Abstract P056: Adolescent Self-Reported School Environment and Obesity Prevalence, the Fragile Families and Child Wellbeing Study

Abstract

Introduction: Childhood obesity continues be a major public health concern in the United States, and disproportionately affects racial/ethnic minorities and children of lower socioeconomic status. Social environments such as schools are particularly influential in shaping child and adolescent health, and represent an important target for interventions to improve health behaviors. Positive school environments, those that are safe, supportive, respectful, and engaging, have been shown to be associated with adolescent health behaviors; however, few studies have examined whether a positive school climate can influence physical health, such as obesity status. Hypothesis: We hypothesized that adolescents’ self-reported positive school environment would be associated with a lower prevalence of obesity in a disadvantaged population and that this association may differ by sex. Methods: Data were from the sixth wave of the Fragile Families and Child Wellbeing Study, a cohort of children born between 1998 and 2000, approximately two-thirds of whom were born to unmarried parents. Adolescents were, on average, 15 years of age at the time of the assessment and had height and weight measured during a home visit. Positive school environment was operationalized using adolescent self-reported responses to survey questions examining school connectedness, school climate (teacher quality and student behavior towards teachers), and presence of bullying behaviors in the past month. A cumulative school environment score was created, ranging from zero to five, with a score of four or five defined as a positive school environment (i.e. high levels of connectedness, positive climate, and no bullying). The final analytic sample size was 1,044 adolescents. Log binomial regression was used to estimate prevalence ratios for obesity. Results: Twenty-six percent of the sample was obese, and 45% reported a positive school environment. Crude and adjusted models were similar. After adjustment for race/ethnicity, parent marital status at first wave, and student receipt of free lunch, there did not appear to be an association between positive school environment and prevalence of obesity among boys (PR: 1.1; (0.8, 1.4)). Among girls, there was a slight inverse association between positive school environment and prevalence of obesity (PR: 0.8; (0.6, 1.1)), however this was not statistically significant. Conclusions: Results suggest that a more positive school environment could be associated with a lower prevalence of obesity among adolescent girls in a high-risk population. However, because of the cross-sectional nature of this analysis, results should be interpreted with caution, as temporality cannot be established. Future work should explore the use of validated measures of school environment to improve measurement and explore whether interactions exist between school environment and adolescents’ sex.