Advancing school & community engagement now for disease prevention

BACKGROUND Schools can help prevent childhood obesity. Parental involvement enhances children's health.

PURPOSE To promote healthy lifestyles among students and families.

SIGNIFICANCE We compared a standard nutrition and physical activity intervention in elementary school classrooms vs. a high-intensity intervention to benefit students and families.

METHODOLOGY Participants were K-5 students in the Independence School District (ISD) and Raytown School District (RSD) in Missouri. We randomly assigned ISD's 17 schools to standard-intensity (SI) or high-intensity (HI) intervention, with RDS's 9 schools serving as controls (C). SI included a program on food labels/choosing healthful foods in third grade, and physical activity program in PreK-5 classrooms. HI included these programs plus enhancements in schools, homes, and a supermarket. We assessed body mass index (BMI), food label literacy, fitness, performance, behavior, and medication for asthma or attention-deficit hyperactivity disorder (ADHD).

FINDINGS Post-intervention, BMI changes were 0.6 ± 1.9, 0.6 ± 1.9, and -0.3 ± 15.8 respectively, in SI, HI, and C schools, with no significant difference between groups (P>0.05). Both intervention groups improved in some fitness measures, more so than controls; comparison between SI and HI yielded mixed results. Food label literacy improved significantly by 20% in SI and by 16% in HI schools; the improvement was significantly greater in SI vs. HI (P=0.02). HI did not confer greater benefits than SI in performance, behavior, or medications.

CONCLUSIONS Both interventions offered some benefits compared to control. The HI intervention seemed to confer little further benefit.