Document Type

Thesis - Open Access

Award Date


Degree Name

Doctor of Philosophy (PhD)

Department / School

Health and Nutritional Sciences

First Advisor

Lacey McCormick


childhood obesity, nutrition environment, rural obesity, school lunch, school meals


Childhood obesity is an ongoing public health concern that impacts many children in the United States. Research has shown that the prevalence of childhood obesity is higher in rural populations compared to non-rural populations. This may be attributable to differences in the school nutrition environment, particularly school meals and school wellness policy implementation. In order to design effective intervention targeted at weight management and obesity reduction, information regarding the school nutrition environment must be known. Therefore, the purpose of this research was to examine the school nutrition environment, particularly school lunch participation and weight outcomes between metro, non-metro and rural counties. Additionally, strength and comprehensiveness of nutrition wellness policies and its association with the nutrition environment along with nutrition policy implementation were examined. Rural populations are understudied and differ from their metro and non-metro counterparts in terms of sociodemographic factors and access to food. The following analyses utilize school meals participation data from the Annie E. Carsey Foundation, SPAN-ET tool from the Oregon State University extension services and WellSAT tool from UCONN Rudd Center. School lunch participation by county ruralness was examined to determine if meal participation was associated with weight outcomes. Strength and comprehensiveness of school nutrition wellness policies and the observed physical, situational and policy nutrition environment were examined and finally SPAN-ET and WellSAT scores were examined to assess whether more comprehensive and stronger policies equate to better nutrition policy implementation and a better nutrition environment. The findings in this dissertation can be used not only to understand how the school nutrition environment can play a role in weight management, particularly in rural neighborhoods but also for determining how to move forward for designing appropriate interventions targeted at reducing obesity in these populations.

Library of Congress Subject Headings

Rural children -- Nutrition.
School children -- Food.
Obesity in children -- Prevention.


Includes bibliographical references



Number of Pages



South Dakota State University



Rights Statement

In Copyright