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通过以公平为导向的混合方法方法方法,了解通用学校餐的实施决定因素
Gabriella M McLoughlin1, Molly Kerstetter2, Yerusalem Yohannes2
1Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, PA, USA. gabriella.mcloughlin@temple.edu.
Implementation science communications
|April 15, 2025
概括
全民学校午餐 (USM) 的实施面临挑战,但强有力的领导和应对市场压力可以改善参与. 以公平为重点的战略对于减少耻辱和提高成功USM计划能力至关重要.
科学领域:
- 实施科学 实施科学
- 健康 公平 卫生 公平
- 公共卫生 营养 公共卫生 营养
背景情况:
- 全民学校午餐 (USM) 对于防止边缘化人口的慢性疾病不平等至关重要.
- 尽管减少了粮食不安全和肥胖风险,但学生在USM的低参与度限制了其对公共卫生的影响.
- 本研究调查了在一个大型城市学区的USM实施决定因素和挑战.
研究的目的:
- 在一个主要的城市学区确定影响通用学校用餐 (USM) 实施的决定因素.
- 评估不同学校的挑战和支持,不同学校的USM参与率不同.
- 通过实施映射过程,为增强USM覆盖范围和影响的战略提供信息.
主要方法:
- 在费城学区内的8所学校 (6所中学,2所高中) 进行了融合混合方法研究.
- 数据收集包括定性访谈,调查和餐时间观察,以"实施研究综合框架" (CFIR) 和"健康公平度量框架"为指导.
- 采访被编码,以确定USM实施的障碍 (-1, -2) 和支持 (+1, +2),并根据参与水平 (低,中等,高) 分组学校.
主要成果:
- 中级和高级领导人是USM实施的最强有力的促进者 (M=1.29和M=0.96,分别).
- 市场压力 (竞争性食品) 和相对优先级是显著的障碍 (分别为M=-1.35和M=-1.17).
- 与参与率较低的学校相比,参与率较高的学校报告的耻辱感较小,程序更公平,食品服务经理参与度更大.
结论:
- 有效的通用学校午餐 (USM) 实施需要在多个层面上强有力的领导.
- 解决市场竞争等外部因素和相对优先级等内部因素至关重要.
- 以公平为重点的战略对于减少耻辱和建立能力以增加美军力量参与和公共卫生影响至关重要.
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