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Bullock, Sally L.; Dawson-McClure, Spring; Truesdale, Kimberly P.; Ward, Stanon W.; Aiello, Allison E.; & Ammerman, Alice S. (2022). Associations between a Universal Free Breakfast Policy and School Breakfast Program Participation, School Attendance, and Weight Status: A District-Wide Analysis. International Journal of Environmental Research and Public Health, 19(7). PMCID: PMC8998064


Breakfast consumption among youth is associated with improved diet quality, weight, cognition, and behavior. However, not all youth in the United States consume breakfast. Participation in the School Breakfast Program (SBP) is also low relative to the lunch program. Universal free breakfast (UFB) policies have been implemented to increase breakfast participation by reducing cost and stigma associated with the SBP. This study examined whether a UFB policy implemented in a school district in the Southeast US was associated with changes in breakfast participation, school attendance, and student weight. A longitudinal study of secondary data was conducted, and a mixed modeling approach was used to assess patterns of change in SBP participation. General linear models were used to assess attendance and student weight change. On average, across schools in the district, there was an increase in breakfast participation of 4.1 percentage points following the implementation of the policy. The change in breakfast participation in schools differed by the percent of students in the school who received school meals for free or at a reduced price, the percent of students of color, and the grade level of the school. Increases in SBP participation were not associated with significant changes in attendance or weight. UFB policies may be effective in increasing participation in the SBP.


Reference Type

Journal Article

Year Published


Journal Title

International Journal of Environmental Research and Public Health


Bullock, Sally L.
Dawson-McClure, Spring
Truesdale, Kimberly P.
Ward, Stanon W.
Aiello, Allison E.
Ammerman, Alice S.

Article Type





United States of America




Aiello - 0000-0001-7029-2537