ARS | Publication request: Effectiveness of School-Based Environmental vs. Individual Approaches to Diet, Physical Activity, and Sedentary Behavior Change Among Youth

Submitted to: Book Chapter
Publication Type: Book / Chapter
Publication Acceptance Date: September 2, 2005
Publication Date: August 30, 2006
Citation: Thompson, D., Baranowski, T., Zakeri, I., Jago, R., Davis, J., Cullen, K. 2006. Effectiveness of school-based environmental vs. individual approaches to diet, physical activity, and sedentary behavior change among youth. In: Flamenbaum, R.K., editor. Childhood Obesity and Health Research. New York, NY: Nova Science Publishers, Inc. p. 157-174.

Technical Abstract: Schools offer unique channels for youth obesity prevention. School-based programs can be categorized as having an individual, environmental, or a combined (individual + environmental) focus. This chapter reviews the literature on school-based interventions focusing on diet, physical activity, and/or sedentary behavior reporting body composition as an outcome measure, and then characterizes these programs as having an individual, environmental, or combined focus. These categories are then examined in an attempt to determine which approach appears to be more effective at promoting change in body composition within the school setting. Primary inclusionary criteria were: school based interventions; a focus on diet, physical activity, and/or sedentary behavior; reporting body composition as an outcome measure; and emphasizing prevention rather than treatment. Secondary inclusionary criteria (to enhance confidence in the inferences drawn) included having an experimental design, with school as the unit of randomization; using appropriate statistical analysis methods to account for clustering within schools; inclusion in a peer-reviewed journal; and reporting results in English. Eleven interventions met all inclusionary criteria. Three of the 11 achieved significant change in body composition (27% of total). Significant group differences in body composition were reported by two of the individual focus (29%), one (50%) of the environmental focus, and none (0%) of the combined focus interventions. No consistent differences in procedures, methods, or intervention components were found among the interventions that did or did not achieve change in body composition. Both individual and environmental interventions promote change in diet, physical activity, and/or sedentary behavior and have demonstrated success in impacting body composition in a school setting. More research is needed to identify the approach, procedures, and methods that are most effective at promoting body composition change in a school setting.