Are differences in exposure to a multicomponent school-based intervention associated with varying dietary outcomes in adolescents?

Amanda Birnbaum, Leslie A. Lytle, Mary Story, Cheryl L. Perry, David M. Murray

Research output: Contribution to journalArticle

72 Scopus citations


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 exposures were 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.

Original languageEnglish
Pages (from-to)427-443
Number of pages17
JournalHealth Education and Behavior
Issue number4
Publication statusPublished - 1 Jan 2002


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