{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:01:48Z","timestamp":1760144508378,"version":"build-2065373602"},"reference-count":45,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,4,27]],"date-time":"2024-04-27T00:00:00Z","timestamp":1714176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"United States Department of Agriculture (USDA) Supplemental Nutrition Assistance Program Education"},{"name":"the University of California 4-H Youth Development Program"},{"name":"Food Smart Families\u2013National 4-H Council &amp; ConAgra Foods Foundation"},{"name":"USDA NIFA, Children, Youth, and Families, At Risk"},{"name":"Counties of San Luis Obispo &amp; Santa Barbara"},{"name":"the Henry Mayo Newhall Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Research indicates that health interventions are most effective when they address multiple social determinants of health to support positive behavior. Schools as Hubs of Health, a comprehensive model of nutrition and physical activity education, was developed to support wellness within school communities defined as low-income by the national Supplemental Nutrition Assistance Program Education (SNAP-Ed). Components of the model include the following: classroom education; garden education; youth engagement; staff training; parent and community engagement; and policies, systems, and environments. Findings over the last decade indicate positive outcomes in nutrition and physical activity behaviors, youth leadership and engagement, and systems and environmental changes that support health and wellness.<\/jats:p>","DOI":"10.3390\/children11050525","type":"journal-article","created":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T08:59:39Z","timestamp":1714553979000},"page":"525","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Schools as Hubs of Health: A Comprehensive Supplemental Nutrition Assistance Program\u2014Education Model for Promoting Wellness in Low-Income Communities"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7237-4448","authenticated-orcid":false,"given":"Shannon A.","family":"Klisch","sequence":"first","affiliation":[{"name":"University of California Cooperative Extension in San Luis Obispo & Santa Barbara Counties, University of California, Agriculture and Natural Resources, 2156 Sierra Way, Suite C, San Luis Obispo, CA 93401, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine E.","family":"Soule","sequence":"additional","affiliation":[{"name":"University of California Cooperative Extension in San Luis Obispo & Santa Barbara Counties, University of California, Agriculture and Natural Resources, 2156 Sierra Way, Suite C, San Luis Obispo, CA 93401, USA"},{"name":"Department of Nutrition, University of California, Davis, 3135 Meyer Hall, One Shields Avenue, Davis, CA 95616, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1001\/jama.2020.0878","article-title":"Trends in Diet Quality Among Youth in the United States, 1999\u20132016","volume":"323","author":"Liu","year":"2020","journal-title":"JAMA"},{"unstructured":"(2024, January 20). Dietary Guidelines for Americans, 2020\u20132025, Available online: https:\/\/www.dietaryguidelines.gov\/.","key":"ref_2"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1001\/jama.2017.0947","article-title":"Association Between Dietary Factors and Mortality From Heart Disease, Stroke, and Type 2 Diabetes in the United States","volume":"317","author":"Micha","year":"2017","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1080\/09637486.2019.1571021","article-title":"Fruit and Vegetable Consumption and Health Outcomes: An Umbrella Review of Observational Studies","volume":"70","author":"Angelino","year":"2019","journal-title":"Int. J. Food Sci. Nutr."},{"doi-asserted-by":"crossref","unstructured":"Scaglioni, S., De Cosmi, V., Ciappolino, V., Parazzini, F., Brambilla, P., and Agostoni, C. (2018). Factors Influencing Children\u2019s Eating Behaviours. Nutrients, 10.","key":"ref_5","DOI":"10.3390\/nu10060706"},{"unstructured":"U.S Department of Health and Human Services (2018). Physical Activity Guidelines for Americans.","key":"ref_6"},{"unstructured":"USDA, and SNAP (2024, April 25). FY 2024 Supplemental Nutrition Assistance Program Education (SNAP-Ed) Plan Guidance, Nutrition Education and Obesity Prevention Program, Available online: https:\/\/snaped.fns.usda.gov\/library\/materials\/fy-2024-snap-ed-plan-guidance-.","key":"ref_7"},{"unstructured":"Food and Nutrition Services (2023). Food and Nutrition Act of 2008.","key":"ref_8"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.jneb.2021.09.008","article-title":"Policy, Systems, and Environmental Change Strategies in the Supplemental Nutrition Assistance Program-Education (SNAP-Ed)","volume":"54","author":"Burke","year":"2022","journal-title":"J. Nutr. Educ. Behav."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"101635","DOI":"10.1016\/j.eclinm.2022.101635","article-title":"Interventions to Prevent Obesity in School-Aged Children 6-18 Years: An Update of a Cochrane Systematic Review and Meta-Analysis Including Studies from 2015\u20132021","volume":"54","author":"Hodder","year":"2022","journal-title":"EClinicalMedicine"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1111\/obr.12277","article-title":"What Childhood Obesity Prevention Programmes Work? A Systematic Review and Meta-analysis","volume":"16","author":"Wang","year":"2015","journal-title":"Obes. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e215262","DOI":"10.1001\/jamanetworkopen.2021.5262","article-title":"Trends in Food Sources and Diet Quality Among US Children and Adults, 2003\u20132018","volume":"4","author":"Liu","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1111\/josh.13365","article-title":"School Nutrition Environment and Services: Policies and Practices That Promote Healthy Eating Among K-12 Students","volume":"93","author":"Merlo","year":"2023","journal-title":"J. Sch. Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1111\/josh.13372","article-title":"Using Health Education to Address Student Physical Activity and Nutrition: Evidence and Implications to Advance Practice","volume":"93","author":"Lee","year":"2023","journal-title":"J. Sch. Health"},{"unstructured":"(2017). 2017 Environmental Justice Implementation Progress Report.","key":"ref_15"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.healthplace.2017.03.009","article-title":"How Neighborhoods Influence Health: Lessons to Be Learned from the Application of Political Ecology","volume":"45","author":"Chitewere","year":"2017","journal-title":"Health Place"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1080\/07315724.2018.1436477","article-title":"Effect of the Shaping Healthy Choices Program, a Multicomponent, School-Based Nutrition Intervention, on Physical Activity Intensity","volume":"37","author":"Fetter","year":"2018","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.healthplace.2017.02.003","article-title":"What Predicts Children\u2019s Active Transport and Independent Mobility in Disadvantaged Neighborhoods?","volume":"44","author":"Veitch","year":"2017","journal-title":"Health Place"},{"unstructured":"(2023, November 27). Healthy People 2030. Office of Disease Prevention and Health Promotion, Available online: https:\/\/health.gov\/healthypeople.","key":"ref_19"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3242","DOI":"10.1017\/S1368980021000069","article-title":"Applying the Socio-Ecological Model to Understand Factors Associated with Sugar-Sweetened Beverage Behaviours among Rural Appalachian Adolescents","volume":"24","author":"McCormick","year":"2021","journal-title":"Public Health Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.diabet.2014.01.002","article-title":"Prevention of Unhealthy Weight in Children by Promoting Physical Activity Using a Socio-Ecological Approach: What Can We Learn from Intervention Studies?","volume":"40","author":"Kellou","year":"2014","journal-title":"Diabetes Metab."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1016\/j.jand.2018.03.005","article-title":"Position of the Academy of Nutrition and Dietetics, Society for Nutrition Education and Behavior, and School Nutrition Association: Comprehensive Nutrition Programs and Services in Schools","volume":"118","author":"Hayes","year":"2018","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"101138","DOI":"10.1016\/j.pmedr.2020.101138","article-title":"Effectiveness of School-Based Health Promotion Interventions Prioritized by Stakeholders from Health and Education Sectors: A Systematic Review and Meta-Analysis","volume":"19","author":"Dabravolskaj","year":"2020","journal-title":"Prev. Med. Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12966-020-01065-9","article-title":"A Systematic Review and Meta-Analysis of School-Based Interventions with Health Education to Reduce Body Mass Index in Adolescents Aged 10 to 19\u2009Years","volume":"18","author":"Jacob","year":"2021","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1111\/josh.13376","article-title":"Coordinated Approach: Comprehensive Policy and Action Planning","volume":"93","author":"Chung","year":"2023","journal-title":"J. Sch. Health"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1111\/josh.13373","article-title":"Transforming Evidence Into Action: A Commentary on School-Based Physical Activity and Nutrition Intervention Research","volume":"93","author":"Lee","year":"2023","journal-title":"J. Sch. Health"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"4642","DOI":"10.1017\/S1368980020004024","article-title":"Characteristics of Successful Primary School-Based Experiential Nutrition Programmes: A Systematic Literature Review","volume":"24","author":"Charlton","year":"2021","journal-title":"Public Health Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1111\/josh.13367","article-title":"Scoping Review of Family and Community Engagement Strategies Used in School-Based Interventions to Promote Healthy Behaviors","volume":"93","author":"Michael","year":"2023","journal-title":"J. Sch. Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1111\/josh.13371","article-title":"Physical Activity Interventions During the School Day: Reviewing Policies, Practices, and Benefits","volume":"93","author":"Cornett","year":"2023","journal-title":"J. Sch. Health"},{"unstructured":"Burton, D., Canto, A., Coon, T., Eschbach, C., Gutter, M., Jones, M., Kennedy, L., Martin, K., Mitchell, A., and O\u2019Neal, L. (2021). Cooperative Extension\u2019s National Framework for Health Equity and Well Being, Extension Committee on Organization and Policy Health Innovation Task Force.","key":"ref_30"},{"unstructured":"(2014). Whole School, Whole Community, Whole Child: A Collaborative Approach to Learning and Health.","key":"ref_31"},{"doi-asserted-by":"crossref","unstructured":"Drouka, A., Brikou, D., Causeret, C., Al Ali Al Malla, N., Sibalo, S., \u00c1vila, C., Alcat, G., Kapetanakou, A.E., Gurviez, P., and Fellah-Dehiri, N. (2023). Effectiveness of School-Based Interventions in Europe for Promoting Healthy Lifestyle Behaviors in Children. Children, 10.","key":"ref_32","DOI":"10.3390\/children10101676"},{"unstructured":"U.S. Department of Agriculture, and U.S. Department of Heath and Human Services (2010). Dietary Guidelines for Americans 2010.","key":"ref_33"},{"doi-asserted-by":"crossref","unstructured":"Ife, J. (2016). Community Development in an Uncertain World: Vision, Analysis and Practice, Cambridge University Press. [2nd ed.].","key":"ref_34","DOI":"10.1017\/CBO9781316342855"},{"unstructured":"(2023, November 27). WSCC Health Equity in Schools Module. Available online: https:\/\/www.sophe.org\/resources\/wscc-health-equity-module\/.","key":"ref_35"},{"unstructured":"Office of Population Affairs (2023, November 28). Health and Human Services. Positive Youth Development. Office of Population Affairs, Available online: https:\/\/opa.hhs.gov\/adolescent-health\/positive-youth-development.","key":"ref_36"},{"unstructured":"Glanz, K., Rimer, B.K., and Viswanath, K. (2015). Health Behavior: Theory, Research, and Practice, Jossey-Bass. [5th ed.].","key":"ref_37"},{"unstructured":"National Child Traumatic Stress Network Schools Committee (2008). Child Trauma Toolkit for Educators, National Child Traumatic Stress Network.","key":"ref_38"},{"unstructured":"Karhan, A. (2023, November 28). Trauma-Informed Policy for Youth: Structuring Policies and Programs to Support the Future of Work. Available online: https:\/\/capeyouth.org\/wp-content\/uploads\/sites\/9\/2021\/10\/CAPE_Youth_TraumaInformedPolicyforYouth.pdf.","key":"ref_39"},{"unstructured":"Klisch, S., Diaz, M., Dimond, E., Hong, K., Marrs, A., Plascencia, B., Rorabough, M., Vargas, R., and Soule, K.E. (2023, November 27). 4-H S.N.A.C Club (Student Nutrition Advisory Council). Available online: https:\/\/shop4-h.org\/products\/4-h-s-n-a-c-club.","key":"ref_40"},{"key":"ref_41","first-page":"19","article-title":"4-H Student Nutrition Advisory Councils Support Positive Youth Development and Health Outcomes among Underserved Populations","volume":"59","author":"Klisch","year":"2021","journal-title":"J. Ext."},{"key":"ref_42","first-page":"7","article-title":"National 4-H Common Measures: Initial Evaluation from California 4-H","volume":"53","author":"Lewis","year":"2015","journal-title":"J. Ext."},{"unstructured":"Vargas, R., and Klisch, S. (2022). Cooking Together (Virtually) to Build Community and Promote Healthy during COVID-19. J. Natl. Ext. Assoc. Fam. Consum. Sci., 74\u201380.","key":"ref_43"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"16091","DOI":"10.1038\/nenergy.2016.91","article-title":"Effects of a Behaviour Change Intervention for Girl Scouts on Child and Parent Energy-Saving Behaviours","volume":"1","author":"Boudet","year":"2016","journal-title":"Nat. Energy"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"015016","DOI":"10.1088\/1748-9326\/8\/1\/015016","article-title":"Child-Orientated Environmental Education Influences Adult Knowledge and Household Behavior","volume":"8","author":"Damerell","year":"2013","journal-title":"Environ. Res. Lett."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/5\/525\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:34:40Z","timestamp":1760106880000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/11\/5\/525"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,27]]},"references-count":45,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5]]}},"alternative-id":["children11050525"],"URL":"https:\/\/doi.org\/10.3390\/children11050525","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2024,4,27]]}}}