Settings and participants

This study took place in eight elementary schools in Iowa, United States, during the spring semester of 2017. The school locations were scattered across the state, and were represented by three town schools, three rural schools, and two suburban schools. The percentage of students eligible for free or reduced price meals ranged from 5.5 to 48.0% (Mean [M] ± standard deviation [SD] = 23.6 ± 15.6%). These schools mainly enrolled non-Hispanic White/Caucasian students (M ± SD = 92.1 ± 3.6%, ranging from 86.7 to 96.7%), which is typical for schools in Iowa. Twenty-three (n = 23) school staff members participated in the SWITCH implementation process that included capacity-building and quality improvement (i.e., nurses = 7, food service directors = 3, classroom teachers = 6, PE teachers = 3, principals = 2, AmeriCorps/other representative = 2). In addition, 602 students in 4th and 5th grade were asked to complete the SWITCH Tracker (i.e., tracking their daily Do, View, and Chew behaviors online for each week) to capture student engagement. The Iowa State University Institutional Review Board reviewed the study protocol and made an exempt determination for the school-based components of the project since the activities were low minimal and consistent with standard educational practices. Parent consent and student assent were not required since the student data collected through the system were all de-identified and not sensitive in nature.