1 University of Illinois at Chicago, Chicago, IL, USA.
Health Educ Behav. 2017 Oct;44(5):685-695. doi: 10.1177/1090198117723961. Epub 2017 Aug 16.
Recent federal policies aimed to ensure that all children have equitable access to healthy school nutrition environments. However, historically, disparities have persisted in the quality of school nutrition environments across geographic and socioeconomic groups. There is limited literature addressing if and how recent efforts to reform the school nutrition environment have influenced such disparities. The main objective of this study was to explore stakeholders' insights on how school nutrition reform intersected with issues of inequity.
Qualitative secondary analysis (QSA) offers a unique method to examine existing data with a related but distinct inquiry. This QSA analyzed three primary studies, including stakeholder interviews and focus group data with school professionals and students (total 60 transcripts). Two trained analysts iteratively coded all transcripts in Atlas.ti Version 7 and followed principles of constant comparative analysis. Measures to enhance "trustworthiness" were built into the primary studies and the QSA.
Broadly, stakeholders' complex insights about the school food environments' ability to compensate for healthy dietary options and "whole child" education that were perceived to be lacking in home environments. Despite the majority of respondents' positive perceptions of reforms, they also noted the challenges of addressing disparities due to family home environments and complex socioeconomic conditions. Overall, respondents reported that school food reform and nutrition education had the potential for long-term impacts on students' health, including the potential to improve disparities through enhanced academic achievement for disadvantaged populations.
QSA allowed for inquiry into frontline stakeholders' understandings of how school nutrition reform may affect health inequities. Qualitative methods allowed for the examination of complex motivations and perspectives involved in policy implementation. Understanding frontline stakeholders' perspectives is key to advance school nutrition reform in a sustainable manner, especially in light of the federal local school wellness policy final rule.
最近的联邦政策旨在确保所有儿童都能公平地获得健康的学校营养环境。然而，从历史上看，在地理和社会经济群体之间，学校营养环境的质量仍然存在差异。关于最近改革学校营养环境的努力是否以及如何影响这些差异的文献有限。本研究的主要目的是探讨利益相关者对学校营养改革如何与不平等问题交叉的看法。
定性二次分析 (QSA) 提供了一种独特的方法，可以用相关但不同的调查来检查现有数据。本 QSA 分析了三项主要研究，包括与学校专业人员和学生的利益相关者访谈和焦点小组数据（共 60 份转录本）。两名经过培训的分析师在 Atlas.ti Version 7 中对所有转录本进行迭代编码，并遵循恒比分析的原则。在主要研究和 QSA 中建立了增强“可信度”的措施。
广义上，利益相关者对学校食品环境能够弥补家庭环境中缺乏的健康饮食选择和“全人”教育的复杂看法。尽管大多数受访者对改革持积极看法，但他们也指出，由于家庭环境和复杂的社会经济条件，解决差异存在挑战。总体而言，受访者报告称，学校食品改革和营养教育有可能对学生的健康产生长期影响，包括通过提高弱势人群的学业成绩来改善差异的潜力。
QSA 允许对一线利益相关者对学校营养改革如何影响健康不平等的理解进行调查。定性方法允许检查政策实施中涉及的复杂动机和观点。了解一线利益相关者的观点是推进学校营养改革的关键，尤其是考虑到联邦地方学校健康政策最终规则。
