Differences in Cardiovascular Disease Risk Factors and Health Behaviors Between Black and Non-Black Students Participating in a School-Based Health Promotion Program

Abstract

Purpose: To compare cardiovascular disease (CVD) risk factors of black and non-black children participating in Project Healthy Schools (PHS), a school-based wellness program.

Design: Participants were surveyed and participated in physiological screenings pre- and post-PHS intervention.

Setting: Middle schools in 4 Michigan communities of varying socioeconomic status.

Participants: A total of 3813 sixth-grade students comprised the survey sample, and 2297 sixth-grade students comprised the screening sample.

Intervention: Project Healthy Schools is a school-based intervention designed to reduce the risk of obesity and CVD in children through the promotion of healthy eating and physical activity.

Measures: Physical examination, blood test, and self-reported survey data on dietary habits, physical activity, and sedentary behaviors were collected pre- and post-PHS.

Analysis: Paired and independent t tests were used for physiologic variables. Wilcoxon sign-rank and rank-sum tests were used for survey variables.

Results: At baseline, blacks had a higher percentage of overweight/obese students (43% vs 34%; P < .0001) and demonstrated poorer health habits than non-blacks; however, non-blacks had poorer lipid profiles. At follow-up (post-PHS intervention), both groups demonstrated significant improvements in physiological measures and health behaviors.

Conclusion: Despite disparities between the groups at both baseline and follow-up, changes seen post-PHS intervention were beneficial in both groups. These results suggest that early intervention for risk factor modification is possible and may be of great importance in the prevention of CVD, particularly in high-risk groups.

Keywords: cardiovascular risk; child and adolescent health; health status disparity; obesity; race/ethnicity; school health instruction.