Predictors for moderate- and vigorous-intensity physical activity during an 18-month coordinated school health intervention

Ewha Womans University, Seoul, Korea. Electronic address: .
Preventive Medicine (Impact Factor: 3.09). 07/2013; 57(5). DOI: 10.1016/j.ypmed.2013.06.024
Source: PubMed


To evaluate if the HEROES Initiative, a school-based childhood obesity prevention program based on the U S. Centers for Disease Control and Prevention (CDC)'s coordinated school health approach, was able to effectively increase physical activity among elementary and middle school students who were exposed to the program for 18 months and to determine student and school-level predictors of success.
Students who participated in physiological data collection were invited to participate in a survey at baseline, 6 months, and 18 months (N = 1091, 8 schools). The dropout rate at 18 months was 39.1% when graduates were counted. Data was analyzed using generalized estimating equations.
A significant increase (p = .0067) was observed in vigorous-intensity physical activity (VPA) but a non-significant increase (p = .1753) in moderate-intensity physical activity (MPA). Each school's implementation fidelity score was also only associated with VPA increases. Students' screen time and vegetable/fruit intake were independently associated with both VPA and MPA increases. Body mass index of students was not predictive of VPA or MPA changes.
An 18-month school-based intervention that employs the CDC's coordinated school health approach appears to be effective in increasing physical activity among elementary and middle school children.

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    ABSTRACT: Purpose: To evaluate the effectiveness of the HEROES (Healthy, Energetic, Ready, Outstanding, Enthusiastic Schools) initiative, a multicomponent school-based obesity prevention intervention based on the Centers for Disease Control and Prevention's coordinated school health approach, on the improvement of blood pressure (BP) and to determine long-term predictors of systolic and diastolic BP changes among high school students who were exposed to the intervention. Methods: Biometric and behavioral data from high school students were analyzed at baseline, 6, 12, and 18 months (N = 847, three schools). The attrition rate at 18 months was 26.1%. Sequential generalized estimating equation models were fit to the data using SAS 9.3, taking into account clustering effects within the same school and correlations within repeated measures. Results: A significant downward trend was observed in systolic BP (p = .0006) and diastolic BP (p < .0001) among the students who were exposed to the HEROES initiative. The prevalence of hypertension decreased from 17.1% at baseline to 12.8% at 6 months (p < .0001), 12.0% at 12 months (p < .0001), and 15.0% (p = .0024) at 18 months. Baseline body mass index, increases in body mass index percentiles, and increases of television-viewing hours were associated with BP increases. Increases in frequencies of eating french fries or chips, skipping breakfast, and consuming supersize meals when eating fast food were predictive of systolic BP changes, not of diastolic BP changes. Conclusions: An 18-month multicomponent school-based obesity intervention program may be effectively used to decrease rates of high BP among adolescents.
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    ABSTRACT: BACKGROUND Curtailing childhood obesity is a public health imperative. Although multicomponent school-based programs reduce obesity among children, less is known about the implementation fidelity of these interventions. This study examines process evaluation findings for the Healthy, Energetic Ready, Outstanding, Enthusiastic, Schools (HEROES) Initiative, a tri-state school-based childhood obesity prevention intervention based on the coordinated school health (CSH) model.METHODS Site visits were conducted that included key stakeholder interviews, observation, and document review. Scores were given for 8 domains, and a total implementation score was calculated. Two-way analyses of variance were conducted to examine the relationship of 4 school-level characteristics: elementary vs. middle/high schools, public vs. private schools, district vs. building level implementation, and socioeconomic status on each implementation area.RESULTSOverall, schools had high fidelity scores, although some domains were implemented more successfully than others. Three school-level characteristics were associated with 1 or more domains, with elementary schools and schools implementing at the building level consistently having higher implementation scores than their counterparts.CONCLUSIONS Process evaluation findings provide insight into successes and challenges schools implementing the CSH approach may encounter. Although preliminary, these findings on school-level characteristics establish a new area of research related to school-based childhood obesity prevention programs' implementation fidelity.
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    ABSTRACT: Objective Evaluate the effectiveness of a healthy weight intervention designed for children of migrant farmworkers embedded in a 7-week summer Midwest Migrant Education Program (MEP) for changes in: weight; Body Mass Index (BMI); BMI-percentiles (BMI-p); muscle strength and muscle flexibility; nutrition knowledge; attitudes; and behaviors.Design and SampleThis is a two-group pre-post quasi-experimental study. Latino children of migrant farmworkers attending summer MEP in grades one through eight were enrolled (n = 171: comparison n = 33, intervention n = 138).MeasuresWeight, BMI, BMI-p, muscle strength and flexibility, knowledge, and healthy behaviors.InterventionClassroom content included: food variety; increasing fruits and vegetables; healthy breakfasts; more family meals; increasing family time; decreasing TV and electronic game time; increasing physical activity; limiting sugar-sweetened drinks; portion sizes; and food labels.ResultsStatistically significant were increase in comparison group mean weight, decrease in intervention group BMI-p, and improvements in muscle flexibility and healthy behavior attitudes. The intervention students showed trends toward healthy BMI. The number of MEP days attended was significantly correlated in four outcomes.Conclusion Study findings have the potential to decrease incidence of unhealthy weight in Latino migrant children, reduce rates of premature adult diseases in these children, and a potential to decrease future health care costs.
    No preview · Article · Jan 2015 · Public Health Nursing
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