Outcomes of a Field Trial to Improve Children's Dietary Patterns and Physical Activity

Abstract

for the CATCH Collaborative Group Objective.\p=m-\To assess the outcomes of health behavior interventions, focusing on the elementary school environment, classroom curricula, and home programs, for the primary prevention of cardiovascular disease.Design.\p=m-\Arandomized, controlled field trial at four sites with 56 intervention and 40 control elementary schools. Outcomes were assessed using prerandomization measures (fall 1991) and follow-up measures (spring 1994).Participants.\p=m-\A total of 5106 initially third-grade students from ethnically diverse backgrounds in public schools located in California, Louisiana, Minnesota, and Texas.Intervention.\p=m-\Twenty-eight schools participated in a third-grade through f i f t h\ x=req-\ grade intervention including school food service modifications, enhanced physical education (PE), and classroom health curricula. Twenty-eight additional schools received these components plus family education.Main Outcome Measures.\p=m-\Atthe school level, the two primary end points were changes in the fat content of food service lunch offerings and the amount of moderate-to-vigorous physical activity in the PE programs. At the level of the individual student, serum cholesterol change was the primary end point and was used for power calculations for the study. Individual level secondary end points included psychosocial factors, recall measures of eating and physical activity patterns, and other physiologic measures.Results.\p=m-\Inintervention school lunches, the percentage of energy intake from

Efficacy of a compulsory homework programme for increasing physical activity and healthy eating in children: the healthy homework pilot study

“…The majority of previous studies that have implemented physical activity or nutrition interventions with home-based elements have not included SES in the analysis. Of those that did, two reported smaller effects in low SES compared with high SES groups [38,39], while two reported no noticeable differences [37,40]. Nonetheless, it is possible that in the latter studies (and the present one) the similar overall effects on physical activity and/or dietary patterns between SES groups were generated through different pathways.…”

Multilevel Interventions: Study Design and Analysis Issues

“…They assessed the effect of the intervention on both the worksite environment and individuals. Luepker et al (5) conducted an intervention in four sites where they randomized 56 elementary schools to an intervention and used 40 schools as controls. They measured changes at both the school and individual levels.…”

“…Many health researchers are interested in developing, implementing, and evaluating multilevel interventions (1,3,5,(18)(19)(20) because they believe that we are most likely to achieve substantial and sustained change with interventions based on ecological theory that target multiple levels, or sources of influence (6,18,(21)(22)(23)(24). The expectation for a multilevel intervention usually is that that the combined effect of the interventions used will at least be additive, which is the sum of the effects of what the interventions would have achieved separately.…”

An Approach to Improving Science Knowledge About Energy Balance and Nutrition Among Elementary- and Middle-School Students

“…It has been shown that nutritional and/or fitness deficits in school-age children and adolescents can be addressed, especially by promoting regular physical activity and dietary awareness (Dowda et al, 2001;Andersen et al, 2002;Centers for Disease Control, 2003). In addition, health education and school health promotion programs for the elementary-and middle-school grades have achieved statistically significant outcomes involving a number of variables, such as students' self-reported attitudes and behaviors (Hunter et al, 1996), reduction of coronary heart disease risk factors (Luepker et al, 1996;Bush et al, 1989), improvements in dietary intake and reduction of time watching television (Gortmaker et al, 1999a), and decreased obesity among girls in grades 6-8 (Gortmaker et al, 1999b).…”