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School Poverty Level Moderates the Effectiveness of a Physical Activity Intervention.

To explore whether school poverty level and funding modified the effectiveness of an evidence-based Comprehensive School Physical Activity Program called Health Empowers You! implemented in elementary schools in Georgia. Secondary data analysis of a multi-level, cluster-randomized controlled trial. 40 elementary schools in Georgia in 2018-2019. 4th grade students in Georgia. Intervention schools implemented the Health Empowers You! program to increase school-day physical activity. The outcome was average daily moderate-to-vigorous physical activity, school free-reduced price lunch (FRPL) percentage and per pupil expenditures were effect modifiers. Separate linear mixed regression models estimated the effect of the intervention on average daily moderate-to-vigorous physical activity, with interaction terms between intervention status and (1) school FRPL percentage or (2) per pupil expenditures. The effect of the intervention was significantly higher in schools with higher FRPL percentage (intervention*school % FRPL β (95% CI): .06 (.01, .12)), and was modestly, but not statistically significantly, higher in schools with lower per pupil expenditures. Findings support the use of the Health Empowers You! intervention, which was effective in lower income schools, and may potentially reduce disparities in students' physical activity levels.

Barriers, Benefits, and Behaviors Related to Breakfast Consumption Among Rural Adolescents.

We sought to determine if perceived barriers, benefits, and modifiable behaviors support or interfere with breakfast consumption in a racially and economically diverse rural high school population. The participants were 832 Minnesota adolescents from 16 rural high schools. We used baseline data from a group randomized trial aimed at increasing school breakfast participation through policy and environmental-level school changes. Students completed an online survey asking about demographics, breakfast eating behaviors, and the barriers and benefits of eating as it relates to school performance. Bivariate and multivariate logistic regression, accounting for clustering by school, was performed using SAS. Each scale was modeled independently. Participants were 9th and 10th grade students, 36% free/reduced-price lunch (FRL), 30% non-White, and 55% female. Breakfast skippers compared to nonbreakfast skippers reported fewer school related benefits and beliefs and more barriers to eating breakfast (p < .01). Adjusted models revealed students reported more positive beliefs (OR = 0.78, 95% CI = 0.73-0.83), more benefits (OR = 0.95, 95% CI = 0.93-0.97) and fewer barriers (OR = 0.85, 95% CI = 0.82-0.87) and were less likely to skip breakfast. Future intervention research should focus on alleviating barriers and enhancing education around the school related benefits of eating breakfast.