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RE-AIM analysis of a randomized school-based nutrition intervention among fourth-grade classrooms in California

  • Original Research
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Translational Behavioral Medicine

Abstract

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.

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Compliance with ethical standards

ᅟ

Funding

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.

Ethical approval

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.

Informed consent

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.

Author information

Authors and Affiliations

  1. Department of Psychology, University of Southern California, 3620 S. McClintock Ave, SGM 501, Los Angeles, CA, 90089-1061, USA

    Andrew L. Larsen

  2. Dairy Council of California, Los Angeles, CA, USA

    Trina Robertson

  3. School of Preventive Medicine, University of Southern California, Los Angeles, CA, USA

    Genevieve Dunton

Authors
  1. Andrew L. Larsen
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  2. Trina Robertson
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  3. Genevieve Dunton
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Corresponding author

Correspondence to Andrew L. Larsen.

Additional information

Implications

Practice: Implementing large scale nutrition education programs in elementary schools can have a positive impact on childhood eating habits and moderate to high public health impact due to the ability to reach a large target audience.

Policy: Education systems should encourage classroom-based nutrition education programs that can be effectively implemented to a large population, are sustainable, and lead to health benefits.

Research: Consistent use of the RE-AIM framework facilitates a more complete understanding of the overall public health impact of programs and can assist the comparison of results from various school-based interventions.

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Larsen, A.L., Robertson, T. & Dunton, G. RE-AIM analysis of a randomized school-based nutrition intervention among fourth-grade classrooms in California. Behav. Med. Pract. Policy Res. 5, 315–326 (2015). https://doi.org/10.1007/s13142-015-0311-6

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  • DOI: https://doi.org/10.1007/s13142-015-0311-6

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