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Am J Public Health. 1999 Oct;89(10):1529-35.

A public health vs a risk-based intervention to improve cardiovascular health in elementary school children: the Cardiovascular Health in Children Study.

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School of Nursing, University of North Carolina at Chapel Hill 27599-7460, USA.



This study sought to determine the population effects of both classroom-based and risk-based interventions designed to reduce cardiovascular disease risk factors in children.


Elementary school children (n = 2109; age range: 7-12 years) were randomized by school to a classroom-based intervention for all third and fourth graders, a risk-based intervention only for those with 1 or more cardiovascular disease risk factors, or a control group. The 8-week interventions involved both knowledge--attitude and physical activity components.


School-level analyses showed that physical activity in the risk-based group and posttest knowledge in the classroom-based group were significantly higher than in the control group. With regard to trends shown by individual-level analyses, cholesterol dropped more in the classroom-based than in the control group, and skinfold thickness decreased 2.9% in the classroom-based group and 3.2% in the risk-based group (as compared with a 1.1% increase in the control group).


Both classroom-based and risk-based interventions had positive effects on physical activity and knowledge, with trends toward reduced body fat and cholesterol. However, the classroom-based approach was easier to implement and evidenced stronger results than the risk-based intervention.

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