School Breakfast Program Participation and Rural Adolescents' Purchasing Behaviors in Food Stores and Restaurants

Caitlin Eicher Caspi, Qi Wang, Amy Shanafelt, Nicole Larson, Susan Wei, Mary O. Hearst, Marilyn S. Nanney

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


BACKGROUND: Little is known about adolescents' food purchasing behaviors in rural areas. This study examined whether purchasing food at stores/restaurants around schools was related to adolescents' participation in school breakfast programs and overall diet in rural Minnesota. METHODS: Breakfast-skippers enrolled in a group-randomized intervention in 2014 to 2015 (N = 404 from 8 schools) completed 24-hour dietary recalls and pre/post surveys assessing food establishment purchase frequency. Healthy Eating Index Scores (HEI-2010) were calculated for each student. Student-level school breakfast participation (SBP) was obtained from school food service records. Mixed-effects regression models estimated: (1) whether SBP was associated with store/restaurant use at baseline, (2) whether an increase in SBP was associated with a decrease in store/restaurant use, and (3) whether stores/restaurant use was associated with HEI-2010 scores at baseline. RESULTS: Students with increased SBP were more likely to decrease fast-food restaurant purchases on the way home from school (OR 1.017, 95% CI 1.005, 1.029), but were less likely to decrease purchases at food stores for breakfast (OR 0.979, 95% CI 0.959, 0.999). Food establishment use was associated with lower HEI-2010 dairy component scores (p =.017). CONCLUSIONS: Increasing participation in school breakfast may result in modest changes in purchases at food establishments.

Original languageEnglish (US)
Pages (from-to)723-731
Number of pages9
JournalJournal of School Health
Issue number10
StatePublished - Oct 2017

Bibliographical note

Funding Information:
This study was funded through the National Heart Lung and Blood Institute grant number 5R01-HL113235-03 (PI: M.S.N). We acknowledge participating schools, the University of Minnesota Extension staff, Community Blueprint, and all study staff for their contribution to this research.

Publisher Copyright:
© 2017, American School Health Association


  • child and adolescent health
  • community health
  • nutrition and diet
  • school food services


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