Format

Send to

Choose Destination
PLoS One. 2015 Aug 21;10(8):e0134470. doi: 10.1371/journal.pone.0134470. eCollection 2015.

Three-Year Improvements in Weight Status and Weight-Related Behaviors in Middle School Students: The Healthy Choices Study.

Author information

1
Department of Nutritional Sciences, School of Public Health and Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, United States of America; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America; Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America.
2
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
3
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America; Center for Community-Based Research, Dana Farber Cancer Institute, Boston, Massachusetts, United States of America; Department of Kinesiology, University of Rhode Island, Kingston, Rhode Island, United States of America.
4
Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America; Division of Adolescent and Young Adult Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts, United States of America.
5
Nutrition Program North East Region, United States Department of Agriculture (USDA), Boston, Massachusetts, United States of America.
6
Hunt Consulting Associates, Logan, Utah, United States of America.
7
Clinical Research Center, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America.
8
Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States of America.
9
Massachusetts Department of Public Health, Boston, Massachusetts, United States of America.
10
Division of Adolescent and Young Adult Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts, United States of America.

Abstract

INTRODUCTION:

Few dissemination evaluations exist to document the effectiveness of evidence-based childhood obesity interventions outside the research setting.

OBJECTIVE:

Evaluate Healthy Choices (HC), a multi-component obesity prevention program, by examining school-level changes in weight-related behaviors and weight status and the association of implementation components with odds of overweight/obesity.

METHODS:

We compared baseline and Year 3 school-level behavioral and weight status outcomes with paired t-tests adjusted for schools' socio-demographic characteristics. We used generalized estimating equations to examine the odds of overweight/obesity associated with program components.

SETTING/PARTICIPANTS:

Consecutive sample of 45 of 51 middle schools participating in the HC program with complete baseline and follow-up survey data including a subsample of 35 schools with measured anthropomentry for 5,665 7th grade students.

INTERVENTION:

Schools developed a multi-disciplinary team and implemented an obesity prevention curriculum, before and after school activities, environmental and policy changes and health promotions targeting a 5-2-1 theme: eat ≥ 5 servings/day of fruits and vegetables (FV), watch ≤ 2 hours of television (TV) and participate in ≥ 1 hours/day of physical activity (PA) on most days.

MAIN OUTCOME MEASURES:

1) School-level percent of students achieving targeted behaviors and percent overweight/obese; and 2) individual odds of overweight/obesity.

RESULTS:

The percent achieving behavioral goals over three years increased significantly for FV: 16.4 to 19.4 (p = 0.001), TV: 53.4 to 58.2 (p = 0.003) and PA: 37.1 to 39.9 (p = 0.02), adjusting for school size, baseline mean age and percent female, non-Hispanic White, and eligible for free and reduced price lunch. In 35 schools with anthropometry, the percent of overweight/obese 7th grade students decreased from 42.1 to 38.4 (p = 0.016). Having a team that met the HC definition was associated with lower odds of overweight/obesity (OR = 0.83, CI: 0.71-0.98).

CONCLUSIONS AND RELEVANCE:

The HC multi-component intervention demonstrated three-year improvements in weight-related behaviors and weight status across diverse middle schools. Team building appears important to the program's effectiveness.

PMID:
26295837
PMCID:
PMC4546621
DOI:
10.1371/journal.pone.0134470
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Public Library of Science Icon for PubMed Central
Loading ...
Support Center