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. 2015 Apr;48(4):436-44.
doi: 10.1016/j.amepre.2014.10.022. Epub 2015 Jan 6.

Regular soda policies, school availability, and high school student consumption

Yvonne M Terry-McElrath  1 , Jamie F Chriqui  2 , Patrick M O'Malley  3 , Frank J Chaloupka  4 , Lloyd D Johnston  3
Affiliations

Regular soda policies, school availability, and high school student consumption

Yvonne M Terry-McElrath et al. Am J Prev Med. 2015 Apr.

Abstract

Background: Beginning in the 2014-2015 school year, all U.S. schools participating in federally reimbursable meal programs are required to implement new nutrition standards for items sold in competitive venues. Multilevel mediation modeling examining direct, mediated, and indirect pathways between policy, availability, and student consumption might provide insight into possible outcomes of implementing aspects of the new standards.

Purpose: To employ multilevel mediation modeling using state- and school district-level policies mandating school soda bans, school soda availability, and student soda consumption.

Methods: The 2010-2012 Monitoring the Future surveys obtained nationally representative data on high school student soda consumption; school administrators provided school soda availability data. State laws and district policies were compiled and coded. Analyses conducted in 2014 controlled for state-, school-, and student-level characteristics.

Results: State-district-school models found that state bans were associated with significantly lower school soda availability (c, p<0.05) but district bans showed no significant associations. No significant direct, mediated, or indirect associations between state policy and student consumption were observed for the overall sample. Among African American high school students, state policy was associated directly with significantly lower school soda availability (a, p<0.01), and-indirectly through lower school availability-with significantly lower soda consumption (a*b, p<0.05).

Conclusions: These analyses indicate state policy focused on regular soda strongly affected school soda availability, and worked through changes in school availability to decrease soda consumption among African American students, but not the overall population.

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Figures

Figure 1
Figure 1
Hypothesized one- and two-level mediation models Note: X indicates the independent variable; M indicates the mediator; Y indicates the outcome variable. Subscripts indicate student i in district/school j in state k. Estimates a, b, and c indicate non-standardized multivariate regression coefficients.
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