1. Making Healthy Eating Policy Practice: A Group Randomized Controlled Trial on Changes in Snack Quality, Costs, and Consumption in After-School Programs.
- Author
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Beets, Michael W., Weaver, R. Glenn, Turner-McGrievy, Gabrielle, Huberty, Jennifer, Ward, Dianne S., Freedman, Darcy, Hutto, Brent, Moore, Justin B., and Beighle, Aaron
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SNACK foods & health , *AFTER school programs , *FOOD quality , *NUTRITION for school children , *NUTRITION policy , *SOFT drinks & health , *CHILD care , *COMPARATIVE studies , *FRUIT , *HEALTH promotion , *RESEARCH methodology , *MEDICAL cooperation , *RESEARCH , *RESEARCH funding , *SCHOOLS , *SNACK foods , *VEGETABLES , *EVALUATION research , *RANDOMIZED controlled trials , *EVALUATION of human services programs - Abstract
Purpose: The aim of this study was to evaluate an intervention designed to assist after-school programs (ASPs) in meeting snack nutrition policies that specify that a fruit or vegetable be served daily and sugar-sweetened beverages/foods and artificially flavored foods eliminated.Design: The study used a 1-year group-randomized controlled trial.Setting: The study took place in ASPs operating in South Carolina, United States.Subjects: Twenty ASPs serving over 1700 children were recruited, match-paired postbaseline on enrollment size and days fruits/vegetables were served per week, and randomized to either intervention (n = 10) or control (n = 10) groups.Intervention: The study used Strategies To Enhance Practice for Healthy Eating (STEPs-HE), a multistep adaptive intervention framework that assists ASP leaders and staff to serve snacks that meet nutrition policies while maintaining cost.Measures: Direct observation of snacks served and consumed and monthly snack expenditures as determined by receipts were used.Analysis: The study used nonparametric and mixed-model repeated measures.Results: By postassessment, intervention ASPs increased serving of fruits/vegetables to 3.9 ± 2.1 vs. 0.7 ± 1.7 d/wk and decreased serving sugar-sweetened beverages to 0.1 ± 0.7 vs. 1.8 ± 2.4 d/wk and sugar-sweetened foods to 0.3 ± 1.1 vs. 2.7 ± 2.5 d/wk compared to controls, respectively. Cost of snacks increased by $0.02/snack in the intervention ASPs ($0.36 to $0.38) compared to a $0.01 per snack decrease in the control group ($0.39 to $0.38). Across both assessments and groups, 80% to 100% of children consumed FVs.Conclusions: The STEPs-HE intervention can assist ASPs in meeting nationally endorsed nutrition policies with marginal increases in cost. [ABSTRACT FROM AUTHOR]- Published
- 2016
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