Sustainable improvements in food and beverages sold to students in school stores and vending machines in alternative high schools: Results from the Team COOL pilot study

Purpose: To assess change in the quality of food and beverages sold to students in vending and school stores, among schools participating in the Team COOL pilot study, an alternative high school-based environmental intervention to prevent excess weight gain and/or promote healthy weight loss among students by promoting physical activity and healthy eating. Increasing numbers of adolescents attend alternative high schools, schools that serve youth at risk for academic failure. Many students are low-income and racial/ethnic minorities. Health risk behaviors are common among students, and include less-than-healthy dietary practices and physical inactivity, practices linked to overweight. However, school-based obesity prevention programs have not been developed or tested in alternative school settings.

Methods: Six schools in St Paul/Minneapolis MN were randomized to intervention or control conditions. The 6-month intervention included youth advisory councils to inform school food policy and increasing healthy foods in vending and school stores. Among intervention schools, two had school stores; one had vending (2 beverage/1 snack machine). One control school had vending (2 beverage/1 snack); two control schools had no vending or stores. Foods-to-promote were categorized as items containing ≤ 200 calories/package. Beverages-to-promote were categorized as diet, low or no-calorie drinks containing ≤ 66 calories/8-ounce serving and 100% fruit juice. Observational data were collected by trained research staff on one day at baseline, post-intervention and 6-months post-intervention. Sample size prohibited significance testing.

Results: Foods-to-promote increased in intervention schools (average reported) compared to the control school from baseline to post-intervention (40% to 58% vs 31% to 25%), and persisted 6-months later (65% vs 30%). Beverages-to-promote increased in intervention schools (average reported) compared to the control school from baseline to post-intervention (30% to 52% vs 25% to 21%), and persisted 6-months later (64% vs 21%).

Conclusions: A brief alternative school-based environmental intervention was effective in creating sustainable healthy change in foods and beverages sold to students in vending and school stores. Outcomes support the development and testing of an expanded intervention in a full scale trial.