title: State-wide dissemination of a school-based nutrition education programme: a RE-AIM (Reach, Efficacy, Adoption, Implementation, Maintenance) analysis.
abstract: OBJECTIVE
  The current study evaluated the overall public health impact of the 'Shaping Up My Choices' (SMC) programme, a 10-week school-based nutrition education curriculum developed for third-grade students, using the RE-AIM (Reach, Efficacy, Adoption, Implementation, Maintenance) framework.
  
  
  METHODS
  Randomized controlled trial to evaluate the programme and secondary analysis of archival data to describe dissemination. Data were collected from programme records, teacher surveys and student pre-, post- and 3-month follow-up surveys.
  
  
  METHODS
  Public elementary schools in California.
  
  
  METHODS
  An evaluation sample (938 students and nineteen teachers) and a dissemination sample (195 245 students and 7359 teachers).
  
  
  RESULTS
  In the evaluation sample, differences between the control and intervention groups were observed for nutrition knowledge, self-efficacy, outcome expectancies, and intakes of vegetables, fruit (girls only), soda, and low-nutrient high-energy foods from pre- to post-survey. Group differences in change in knowledge, outcome expectancies and vegetable intake were sustained through the 3-month follow-up (efficacy). One hundred per cent of intervention teachers in the evaluation sample implemented all of the lessons (implementation). The dissemination sample represented 42% of third-grade students (reach) and 39% of third-grade classrooms in public elementary schools in California during 2010-2011 (adoption). Thirty-seven per cent of third-grade teachers in the dissemination sample reordered SMC materials during the subsequent school year (2011-2012; maintenance).
  
  
  CONCLUSIONS
  The SMC programme demonstrates the potential for moderate to high public health impact.
authors.affiliation: 1 Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street Building (SSB), 3rd Floor, Room 302E, MC 9239, Los Angeles, CA 90033-9045, USA.
authors.forename: Genevieve Fridlund
authors.initials: GF
authors.lastname: Dunton
authors.affiliation: 1 Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street Building (SSB), 3rd Floor, Room 302E, MC 9239, Los Angeles, CA 90033-9045, USA.
authors.forename: Yue
authors.initials: Y
authors.lastname: Liao
authors.affiliation: 2 Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Grana
authors.affiliation: 3 Harder + Company Community Research, Los Angeles, CA, USA.
authors.forename: Renee
authors.initials: R
authors.lastname: Lagloire
authors.affiliation: 4 Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA.
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Riggs
authors.affiliation: 1 Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street Building (SSB), 3rd Floor, Room 302E, MC 9239, Los Angeles, CA 90033-9045, USA.
authors.forename: Chih-Ping
authors.initials: CP
authors.lastname: Chou
authors.affiliation: 5 Dairy Council of California, Irvine, CA, USA.
authors.forename: Trina
authors.initials: T
authors.lastname: Robertson
mesh_terms: D002140:California; D002648:Child; D002755:Choice Behavior; D005247:Feeding Behavior; D005260:Female; D005518:Food Preferences; D005638:Fruit; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009043:Motor Activity; D009749:Nutrition Surveys; D009752:Nutritional Status; D015397:Program Evaluation; D011634:Public Health; D012574:Schools; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D014675:Vegetables