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Clinical Trial
. 2003 Dec;37(6 Pt 2):S24-34.
doi: 10.1016/j.ypmed.2003.08.011.

Pathways curriculum and family interventions to promote healthful eating and physical activity in American Indian schoolchildren

Sally M Davis  1 , Theresa Clay, Mary Smyth, Joel Gittelsohn, Vivian Arviso, Hilary Flint-Wagner, Bonnie Holy Rock, Richard A Brice, Lauve Metcalfe, Dawn Stewart, Maihan Vu, Elaine J Stone
Affiliations
Clinical Trial

Pathways curriculum and family interventions to promote healthful eating and physical activity in American Indian schoolchildren

Sally M Davis et al. Prev Med. 2003 Dec.

Abstract

Background: Pathways, a multisite school-based study aimed at promoting healthful eating and increasing physical activity, was a randomized field trial including 1704 American Indian third to fifth grade students from 41 schools (21 intervention, 20 controls) in seven American Indian communities.

Methods: The intervention schools received four integrated components: a classroom curriculum, food service, physical activity, and family modules. The curriculum and family components were based on Social Learning Theory, American Indian concepts, and results from formative research. Process evaluation data were collected from teachers (n=235), students (n=585), and families. Knowledge, Attitudes, and Behavior Questionnaire data were collected from 1150 students including both intervention and controls.

Results: There were significant increases in knowledge and cultural identity in children in intervention compared to control schools with a significant retention of knowledge over the 3 years, based on the results of repeating the third and fourth grade test items in the fifth grade. Family members participated in Family Events and take-home activities, with fewer participating each year.

Conclusion: A culturally appropriate school intervention can promote positive changes in knowledge, cultural identity, and self-reported healthful eating and physical activity in American Indian children and environmental change in school food service.

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Figures

Fig. 1
Fig. 1
Selected constructs from Social Learning Theory (adapted from Ref. [30] with permission).
Fig. 2
Fig. 2
The review and approval process used during the development of the Pathways curricula.
See this image and copyright information in PMC

References

    1. Caballero B, Davis SM, Davis CE, Ethelbah B, Evans M, Lohman T, et al. Pathways: a school-based program for the primary prevention of obesity in American Indian children. J Nutr Biochem. 1998;9:535–43. - PMC - PubMed
    1. U.S. Department of Health and Human Services. The Surgeon General’s call to action to prevent and decrease overweight and obesity. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General; U.S. GPO; Washington: 2001. - PubMed
    1. NCHS, CDC. Prevalence of overweight and obesity among adults: United States, 1999 [Internet] Hyattsville, MD: NCHS; [cited 2001 Oct 31]. Available from www.cdc.gov/nchs/products/pubd/hestats/obese/obese99.htm.
    1. NCHS, CDC. Prevalence of overweight among children and adolescents: United States, 1999 [Internet] Hyattsville, MD: NCHS; [cited 2001 Oct 31]. Available from www.cdc.gov/nchs/products/pubd/hestats/over99fig1.htm.
    1. U.S. Department of Health and Services. Prevention Report. 2001;16(1) http://odphp.oaopha.dhhs.gov/puba/prevrpt/

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