Impact of delaying high school start times on weight and related behaviors - the START study

Rachel Widome; Darin J. Erickson; Melissa N. Laska; Aaron T. Berger; Kathleen M. Lenk; Conrad Iber; Gudrun Kilian; Sara Lammert; Kyla L. Wahlstrom

doi:10.1016/j.ypmed.2023.107548

Impact of delaying high school start times on weight and related behaviors - the START study

Rachel Widome, Darin J. Erickson, Melissa N. Laska, Aaron T. Berger, Kathleen M. Lenk, Conrad Iber, Gudrun Kilian, Sara Lammert, Kyla L. Wahlstrom

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

In the US, few adolescents get adequate school night sleep, largely due to early school start times. In the START study we aimed to test the following hypothesis: That following the implementation of later high school start times students have lesser longitudinal increases in body mass index (BMI) and shift to more healthful weight-related behaviors relative to students attending schools that retain early start times. The study enrolled a cohort of students (n = 2426) in five high schools in the Twin Cities, MN metro. Heights and weights were measured objectively, and surveys were administered annually from 9th through 11th grades (2016–2018). All study schools started early (either 7:30 am or 7:45 am) at baseline (2016). At follow-up 1 (2017) and continuing through follow-up 2 (2018), two schools delayed their start times by 50–65 min, while three comparison schools started at 7:30 am throughout the observation period. Using a difference-in-differences natural experiment design, we estimated differences in changes in BMI and weight-related behaviors over time between policy change and comparison schools. Students' BMIs increased in parallel in both policy change and comparison schools over time. However relative to changes in comparison schools after the start time shift, students in policy change schools had a modestly more healthful profile of weight-related behaviors – for instance they had a relatively greater probability of eating breakfast, having supper with their family, getting more activity, eating fast food less frequently, and eating vegetables daily. Later start times could be a durable, population-wide strategy that promotes healthful weight behaviors.

Original language	English (US)
Article number	107548
Journal	Preventive medicine
Volume	172
DOIs	https://doi.org/10.1016/j.ypmed.2023.107548
State	Published - Jul 2023

Bibliographical note

Funding Information:
The Authors would like to thank the adolescents participating in the START study, the districts that welcomed us to do research in their schools, the START data collectors, and Bill Baker for his work to manage the data. Thank you to Kate Bauer for sharing your great ideas. This study is supported by funding from the National Institutes of Health's (NIH) Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) ( R01 HD088176 ). Additionally, the authors gratefully acknowledge support from the Minnesota Population Center ( P2C HD041023 ) funded through a grant from NICHD .

Publisher Copyright:
© 2023 Elsevier Inc.

Keywords

Adolescents
BMI
Natural experiment
Obesity
Overweight
School policy
School start time

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ypmed.2023.107548

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title = "Impact of delaying high school start times on weight and related behaviors - the START study",

abstract = "In the US, few adolescents get adequate school night sleep, largely due to early school start times. In the START study we aimed to test the following hypothesis: That following the implementation of later high school start times students have lesser longitudinal increases in body mass index (BMI) and shift to more healthful weight-related behaviors relative to students attending schools that retain early start times. The study enrolled a cohort of students (n = 2426) in five high schools in the Twin Cities, MN metro. Heights and weights were measured objectively, and surveys were administered annually from 9th through 11th grades (2016–2018). All study schools started early (either 7:30 am or 7:45 am) at baseline (2016). At follow-up 1 (2017) and continuing through follow-up 2 (2018), two schools delayed their start times by 50–65 min, while three comparison schools started at 7:30 am throughout the observation period. Using a difference-in-differences natural experiment design, we estimated differences in changes in BMI and weight-related behaviors over time between policy change and comparison schools. Students' BMIs increased in parallel in both policy change and comparison schools over time. However relative to changes in comparison schools after the start time shift, students in policy change schools had a modestly more healthful profile of weight-related behaviors – for instance they had a relatively greater probability of eating breakfast, having supper with their family, getting more activity, eating fast food less frequently, and eating vegetables daily. Later start times could be a durable, population-wide strategy that promotes healthful weight behaviors.",

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author = "Rachel Widome and Erickson, {Darin J.} and Laska, {Melissa N.} and Berger, {Aaron T.} and Lenk, {Kathleen M.} and Conrad Iber and Gudrun Kilian and Sara Lammert and Wahlstrom, {Kyla L.}",

note = "Funding Information: The Authors would like to thank the adolescents participating in the START study, the districts that welcomed us to do research in their schools, the START data collectors, and Bill Baker for his work to manage the data. Thank you to Kate Bauer for sharing your great ideas. This study is supported by funding from the National Institutes of Health's (NIH) Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) ( R01 HD088176 ). Additionally, the authors gratefully acknowledge support from the Minnesota Population Center ( P2C HD041023 ) funded through a grant from NICHD . Publisher Copyright: {\textcopyright} 2023 Elsevier Inc.",

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AU - Iber, Conrad

AU - Kilian, Gudrun

AU - Lammert, Sara

AU - Wahlstrom, Kyla L.

N1 - Funding Information: The Authors would like to thank the adolescents participating in the START study, the districts that welcomed us to do research in their schools, the START data collectors, and Bill Baker for his work to manage the data. Thank you to Kate Bauer for sharing your great ideas. This study is supported by funding from the National Institutes of Health's (NIH) Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) ( R01 HD088176 ). Additionally, the authors gratefully acknowledge support from the Minnesota Population Center ( P2C HD041023 ) funded through a grant from NICHD . Publisher Copyright: © 2023 Elsevier Inc.

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N2 - In the US, few adolescents get adequate school night sleep, largely due to early school start times. In the START study we aimed to test the following hypothesis: That following the implementation of later high school start times students have lesser longitudinal increases in body mass index (BMI) and shift to more healthful weight-related behaviors relative to students attending schools that retain early start times. The study enrolled a cohort of students (n = 2426) in five high schools in the Twin Cities, MN metro. Heights and weights were measured objectively, and surveys were administered annually from 9th through 11th grades (2016–2018). All study schools started early (either 7:30 am or 7:45 am) at baseline (2016). At follow-up 1 (2017) and continuing through follow-up 2 (2018), two schools delayed their start times by 50–65 min, while three comparison schools started at 7:30 am throughout the observation period. Using a difference-in-differences natural experiment design, we estimated differences in changes in BMI and weight-related behaviors over time between policy change and comparison schools. Students' BMIs increased in parallel in both policy change and comparison schools over time. However relative to changes in comparison schools after the start time shift, students in policy change schools had a modestly more healthful profile of weight-related behaviors – for instance they had a relatively greater probability of eating breakfast, having supper with their family, getting more activity, eating fast food less frequently, and eating vegetables daily. Later start times could be a durable, population-wide strategy that promotes healthful weight behaviors.

AB - In the US, few adolescents get adequate school night sleep, largely due to early school start times. In the START study we aimed to test the following hypothesis: That following the implementation of later high school start times students have lesser longitudinal increases in body mass index (BMI) and shift to more healthful weight-related behaviors relative to students attending schools that retain early start times. The study enrolled a cohort of students (n = 2426) in five high schools in the Twin Cities, MN metro. Heights and weights were measured objectively, and surveys were administered annually from 9th through 11th grades (2016–2018). All study schools started early (either 7:30 am or 7:45 am) at baseline (2016). At follow-up 1 (2017) and continuing through follow-up 2 (2018), two schools delayed their start times by 50–65 min, while three comparison schools started at 7:30 am throughout the observation period. Using a difference-in-differences natural experiment design, we estimated differences in changes in BMI and weight-related behaviors over time between policy change and comparison schools. Students' BMIs increased in parallel in both policy change and comparison schools over time. However relative to changes in comparison schools after the start time shift, students in policy change schools had a modestly more healthful profile of weight-related behaviors – for instance they had a relatively greater probability of eating breakfast, having supper with their family, getting more activity, eating fast food less frequently, and eating vegetables daily. Later start times could be a durable, population-wide strategy that promotes healthful weight behaviors.

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Impact of delaying high school start times on weight and related behaviors - the START study

Abstract

Bibliographical note

Keywords

UN SDGs

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