A Multi-year Evaluation of a School-based Childhood Obesity Prevention Program

Background:Childhood obesity rates have nearly tripled in the last 30 years; approximately 17% of American children and adolescents are obese.  To address these rates, a health insurance company awarded one-year small grants to 39 elementary schools (K-6) to implement evidence-based healthy eating and physical activity programs. All schools agreed to sustain the program. The focus of this study is thirteen schools that sustained programming and committed to a second year of the evaluation.

Methods:We measured the effects of sustaining the program for two years on healthy eating and physical activity outcomes using a 90-question survey. Students completed four surveys over two years--in the fall and spring of fourth and fifth grades (n=343). We created scales for physical activity knowledge, physical activity beliefs, nutrition knowledge and nutrition beliefs for the outcome analyses. We conducted a repeated measures analysis.

Results:In the first year, we noted statistically significant improvements including: increased knowledge about the effects of physical activity and stronger beliefs about the positive effects of physical activity. At the end of the second year, physical activity knowledge and beliefs continued to rise significantly; nutrition knowledge also improved statistically. We did not note significant improvement in nutrition beliefs.

Conclusions: We discuss the survey results and implications for sustained exposure to programming. We note improvements across the 13 schools, but we remain cautious about direct program effects until we can study outcomes in comparison schools. We share lessons learned in partnership between schools, a health insurance company and a university.