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Using implementation mapping to optimize the impact of Universal School meals: a type III hybrid

Gabriella M McLoughlin1, Angel Smith2, Alex R Dopp3

  • 1Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, PA, USA. gabriella.mcloughlin@temple.edu.

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Summary

Government-subsidized Universal School Meals aim to reduce child food insecurity and obesity. This study develops and tests equity-focused strategies to improve meal program uptake and effectiveness in schools. Findings will advance obesity prevention for vulnerable youth.

Keywords:
Community-engaged researchEquityFood insecurityImplementation mappingImplementation strategiesObesity policyUniversal school meals

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Area of Science:

  • Public Health
  • Implementation Science
  • Nutrition Policy

Background:

  • Universal School Meals (USM) address food insecurity and obesity risk in children.
  • Implementation challenges hinder USM uptake and impact.
  • Equity-focused strategies are needed for sustainable policy implementation.

Purpose of the Study:

  • To co-develop equity-focused implementation strategies for Universal School Meals.
  • To test these strategies via a hybrid type III cluster-randomized trial.
  • To examine effectiveness on student uptake and implementation across school systems.

Main Methods:

  • Implementation Mapping used to co-develop context-specific strategies.
  • Hybrid type III cluster-randomized trial to assess implementation and effectiveness outcomes.
  • Convergent mixed methods design with quantitative and qualitative data analysis.

Main Results:

  • Primary implementation outcomes include reach, penetration, acceptability, feasibility, cost, and sustainability.
  • Health outcomes assessed: family food security, student dietary behaviors, and BMI.
  • Data collected at baseline, 6 months, and 12 months.

Conclusions:

  • Equity-driven strategies can improve USM uptake in schools.
  • These strategies have the potential to reduce food insecurity and obesity disparities.
  • The study advances school-based obesity prevention for vulnerable student populations.