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Table 1 Summary of study characteristics

From: A systematic review of how researchers characterize the school environment in determining its effect on student obesity

Study/location Study design/sample Outcome of interest Exposure measure used School exposure measure and reported association(s) with student weight outcome (95% CI) (^ = p-value less than 0.05) QA
Method of data collection Validity/reliability ANGELO framework
Veugelers & Fitzgerald, 2005 [13]/Canada Cross-sectional/5,200 Yr 5 students from 228 schools Body Mass Index (BMI) A written survey was completed by the school principal on the presence of healthy menu alternatives. Not reported A Policy-related factor was researched (1) 1. School provided healthy menu alternatives: Overweight = OR 0.91 (0.77, 1.09) Obesity = OR 0.85 (0.63, 1.15) 5
Fox et al. 2009 [14]/US Cross-sectional/2,228 Yr 1–12 students from 287 schools BMI (obesity only) A written survey was completed by a foodservice manager about the frequency and type of foods made available in the cafeteria. Not reported Policy (2–6) 2. Low-nutrient, energy-dense foods available = OR 1.09 (0.57 – 2.08)^ 8
3. Whole or 2% milk offered = OR 1.17 (0.75 – 1.82)^
4. Fresh fruit/raw vegetables not offered daily = OR 1.13 (0.73 – 1.75)^
5. French fries/ similar products offered regularly = OR 2.70 (1.58 – 4.62)^
6. Dessert offered more than once per week = OR 1.78 (1.13 – 2.80)^
Harrison et al. 2011 [15]/UK Cross-sectional/1,725 Yr 5 students from 92 schools Fat Mass Index (FMI) A written survey was completed by a ‘head teacher’ about school policies. Not reported Physical (7) 7. Lower FMI was found in girls attending schools with more pupils in their age group^ (interquartile analysis) 4
Policy(8–11)
Economic (12)
A ‘trained assessor’ completed an audit of school grounds. 8. Better cycle support was associated with higher FMI in girls^ (interquartile analysis)
Local council provided general information. 9. Higher FMI was associated with boys who were allowed to eat any foods at break-time^ (interquartile analysis)
Insignificant findings not reported for:
10. Food-related learning
11. UK Govt ‘healthy school programme’
12. Free school meals.
Rundle et al. 2012 [16]/US Cross-sectional/624,204 Yr K-12 students from 1,276 schools BMI Data were extracted from the New York City Department of Education enrolment database. Not reported Economic (13) & Socio-cultural (14) 13. Students received free or reduced-price lunches: Overweight = OR 1.05 (1.00, 1.08)^ and Obesity = OR 1.13 (1.10, 1.18)^ 5
Insignificant findings not reported for:
14. Ethnicity of students in school.
Leatherdale, 2013 [17]/Canada Cross-sectional/2,331 Yr 1–4 students from 30 schools BMI (over-weight only) A written survey was completed by the ‘senior administrator most knowledgeable about school policies and practices’. Not reported Physical (15–16) 15. Moderate level of student access to a variety of facilities on and off school grounds during school hours = OR 0.39 (0.16, 0.92)^ 1
Policy (17–21)
Socio-cultural (22–25)
A school built environment survey was completed by a ‘trained assessor’ using the ‘Environmental Points of Interest’ tool. 16. Good level of student access to a variety of facilities on and off school grounds during school hours = OR 0.32 (0.12, 0.86)^
Insignificant findings not reported for:
17. PA used as reward
18. Good PA transport to and from school
19. Good implementation of daily PA
20. Good amount of daily PA
21. Good training of PA teachers
22. Good consistency of intramural PA
23. Good incorporation of PA into other subjects
24. Good community feedback on school PA
25. Good PA promotion by teachers
  1. ^Results were reported as statistically significant (p-value less than 0.05).