Promising results from a school-based intervention to address childhood obesity in Texas-Mexico border communities

Background: Childhood obesity, especially among Hispanic youth, is a serious public health problem. In response to alarming results of a diabetes-risk screening program, Laredo Independent School District implemented a comprehensive Local Wellness Policy that included the following components: (1) access to healthy food options (2) increasing levels of physical activity beyond state mandates, (3) creation of a "Coordinator for School Health" position, and (4) adoption of a diabetes prevention program at elementary/middle schools. The community is characterized by high rates of obesity (34% of county population versus 26% nationwide) and diabetes prevalence (17% of county population versus 8% nationwide).

Purpose: To assess the impact of a coordinated school-based intervention on obesity rates among Hispanic children in Texas-Mexico border communities.

Methodology: Intervention programs were gradually implemented between 2003-2008. Data were collected by school nurses from 3rd, 5th, and 7th grade students annually (weight and height measurements, blood pressure, and acanthosis nigricans (a diabetes-associated marker)).

Findings/Results: District students (n=5,534 in 2003; n=5,331 in 2008) were primarily Hispanic (99.5%) and economically disadvantaged (96.5%). Data reveal a substantial drop in obesity rates (BMI ≥ 95th percentile) by 1-2 percentage points annually between 2003 and 2008.

Significance: Short-term interventions have been successful at modifying behaviors and attitudes towards physical activity and nutrition. However, translation of those behavioral changes into obesity rate declines among school-aged children has been more difficult to achieve. Preliminary findings from this study demonstrate that a long-term, multi-component, coordinated school health approach can be effective at addressing childhood obesity in minority communities.