Preliminary Healthy Eating Outcomes of SNaX, a Pilot Community-Based Intervention for Adolescents

Published in: Journal of Adolescent Health, v. 48, no. 2, Feb 2011, p.196-202

Posted on RAND.org on January 31, 2011

by Laura M. Bogart, Marc N. Elliott, Kimberly E. Uyeda, Jennifer Hawes-Dawson, David J. Klein, Mark A. Schuster

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PURPOSE: We used principles of community-based participatory research to develop and pilot test a 5-week intervention for middle school students, Students for Nutrition and eXercise (SNaX). SNaX aimed to translate school obesity-prevention policies into practice with peer advocacy of healthy eating and school cafeteria changes. METHODS: A total 425 seventh graders (63% of all seventh graders) in the intervention school were surveyed at baseline regarding cafeteria attitudes and sugar-sweetened beverage consumption; of the 425 students, 399 (94%) were surveyed again at 1-month post-intervention. School cafeteria records were obtained from two schools: the intervention school and a nonrandomized selected comparison school with similar student socio-demographic characteristics. RESULTS: A total of 140 students in the intervention school were trained as peer advocates. In the intervention school, cafeteria attitudes among peer advocates significantly improved over time (approximately one-third of a standard deviation), whereas cafeteria attitudes of non-peer advocates remained stable; the improvement among peer advocates was significantly greater than the pre-post-change for non-peer advocates (b = .71, p < .001). Peer advocates significantly reduced their sugar-sweetened beverage intake (sports and fruit drinks), from 33% before intervention to 21% after intervention (p = .03). Cafeteria records indicated that servings of fruit and healthier entrées (salads, sandwiches, and yogurt parfaits) significantly decreased in the comparison school and significantly increased in the intervention school; the magnitude of changes differed significantly between the schools (p < .001). CONCLUSIONS: As compared with the non-peer advocates, peer advocates appeared to benefit more from the intervention. Future research should consider engaging parents, students, and other key community stakeholders to determine acceptable and sustainable cafeteria changes.

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