the degree to which school policies for longer lunch periods and integrated physical activity opportunities influence students’ dietary intakes, physical activity levels, weight status, and factors related to academic performance. This rigorous, innovative, and time-sensitive study will contribute to the development of a comprehensive evidence base on the potential effectiveness of school nutrition and physical activity policies, which can help to address health disparities in children, including among an underserved and understudied Alaska Native population. Study results will also provide essential evidence to inform local, state, and federal policymakers’ decisions regarding school nutrition and physical activity policies as well as have the strong potential to impact children’s health more broadly.
