title: Assessing the impact of pilot school snack programs on milk and alternatives intake in 2 remote First Nation communities in northern Ontario, Canada.
abstract: BACKGROUND
  Canadian Aboriginal youth have poorer diet quality and higher rates of overweight and obesity than the general population. This research aimed to assess the impact of simple food provision programs on the intakes of milk and alternatives among youth in Kashechewan and Attawapiskat First Nations (FNs), Ontario, Canada.
  
  
  METHODS
  A pilot school snack program was initiated in Kashechewan in May 2009 including coordinator training and grant writing support. A supplementary milk and alternatives program was initiated in Attawapiskat in February 2010. Changes in dietary intake were assessed using Web-based 24-hour dietary recalls in grade 6 to 8 students, pre- and 1-week post-program, with a 1-year follow-up in Kashechewan. Student impressions were collected after 1 week using open-ended questions in the Web survey. Teacher and administrator impressions were collected via focus groups after 1 year in Kashechewan.
  
  
  RESULTS
  After 1 week, calcium intake increased in Kashechewan (805.9 ± 552.0 to 1027.6 ± 603.7 mg, p = .044); however, improvements were not sustained at 1 year; milk and alternatives (1.7 ± 1.7 servings to 2.1 ± 1.4 servings, p = .034) and vitamin D (2.5 ± 2.6 to 3.5 ± 3.4 µg, p = .022) intakes increased in Attawapiskat. Impressions of the programs were positive, though limited resources, staff, facilities, and funding were barriers to sustaining the consistent snack provision of the 1-week pilot phase.
  
  
  CONCLUSIONS
  These illustrations show the potential of snack programs to address the low intakes of milk and alternatives among youth in remote FNs. Community-level constraints must be addressed for sustained program benefits.
authors: University of Waterloo, School of Public Health and Health Systems, 200 University Ave. West, Waterloo, Ontario N2L 3G1, Canada. m2gates@uwaterloo.ca
authors: Michelle
authors: M
authors: Gates
authors: Rhona M
authors: RM
authors: Hanning
authors: Allison
authors: A
authors: Gates
authors: Daniel D
authors: DD
authors: McCarthy
authors: Leonard J S
authors: LJ
authors: Tsuji
mesh_terms: D000293:Adolescent; D000818:Animals; D015992:Body Mass Index; D002170:Canada; D002648:Child; D004435:Eating; D005260:Female; D005522:Food Services / Q000458:organization & administration*; D006801:Humans; D007198:Indians, North American; D008297:Male; D008892:Milk; D015596:Nutrition Assessment; D009864:Ontario; D010865:Pilot Projects; D016730:Program Development; D015397:Program Evaluation; D012424:Rural Population; D012525:Saskatchewan; D012572:School Health Services / Q000458:organization & administration*; D062410:Snacks; D013997:Time Factors; D035862:Vulnerable Populations / Q000208:ethnology*