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PURPOSE/OBJECTIVES The purpose of this study was to identify key drivers of students' breakfast habits, including eating breakfast at home or at school, to inform strategies that school nutrition professionals might use to increase participation in School Breakfast Programs (SBPs). METHODS A convenience sample of students in grades 1-12 from two public school districts in Connecticut participated in focus groups. Each of the 13 focus groups included students from two or three grade levels and was facilitated by a lead moderator and note-taker. Recorded discussions were transcribed with students' comments coded to identify common themes. Within each theme, the grade levels of participants were identified to determine whether the theme represented comments by elementary school (grades 1-6), middle school (grades 7-8), and/or high school (grades 9-12) participants. RESULTS A total of 105 students (57% female, 43% male) participated. Across all grade levels, hunger, or a desire to avoid its adverse effects (e.g., grumpiness, headache), was identified as a consistently mentioned reason for eating breakfast. Other reasons included parental influence (elementary students), desire to improve energy (elementary students), and desire to improve school performance (elementary and middle school students). Breakfast skipping was often reported by middle and high school students, who cited inadequate time and lack of hunger as reasons. Across all grade levels, reasons for not participating in the SBP included distaste for, distrust of, and/or cost of school foods. Inconvenience of eating at school and perception of school foods as unhealthy or "junk" were cited by elementary and middle school students. Suggestions to improve school breakfast included more choices (all grades), improved freshness or quality of foods (all grades), and healthier options (elementary and middle school students). APPLICATION TO CHILD NUTRITION PROFESSIONALS Emphasizing food quality and increasing convenience of school breakfast may help to increase SBP participation. [ABSTRACT FROM AUTHOR]

Purpose: To compare two intensity levels (standard vs. enhanced) of a nutrition and physical activity intervention vs. a control (usual programs) on nutrition knowledge, body mass index, fitness, academic performance, behavior, and medication use among elementary school students.Design: Quasi-experimental with three arms.Setting: Elementary schools, students' homes, and a supermarket.Subjects: A total of 1487 third-grade students.Intervention: The standard intervention (SI) provided daily physical activity in classrooms and a program on making healthful foods, using food labels. The enhanced intervention (EI) provided these plus additional components for students and their families.Measures: Body mass index (zBMI), food label literacy, physical fitness, academic performance, behavior, and medication use for asthma or attention-deficit hyperactivity disorder (ADHD).Analysis: Multivariable generalized linear model and logistic regression to assess change in outcome measures.Results: Both the SI and EI groups gained less weight than the control (p < .001), but zBMI did not differ between groups (p = 1.00). There were no apparent effects on physical fitness or academic performance. Both intervention groups improved significantly but similarly in food label literacy (p = .36). Asthma medication use was reduced significantly in the SI group, and nonsignificantly (p = .10) in the EI group. Use of ADHD medication remained unchanged (p = .34).Conclusion: The standard intervention may improve food label literacy and reduce asthma medication use in elementary school children, but an enhanced version provides no further benefit. [ABSTRACT FROM AUTHOR]