Objective Evaluating the factor structure of four dietary subscales (Fruits, Fruit Juice, Vegetables, and Milk) from the School Physical Activity and Nutrition (SPAN) questionnaire elementary version. Methods Secondary analysis of intervention data from 3rd grade classrooms measured at pre-intervention, post-intervention (10 weeks), and three month follow-up. SEM invariance analysis was conducted to test the stability of the factor structure of the four subscales. Results 1,147 students participated. Fit indices revealed good fit for a single factor remaining stable across time (χ2 [df = 59] = 59.75), across gender (χ2 [df = 128] = 149.72), and across study group (χ2 [df = 128] = 143.04). Conclusions and implications A Healthy Food factor consisting of the four subscales can be used in future data analysis. This offers several advantages in analysis, including the use of latent change scores that are more powerful, more informative, and more easily interpreted than traditional approaches.

Childhood overweight and obesity are major health problems. School-based programs enable intervening with large groups of children, but program overall health impact is rarely completely assessed. A RE-AIM (Reach, Efficacy, Adoption, Implementation, Maintenance) analysis tested the overall public health impact of the fourthgrade BNutrition Pathfinders^school-based nutritioneducation program. A randomized controlled trial in 47 fourth-grade California classrooms (1713 students) tested program efficacy, and a secondary analysis of archival data tested program dissemination. Desired effects were seen in child nutrition knowledge, attitudes, consumption of low-nutrient high-density foods, sugar-sweetened beverages, proteins, grains, and parent willingness to serve new foods. The program was disseminated to ∼25 % of public school fourth-grade classrooms in California and cost about $1.00 per student to implement. The Nutrition Pathfinders program demonstrates potential for moderate to high public health impact due to its wide dissemination, effectiveness in altering attitudes and behaviors, and its relatively inexpensive cost of implementation.

The BHM program was effective, implemented with fidelity, and broadly disseminated, highlighting its potential public health impact for kindergarteners.

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