School Provision of Universal Free Meals and Blood Pressure Outcomes Among Youths
Notice bibliographique
Résumé
Importance: The Community Eligibility Provision is a federal universal free school meals policy for schools in low-income areas. Expanding access to school meals, which are children's most nutritious food source, may be a health-promoting policy. Objective: To assess whether school-level adoption of the Community Eligibility Provision was associated with childhood blood pressure outcomes. Design, Setting, and Participants: This cohort study used a difference-in-differences design for staggered policy adoption, observing low-income public and charter schools in 12 US states longitudinally from 2013 through 2019. The medical records for patients aged 4 to 18 years receiving care from community health organizations in the OCHIN health care network were matched to schools based on address. Data were analyzed from April 1 to July 5, 2024. Exposure: School participation in the Community Eligibility Provision. Main Outcomes and Measures: The primary outcome was the annual school-level proportion of patients with a high blood pressure measurement (at or above the 90th percentile for age, sex, and height), and the secondary outcomes included a hypertensive measurement (at or above the 95th percentile) and mean systolic and diastolic blood pressure percentiles. Results: The sample included 1052 schools matched to 155 778 distinct patients. The mean (SD) proportions of patients based on race and ethnicity were as follows: 0.04 (0.08) Asian patients, 0.46 (0.33) Hispanic patients, 0.01 (0.03) patients of multiple races, 0.01 (0.02) Native Hawaiian or Other Pacific Islander patients, 0.13 (0.22) non-Hispanic Black patients, 0.25 (0.26) non-Hispanic White patients, and 0.09 (0.09) patients with unknown race and ethnicity. The majority of schools (n = 670 [63.7%]) were located in California or Oregon. School participation in the Community Eligibility Provision was associated with a -2.71 percentage point (95% CI, -5.10 to -0.31 percentage point; P = .03) net reduction in the proportion of patients with a high blood pressure measurement, corresponding to a -10.8% (95% CI, -20.4% to -1.2%) net decrease over 5 years. Participation was also negatively associated with the proportion of patients with a hypertensive measurement and with the mean diastolic blood pressure. Conclusions and Relevance: This cohort study of schools matched to child and adolescent patient medical records from a large network of community health organizations found that school participation in the Community Eligibility Provision was associated with a net reduction in blood pressure outcomes. These findings add to mounting evidence that universal free school meals may be associated with improved child health.
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Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
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