It's all about kids: preventing overweight in elementary school children in Tulsa, OK

Abstract

In response to the increased incidence of child overweight, a school-based program, It's All About Kids, was designed by the Tulsa Health Department, Tulsa Public Schools, and community partners to improve food choices and increase physical activity of students in first through fifth grade. The nutrition component consisted of six weekly 30-minute experiential, age-appropriate classroom lessons, including healthful-eating food games, taste-testing foods, whole-grain bread baking, information on portion sizes, and food demonstrations. Documenting and evaluating school-based intervention programs is critical for setting evidence-based health policy, justifying funding, and achieving broader implementation of successful interventions. To evaluate the effectiveness of the It's All About Kids nutrition component in fourth-grade children, we conducted a controlled trial from 20 fourth-grade classes in five intervention and five comparison Title I public schools. Evaluation included 140 fourth-grade students, including 69 in the comparison group and 71 in the intervention group. Outcomes were measured by pre-, post-, and follow-up tests using a modified version of the Pathways Knowledge, Attitudes, and Behaviors questionnaire and the Child and Adolescent Trial of Cardiovascular Health (CATCH) Food Checklist. Data were analyzed using repeated measures analysis of variance over time controlling for sex, paired samples t tests, and independent samples t tests. Intervention students had significant improvements in knowledge of which food had more fat (P<0.043). Intervention students' behavioral intent scale scores for food choice intentions improved significantly (P<0.014). Self-reported consumption of saturated fat and sodium improved considerably in both intervention and comparison students. We conclude that results support a broader program implementation. More reinforcement over time may be needed to sustain the level of improvement.