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Are Differences in Exposure to a Multicomponent School-Based Intervention Associated with Varying Dietary Outcomes in Adolescents?

Division of Epidemiology, University of Minnesota, Minneapolis; Division of Epidemiology, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454; phone: (612) 625-1843; fax: (612) 624-0315birnbaum{at}epi.umn.edu

Leslie A. Lytle, PhD, RD

Mary Story, PhD

Cheryl L. Perry, PhD

Division of Epidemiology, University of Minnesota, Minneapolis.

David M. Murray, PhD

Department of Psychology, University of Memphis

Multicomponent interventions are recommended for health behavior change among adolescents. However, it is difficult to disentangle the effects of multiple intervention components. This article reports outcomes associated with varying levels of exposure to a school-based nutrition intervention, Teens Eating for Energy and Nutrition at School (TEENS). Four incremental exposureswere possible: (1) control group, (2) school environment interventions only, (3) classroom plus environment interventions, and (4) peer leaders plus classroom plus environment interventions. Patterns suggesting dose response were observed, with peer leaders reporting the largest increases in fruit, vegetable, and lower fat food consumption. Students exposed to classroom plus environment interventions also improved, whereas students exposed only to school environment interventions showed trends toward choosing lower fat foods and declining fruit intake and no change in vegetable intake. Control students’ choices remained stable. Future studies may investigate mechanisms for peer leaders’ changes, maximizing curriculum effectiveness, and improving environmental interventions.

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