Slowing BMI Growth Trajectories in Elementary School-Aged Children: The Northeast Iowa Food and Fitness Initiative (original) (raw)
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A Policy-Based School Intervention to Prevent Overweight and Obesity
PEDIATRICS, 2008
The increasing prevalence and consequences of childhood obesity have prompted calls for broad public health solutions that reach beyond clinic settings. Schools are ideal settings for population-based interventions. Despite their intuitive appeal, the results for school-based interventions are mixed.
The Childhood Obesity Declines Project: A Review of Enacted Policies
Childhood obesity (Print), 2018
State- and local-level policies can influence children's diet quality and physical activity (PA) behaviors. The goal of this article is to understand the enacted state and local policy landscape in four communities reporting declines in childhood obesity. State-level policies were searched within the CDC's online Chronic Disease State Policy Tracking System. Local level policies were captured during key informant interviews in each of the sites. Policies were coded by setting [i.e., early care and education (ECE) also known as child care, school, community], jurisdictional level (i.e., state or local) and policy type (i.e., legislation or regulation). The time period for each site was unique, capturing enacted policies 5 years before the reported declines in childhood obesity in each of the communities. A total of 39 policies were captured across the 4 sites. The majority originated at the state level. Two policies pertaining to ECE, documented during key informant interview...
Childhood obesity (Print), 2018
Recent findings show that national childhood obesity prevalence overall is improving among some age groups, but that disparities continue to persist, particularly among populations that have historically been at higher risk of obesity and overweight. Over the past several years, many jurisdictions at the city or county level across the nation have also reported declines. Little evaluation has focused on understanding the factors that influence the implementation of efforts to reduce childhood obesity rates. This article summarizes the rationale, aims, and overall design of the Childhood Obesity Declines Project (COBD), which was the first of its kind to systematically study and document the what, how, when, and where of community-based obesity strategies in four distinct communities across the nation. COBD was initiated by the National Collaborative on Childhood Obesity Research (NCCOR), was led by a subset of NCCOR advisors and a research team at ICF, and was guided by external adv...
A Community Intervention Reduces BMI z-score in Children: Shape Up Somerville First Year Results*
Obesity, 2007
Objective: The objective was to test the hypothesis that a community-based environmental change intervention could prevent weight gain in young children (7.6 Ϯ 1.0 years). Research Methods and Procedures: A non-randomized controlled trial was conducted in three culturally diverse urban cities in Massachusetts. Somerville was the intervention community; two socio-demographically-matched cities were control communities. Children (n ϭ 1178) in grades 1 to 3 attending public elementary schools participated in an intervention designed to bring the energy equation into balance by increasing physical activity options and availability of healthful foods within the before-, during-, afterschool, home, and community environments. Many groups and individuals within the community (including children, parents, teachers, school food service providers, city departments, policy makers, healthcare providers, before-and after-school programs, restaurants, and the media) were engaged in the intervention. The main outcome measure was change in BMI z-score. Results: At baseline, 44% (n ϭ 385), 36% (n ϭ 561), and 43% (n ϭ 232) of children were above the 85th percentile for BMI z-score in the intervention and the two control communities, respectively. In the intervention community, BMI z-score decreased by Ϫ0.1005 (p ϭ 0.001, 95% confidence interval, Ϫ0.1151 to Ϫ0.0859) compared with children in the control communities after controlling for baseline covariates. Discussion: A community-based environmental change intervention decreased BMI z-score in children at high risk for obesity. These results are significant given the obesigenic environmental backdrop against which the intervention occurred. This model demonstrates promise for communities throughout the country confronted with escalating childhood obesity rates.
It's All About Kids: Preventing Overweight in Elementary School Children in Tulsa, OK
Journal of The American Dietetic Association, 2009
In response to the increased incidence of child overweight, a school-based program, It's All About Kids, was designed by the Tulsa Health Department, Tulsa Public Schools, and community partners to improve food choices and increase physical activity of students in first through fifth grade. The nutrition component consisted of six weekly 30-minute experiential, age-appropriate classroom lessons, including healthful-eating food games, taste-testing foods, whole-grain bread baking, information on portion sizes, and food demonstrations. Documenting and evaluating school-based intervention programs is critical for setting evidence-based health policy, justifying funding, and achieving broader implementation of successful interventions. To evaluate the effectiveness of the It's All About Kids nutrition component in fourth-grade children, we conducted a controlled trial from 20 fourth-grade classes in five intervention and five comparison Title I public schools. Evaluation included 140 fourth-grade students, including 69 in the comparison group and 71 in the intervention group. Outcomes were measured by pre-, post-, and follow-up tests using a modified version of the Pathways Knowledge, Attitudes, and Behaviors questionnaire and the Child and Adolescent Trial of Cardiovascular Health (CATCH) Food Checklist. Data were analyzed using repeated measures analysis of variance over time controlling for sex, paired samples t tests, and independent samples t tests. Intervention students had significant improvements in knowledge of which food had more fat (PϽ0.043). Intervention students' behavioral intent scale scores for food choice intentions improved significantly (PϽ0.014). Self-reported consumption of saturated fat and sodium improved considerably in both intervention and comparison students. We conclude that results support a broader program implementation. More reinforcement over time may be needed to sustain the level of improvement.
Fighting an epidemic: The role of schools in reducing childhood obesity
Psychology in The Schools, 2006
Obesity among children and adolescents is a major public health concern affecting the physical and emotional health of youth while increasing their risk of reduced quality and duration of life. Schools and communities have begun to galvanize to address this epidemic and need quality empirical information to guide their policy, programming, and intervention efforts. This article reviews the definition of childhood obesity and the physical, psychosocial, and academic consequences of obesity among youth. The roles of schools and school psychologists in intervening against this overwhelming trend are discussed as well as current empirically based programs. Schools are recommended to take a comprehensive, multifaceted approach to school policies and programs to increase nutrition and physical activity. © 2006 Wiley Periodicals, Inc. Psychol Schs 43: 361–376, 2006.
Childhood Obesity Declines Project: Highlights of Community Strategies and Policies
Childhood obesity (Print), 2018
The social ecological model (SEM) is a framework for understanding the interactive effects of personal and environmental factors that determine behavior. The SEM has been used to examine childhood obesity interventions and identify factors at each level that impact behaviors. However, little is known about how those factors interact both within and across levels of the SEM. The Childhood Obesity Declines (COBD) project was exploratory, attempting to capture retrospectively policies and programs that occurred in four communities that reported small declines in childhood obesity. It also examined contextual factors that may have influenced initiatives, programs, or policies. Data collection included policy and program assessments, key informant interviews, and document reviews. These data were aggregated by the COBD project team to form a site report for each community (available at www.nccor.org/projects/obesity-declines ). These reports were used to develop site summaries that illus...
American Journal of Health Education, 2007
Background: University-community partnerships can support schools in implementing evidence-based responses to youth obesity trends. An interorganizational partnership was established to implement and evaluate the Healthy Choices Collaborative Intervention (HCCI). HCCI combines an interdisciplinary curriculum, before/after school activities, and the School Health Index to promote physical activity, reduce television viewing, and increase fruit and vegetable consumption among middle school youths. Purpose: A modifi ed rapid assessment process was used to explore potential infl uences on feasibility of implementing and sustaining HCCI before wide-scale implementation. Methods: Twenty-one in-depth interviews were conducted with administrators, program coordinators, and teachers who had experience with one or more of the intervention components. Results: Respondents believed combining programs would be benefi cial because of common behavioral goals. A key leader, an engaged, multidisciplinary team, and parental, community, and administrative support were viewed as being important for effective implementation. Respondents believed sustainability would be facilitated through resources for networking and refreshers on intervention components. Discussion: Findings resulted in hiring regional coordinators to assist schools in implementation, allowing schools fl exibility in implementation, and reducing the required number of Planet Health lessons and School Health Index modules. Translation to Health Education Practice: Findings illustrate the utility of rapid assessment procedures to gauge feasibility of combining multiple interventions before implementation. BACKGROUND Persistent increases in the prevalence 1 and earlier age at peak incidence of childhood overweight, 2 along with predictions of reduced life expectancy associated with overweight status, 3 have challenged researchers and practitioners to develop effective, sustainable interventions to avert the health and social consequences of said status. 4-7 In 2005, the Institute of Medicine called for immediate public health action based on the best available, rather than the best possible, evidence to address pediatric obesity trends. 8 Schools are important organizational set