Third year medical student Wake Forest School of Medicine of Wake Forest Baptist Medical Center Winston-Salem, North Carolina, United States
Background: Poor early-life nutrition can contribute to chronic disease later in life. School-provided meals mitigate food insecurity by providing reliable nutrition for all students even at reduced or free cost for those who qualify. Meta-analyses indicate a positive correlation between healthier school meals and reduced risk of obesity. However, we do not know if school meal programs influence meal choices outside of school, particularly in youth with other nutrition-influenced chronic conditions such as hypertension disorders. Objective: The goal of this study is to understand how school meals influence the meal choices that youth make outside of school. Design/Methods: This is the quantitative portion of a pilot prospective longitudinal mixed methods study of youth aged 6–19 years referred to a subspecialty clinic for hypertension disorders who utilized school meal programs. Participant recruitment began on June 15th, 2023, and data collection is ongoing, with a target of 30 participants; currently our sample size is 7 participants. We contact new patients who are referred for hypertension disorders such as elevated blood pressure, hypertension or abnormal blood pressure readings based on ICD-10 diagnostic codes. We exclude patients with secondary hypertension disorders. Participants complete a self-reported demographic survey, a novel school meal questionnaire and a self-reported 3-day food diary. The questionnaire responses are represented using a 5-point Likert scale to measure participants’ opinions and behaviors. We are reviewing and analyzing the self-reported food diary for emerging patterns in diets of participants. IRB approval for this study was obtained in June of 2023; we obtain informed consent and assent. Data collection is ongoing and is scheduled to be completed by March 2024. Planned future steps include investigating the effect of social risk factors such as individual-level food insecurity and neighborhood-level access to food.
