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Title: Impact of a school-based pediatric obesity prevention program faciliated by health professionals

item JOHNSTON, CRAIG - Children'S Nutrition Research Center (CNRC)
item MORENO, JENNETTE - Children'S Nutrition Research Center (CNRC)
item EL-MUBASHER, ABEER - Children'S Nutrition Research Center (CNRC)
item GALLAGHER, MARTINA - University Of Texas Health Science Center
item TYLER, CHERMAINE - Children'S Nutrition Research Center (CNRC)
item WOEHLER, DEBORAH - The Cluthe And William B Oliver Foundation

Submitted to: Journal of School Health
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/12/2012
Publication Date: 3/1/2013
Citation: Johnston, C.A., Moreno, J.P., El-Mubasher, A., Gallagher, M., Tyler, C., Woehler, D. 2013. Impact of a school-based pediatric obesity prevention program faciliated by health professionals. Journal of School Health. 83(3):171-181.

Interpretive Summary: Childhood obesity has become an epidemic in the United States, due to the consumption of more energy dense diets and less activity spent at home and/or in schools. In order for states to receive federal funding, students must reach a certain academic standard; and physical education has been cut from many curriculums to attain this standard. In order to prevent the rate of childhood obesity from rising, health awareness in children is required. It has been concluded that schools are an effective means of introducing health awareness amongst children, and should be a focus point for obesity prevention. This study focused on preventing obesity in elementary school children, by introducing health professionals into the school curriculum. Health professionals assisted teachers on integrating healthy messages into the curriculum through a professional-facilitated intervention (PFI) for a total of 2 years. Body mass index (BMI) was compared amongst children in the treatment group (PFI) versus the self-help group (SH), where health professionals did not assist teachers in integrating healthy messages. Overall, students in the treatment condition reduced their BMI significantly versus students in the SH group. Overall, at the end of the 2 years, grade point averages for overweight students in the treatment condition and the SH group decreased, but students in the PFI condition showed a smaller decrease in grades compared to students in the SH group. Results indicate that the obesity prevention intervention was effective in reducing BMI of overweight and obese children, compared to students in the SH condition. Integrating health professional and teachers has proven to produce positive results amongst obese/overweight and normal weight students.

Technical Abstract: This study evaluated a school-based obesity intervention for elementary school children (N=835) where health professionals assisted teachers with the integration of healthy messages into the school curriculum. Schools were randomized into a professional-facilitated intervention (PFI; N=4) or a self-help (SH; N=3) condition. Changes in weight-based outcomes were assessed in students enrolled in the second grade from all 7 schools (overall: N=835 students; PFI: N=509 students, SH: N=326 students). Students were between ages 7 and 9 and from diverse ethnic backgrounds (Asian=25.3%, Black=23.3%, Hispanic=23.1%, White=28.3%). The sample included 321 overweight/obese (BMI greater than or equal to 85th percentile), 477 normal-weight (BMI greater than or equal to 5th percentile and less than 85th percentile), and 37 underweight (BMI less than 5th percentile) students. After 2 years, children who were overweight/obese in the PFI condition significantly reduced their standardized BMI (zBMI) compared to children in the SH condition (Wald chi**2=28.7, p less than .001). End-of-year grades decreased for overweight/obese students in both conditions; however, students in the PFI exhibited a smaller decrease in grades compared to the SH condition (Wald chi**2=80.3, p less than .001). The results indicate that an obesity prevention program where health professionals assist teachers by integrating healthy messages into existing curriculum was effective in reducing zBMI compared to the SH condition.