Terry-McElrath Yvonne M, Chriqui Jamie F, O'Malley Patrick M, Chaloupka Frank J, Johnston Lloyd D
Institute for Social Research, University of Michigan, Ann Arbor, Michigan.
Division of Health Policy and Administration, School of Public Health; Institute for Health Research and Policy.
Am J Prev Med. 2015 Apr;48(4):436-44. doi: 10.1016/j.amepre.2014.10.022. Epub 2015 Jan 6.
Beginning in the 2014-2015 school year, all U.S. schools participating in federally reimbursable meal programs are required to implement new nutrition standards for items sold in competitive venues. Multilevel mediation modeling examining direct, mediated, and indirect pathways between policy, availability, and student consumption might provide insight into possible outcomes of implementing aspects of the new standards.
To employ multilevel mediation modeling using state- and school district-level policies mandating school soda bans, school soda availability, and student soda consumption.
The 2010-2012 Monitoring the Future surveys obtained nationally representative data on high school student soda consumption; school administrators provided school soda availability data. State laws and district policies were compiled and coded. Analyses conducted in 2014 controlled for state-, school-, and student-level characteristics.
State-district-school models found that state bans were associated with significantly lower school soda availability (c, p<0.05) but district bans showed no significant associations. No significant direct, mediated, or indirect associations between state policy and student consumption were observed for the overall sample. Among African American high school students, state policy was associated directly with significantly lower school soda availability (a, p<0.01), and-indirectly through lower school availability-with significantly lower soda consumption (a*b, p<0.05).
These analyses indicate state policy focused on regular soda strongly affected school soda availability, and worked through changes in school availability to decrease soda consumption among African American students, but not the overall population.
从2014 - 2015学年开始,所有参与联邦可报销膳食计划的美国学校都必须对在竞争场所销售的食品实施新的营养标准。多层次中介模型研究政策、供应情况和学生消费之间的直接、中介和间接途径,可能有助于深入了解实施新标准各方面可能产生的结果。
运用多层次中介模型,分析州和学区层面关于学校苏打水禁令、学校苏打水供应情况以及学生苏打水消费的政策。
2010 - 2012年“未来监测”调查获取了全国范围内具有代表性的高中生苏打水消费数据;学校管理人员提供了学校苏打水供应情况数据。对州法律和学区政策进行了汇编和编码。2014年进行的分析控制了州、学校和学生层面的特征。
州 - 学区 - 学校模型发现,州禁令与学校苏打水供应显著减少相关(c,p<0.05),但学区禁令未显示出显著相关性。对于总体样本,未观察到州政策与学生消费之间存在显著的直接、中介或间接关联。在非裔美国高中生中,州政策直接与学校苏打水供应显著减少相关(a,p<0.01),并且通过学校供应减少间接导致苏打水消费显著降低(a*b,p<0.05)。
这些分析表明,关注普通苏打水的州政策强烈影响了学校苏打水的供应情况,并通过学校供应情况的变化减少了非裔美国学生的苏打水消费,但对总体人群没有影响。