Association between Community Eligibility Provision and Student Weight Outcomes: A Longitudinal Analysis

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Description
The U.S. Department of Agriculture’s (USDA) National School Lunch Program and School Breakfast Program provide nutritious meals to school-age children. USDA’s Community Eligibility Provision (CEP) is designed to extend the reach of these programs by allowing schools in low-income areas…

The U.S. Department of Agriculture’s (USDA) National School Lunch Program and School Breakfast Program provide nutritious meals to school-age children. USDA’s Community Eligibility Provision (CEP) is designed to extend the reach of these programs by allowing schools in low-income areas to provide free school meals to all students at no cost to families. CEP has been shown to increase school meal participation, nutritional intake, academic achievement, and attendance in previous research studies. This study aims to examine the impact of long-term CEP participation on student weight outcomes. Nurse-measured height and weight data for school years 2013-14 to 2019-20 were collected from 141 K-12 public schools in four low-income cities. School-level prevalence of obesity was calculated from students’ heights and weights using the Centers for Disease Control and Prevention protocol. CEP participation for each school year was obtained from the state Department of Education. Schools in the sample began participating in CEP at different times yielding varying numbers of years of CEP exposure over the study period. Multivariable analyses examined the relationship between school CEP exposure and the prevalence of obesity, controlling for school-level covariates. Multivariable analyses showed that for every additional year of CEP participation, the school-level prevalence of obesity was 0.4% lower (p=0.018). The regression-adjusted obesity prevalence for schools that never participated in CEP was 28.0%, while the obesity prevalence for schools with 6 years of CEP participation was 25.4%. The lower prevalence of obesity in CEP-participating schools was primarily driven by elementary schools. These results suggest that the benefits of CEP participation can cumulate over time, significantly reducing school-level obesity prevalence over time.
Date Created
2024
Agent

Examining Associations Between Participation in the Supplemental Nutrition Assistance Program (SNAP) and Dietary Behaviors: A Longitudinal Analysis

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Description
The Supplemental Nutrition Assistance Program (SNAP) participants have been shown to have worse dietary behaviors compared to eligible non-participants. It is suggested that individuals who self-select into SNAP have unhealthy diets prior to program participation. This study examined the association…

The Supplemental Nutrition Assistance Program (SNAP) participants have been shown to have worse dietary behaviors compared to eligible non-participants. It is suggested that individuals who self-select into SNAP have unhealthy diets prior to program participation. This study examined the association between low-income adults’ SNAP participation status and dietary behaviors over time. A sample of households from low-income high-minority cities were surveyed at baseline (T1) and 2-4 years later (T2). Analyses were restricted to adults with household income < 200% of the federal poverty line (n=338). Participants were grouped into the four following categories: Long-term (n=171): SNAP participation at T1 and T2; Previous (n=47): SNAP participation at T1 but not T2; Current (n=38): SNAP participation at T2 but not T1; and Never (n=132): no SNAP participation at T1 or T2. Self-reported daily consumption frequency of whole fruits, fruit juice, vegetables, sugar-sweetened beverages (SSBs), and snacks were measured through self-reports. To observe dietary differences based on SNAP participation status, T2 behaviors of all groups were compared to those of the Never group. To observe dietary differences prior to SNAP participation, T1 behaviors were compared between Current and Never groups. There were no significant differences in dietary behaviors at T1 (prior to SNAP participation) between Never and Current participants providing no evidence of self-selection of unhealthy households into SNAP. Only marginal differences were found between SNAP participation status and dietary behaviors at T2. Improvements in SNAP participants’ diets may benefit from focusing on policy changes that encourage healthy dietary habits during participation in the program.
Date Created
2023
Agent

Macy Young Honors Thesis Defense.pdf

Date Created
2023-05
Agent

The Effect of the COVID-19 Pandemic on the Fertility of Women in Reproductive Ages:
Cross-sectional Study

Description

Background: Recent studies have shown a decline in birth rates in large metropolitan areas (after accounting for population), which can be possibly explained by barriers to reproduction associated with the COVID-19 pandemic and related lockdowns. Objective: This study’s objective was…

Background: Recent studies have shown a decline in birth rates in large metropolitan areas (after accounting for population), which can be possibly explained by barriers to reproduction associated with the COVID-19 pandemic and related lockdowns. Objective: This study’s objective was to investigate the impact of the COVID-19 pandemic and related lockdowns on the fertility rates of women in reproductive ages living in Greater Phoenix. Methods: The total number of inpatient births and people in both Maricopa and Pinal Counties during pre-COVID-19 years (2017-2019) were compared with those during the COVID-19 years (2021) among women in reproductive ages (15-49 years). To make age-specific comparisons, women in reproductive years were divided into eight distinct age group categories (15-17, 18-20, and then five year age group categories to age 49) from which age-specific, general, and total fertility rates were calculated. Results: Using a two-sample z-test for difference in proportions, findings revealed that the general fertility rate in Greater Phoenix had significantly declined from 48 to 46 per 1,000 population from the pre-COVID-19 period to COVID-19 period (P<0.001). Two sample z-tests were also used to compare age-specific fertility rates, which revealed a significant decline in the fertility rate in women ages 15-17 (from 8.0/1000 to 5.0/1000) (P<0.001), 18-20 (from 43.0/1000 to 35.0/1000) (P<0.001), and 21-24 (from 79.0/1000 to 68.0/1000) (P<0.001) from the pre-COVID-19 period to COVID-19 period, while no significant change was observed in the fertility rate in women ages 25-49. Conclusions: The observed general fertility decline in Greater Phoenix as a result of the COVID-19 pandemic poses significant implications for further research on barriers to reproduction brought upon by the COVID-19 pandemic and related lockdown measures. Another direction for further research involves possibly continuing this study to include years 2022 and 2023 in the COVID-19 period, as well as calculating age-specific fertility rates by race.

Date Created
2023-05
Agent

Healthy school meals for all in Arizona: A comprehensive assessment of benefits, cost scenarios, and community perspectives

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Description

We surveyed a diverse group of Arizona residents, including over 2,300 parents of school-age children and nearly 1,300 members of the school community, consisting of teachers, lunchroom staff, school administrators,and other school employees. Respondents represented a wide range of racial, economic, educational, and political backgrounds.

Agent

Healthy school meals for all in Arizona: A comprehensive assessment of benefits, cost scenarios, and community perspectives

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Description

We surveyed a diverse group of Arizona residents, including over 2,300 parents of school-age children and nearly 1,300 members of the school community, consisting of teachers, lunchroom staff, school administrators,and other school employees. Respondents represented a wide range of racial, economic, educational, and political backgrounds.

Agent

Cost estimation: Covering the reduce-price meal co-pay

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Description

Under current United States Department of Agriculture (USDA) guidelines, Arizona schools participating in the National School Lunch Program and the School Breakfast Program are reimbursed for the meals they serve students through federal dollars and co-pays from student families. For…

Under current United States Department of Agriculture (USDA) guidelines, Arizona schools participating in the National School Lunch Program and the School Breakfast Program are reimbursed for the meals they serve students through federal dollars and co-pays from student families. For this analysis, our goal was to estimate the cost to the State of Arizona if the breakfast and lunch co-pays for students that qualify for reduced-price meals were covered by the state.

Date Created
2022-12
Agent

Cost estimation: Covering the reduce-price meal co-pay

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Description

Under current United States Department of Agriculture (USDA) guidelines, Arizona schools participating in the National School Lunch Program and the School Breakfast Program are reimbursed for the meals they serve students through federal dollars and co-pays from student families. For…

Under current United States Department of Agriculture (USDA) guidelines, Arizona schools participating in the National School Lunch Program and the School Breakfast Program are reimbursed for the meals they serve students through federal dollars and co-pays from student families. For this analysis, our goal was to estimate the cost to the State of Arizona if the breakfast and lunch co-pays for students that qualify for reduced-price meals were covered by the state.

Date Created
2022-12
Agent
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