RE-AIM analysis of a randomized school-based nutrition intervention among fourth-grade classrooms in California
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Childhood overweight and obesity are major health problems. School-based programs enable intervening with large groups of children, but program overall health impact is rarely completely assessed. A RE-AIM (Reach, Efficacy, Adoption, Implementation, Maintenance) analysis tested the overall public health impact of the fourth-grade “Nutrition Pathfinders” school-based nutrition-education program. A randomized controlled trial in 47 fourth-grade California classrooms (1713 students) tested program efficacy, and a secondary analysis of archival data tested program dissemination. Desired effects were seen in child nutrition knowledge, attitudes, consumption of low-nutrient high-density foods, sugar-sweetened beverages, proteins, grains, and parent willingness to serve new foods. The program was disseminated to ∼25 % of public school fourth-grade classrooms in California and cost about $1.00 per student to implement. The Nutrition Pathfinders program demonstrates potential for moderate to high public health impact due to its wide dissemination, effectiveness in altering attitudes and behaviors, and its relatively inexpensive cost of implementation.
KeywordsChild nutrition Nutrition knowledge Obesity RE-AIM Self-efficacy
Compliance with ethical standards
This study was funded by the Dairy Council of California and the American Cancer Society (118283-MRSGT-10-012-01-CPPB).
Conflict of interest
Andrew Larsen and Genevieve Dunton were supported by the Dairy Council of California for conducting analyses and writing the report. Trina Robertson is employed by the Dairy Council of California.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Written informed assent was obtained from all minors. A passive parental consent procedure was used. The minor was approached for assent if the parent did not decline consent.
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