Nanney Marilyn S, MacLehose Richard F, Kubik Martha Y, Davey Cynthia S, O'Connell Michael J, Grannon Katherine Y, Nelson Toben F
Department of Family Medicine and Community Health, Program in Health Disparities Research, University of Minnesota, Minneapolis, Minnesota.
Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota.
Am J Prev Med. 2016 Nov;51(5):656-663. doi: 10.1016/j.amepre.2016.05.008. Epub 2016 Jun 16.
The School Obesity-related Policy Evaluation (ScOPE) Study uses existing public surveillance data and applies a rigorous study design to evaluate effectiveness of school policies and practices impacting student behavioral and weight outcomes.
The ScOPE Study used a cohort of 50 combined junior-senior and high schools in Minnesota to evaluate the change in weight-related policy environments in 2006 and 2012 and test the effect of policy change on students attending those schools in 2007 and 2013. Exposure variables included school practices about foods and beverages available in school vending machines and school stores, physical education requirements, and intramural opportunities. Primary study outcomes were average school-level ninth grade student BMI percentile, obesity prevalence, daily servings of fruits/vegetables, and daily glasses of soda.
Availability of fruits/vegetables in schools was associated with a significant increase in total daily intake among ninth grade students by 0.4 servings. Availability of soda in schools was associated with a significant increase in total daily intake among ninth grade boys by 0.5 servings. Less-healthy snack and drink availability in schools was associated with a small, significant increase (1%) in student BMI percentile at the school level.
Use of a school-level longitudinal cohort study design over a 6-year period uniquely adds to the methodologic rigor of school policy and practice evaluation studies. The ScOPE Study provides marginal evidence that school policies and practices, especially those that restrict vending and school store offerings, may have small effects on weight status among ninth grade students.
学校肥胖相关政策评估（ScOPE）研究利用现有的公共监测数据，并采用严格的研究设计来评估影响学生行为和体重结果的学校政策及实践的有效性。
ScOPE研究以明尼苏达州的50所初、高中联合学校为队列，评估2006年和2012年与体重相关的政策环境变化，并测试政策变化对2007年和2013年就读于这些学校的学生的影响。暴露变量包括学校自动售货机和学校商店提供的食品和饮料、体育教育要求以及校内活动机会。主要研究结果是学校层面九年级学生的平均BMI百分位数、肥胖患病率、每日水果/蔬菜摄入量以及每日汽水饮用量。
学校提供水果/蔬菜与九年级学生每日总摄入量显著增加0.4份有关。学校提供汽水与九年级男生每日总摄入量显著增加0.5份有关。学校提供不健康的零食和饮料与学校层面学生BMI百分位数小幅显著增加（1%）有关。
在6年期间采用学校层面的纵向队列研究设计独特地增加了学校政策和实践评估研究的方法严谨性。ScOPE研究提供了边际证据，表明学校政策和实践，尤其是那些限制自动售货机和学校商店供应的政策和实践，可能对九年级学生的体重状况有微小影响。
