A Multicomponent, School-Based Intervention, the Shaping Healthy Choices Program, Improves Nutrition-Related Outcomes

Rachel E Scherr; Jessica D Linnell; Madan Dharmar; Lori M Beccarelli; Jacqueline J Bergman; Marilyn Briggs; Kelley M Brian; Gail Feenstra; J Carol Hillhouse; Carl L Keen; Lenna L Ontai; Sara E Schaefer; Martin H Smith; Theresa Spezzano; Francene M Steinberg; Carolyn Sutter; Heather M Young; Sheri Zidenberg-Cherr

doi:10.1016/j.jneb.2016.12.007

A Multicomponent, School-Based Intervention, the Shaping Healthy Choices Program, Improves Nutrition-Related Outcomes

J Nutr Educ Behav. 2017 May;49(5):368-379.e1. doi: 10.1016/j.jneb.2016.12.007. Epub 2017 Feb 8.

Authors

Rachel E Scherr¹, Jessica D Linnell², Madan Dharmar³, Lori M Beccarelli¹, Jacqueline J Bergman⁴, Marilyn Briggs¹, Kelley M Brian⁵, Gail Feenstra⁶, J Carol Hillhouse⁶, Carl L Keen⁷, Lenna L Ontai⁸, Sara E Schaefer⁹, Martin H Smith¹⁰, Theresa Spezzano¹¹, Francene M Steinberg¹², Carolyn Sutter¹³, Heather M Young³, Sheri Zidenberg-Cherr¹⁴

Affiliations

¹ Department of Nutrition, University of California, Davis, Davis, CA; Center for Nutrition in Schools, University of California, Davis, Davis, CA.
² Oregon State University Extension Service, Tillamook, OR.
³ Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA.
⁴ Department of Nutrition, University of California, Davis, Davis, CA.
⁵ University of California Cooperative Extension, Placer and Nevada Counties, University of California Agriculture and Natural Resources, Auburn, CA; University of California Agriculture and Natural Resources, Davis, CA.
⁶ University of California Agriculture and Natural Resources, Davis, CA; Agricultural Sustainability Institute, University of California Sustainable Agriculture Research and Education Program, University of California, Davis, Davis, CA.
⁷ Department of Nutrition, University of California, Davis, Davis, CA; University of California Agriculture and Natural Resources, Davis, CA; Department of Internal Medicine, University of California, Davis, Davis, CA.
⁸ University of California Agriculture and Natural Resources, Davis, CA; Department of Human Ecology, University of California, Davis, Davis, CA.
⁹ Foods for Health Institute, University of California, Davis, Davis, CA.
¹⁰ University of California Agriculture and Natural Resources, Davis, CA; Department of Human Ecology, University of California, Davis, Davis, CA; Department of Population Health and Reproduction, University of California, Davis, Davis, CA.
¹¹ University of California Agriculture and Natural Resources, Davis, CA; University of California Cooperative Extension, Merced and Stanislaus Counties, University of California Agriculture and Natural Resources, Modesto, CA.
¹² Department of Nutrition, University of California, Davis, Davis, CA; University of California Agriculture and Natural Resources, Davis, CA.
¹³ Department of Human Ecology, University of California, Davis, Davis, CA.
¹⁴ Department of Nutrition, University of California, Davis, Davis, CA; Center for Nutrition in Schools, University of California, Davis, Davis, CA; University of California Agriculture and Natural Resources, Davis, CA. Electronic address: sazidenbergcherr@ucdavis.edu.

PMID: 28189500
DOI: 10.1016/j.jneb.2016.12.007

Abstract

Objective: To evaluate the effectiveness of the Shaping Healthy Choices Program (SHCP).

Design: A clustered, randomized, controlled intervention lasting 1 school year.

Setting: Schools in northern and central California.

Participants: Fourth-graders (aged 9-10 years) at 2 control schools (n = 179) and 2 intervention schools (n = 230).

Intervention: Garden-enhanced education, family, and community partnerships; increased regionally procured produce in the lunchroom; and school-site wellness committees.

Main outcome measures: Changes in body mass index (BMI) percentiles/Z-scores; nutrition knowledge, science process skills, and vegetable identification and preferences; and reported fruit and vegetable intake.

Analysis: Student t test, chi-square, ANOVA of change, and multilevel regression mixed model to evaluate change in outcomes with school as a random effect to account for cluster design effects. Statistical significance was set at P < .05.

Results: There was a greater improvement in BMI percentile (-6.08; P < 0.01), BMI Z-score (-0.28; P < .001), and waist-to-height ratio (-0.02; P < .001) in the intervention compared with the control schools.

Conclusions and implications: The SHCP resulted in improvements in nutrition knowledge, vegetable identification, and a significant decrease in BMI percentiles. This supports the concept that the SHCP can be used to improve the health of upper elementary school students.

Keywords: body mass index percentiles; childhood obesity; multicomponent programs; nutrition education; school-based programs.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Body Mass Index
California
Child
Choice Behavior*
Female
Health Behavior*
Health Knowledge, Attitudes, Practice
Health Promotion / methods*
Humans
Male
Nutritional Sciences / education
Pediatric Obesity / epidemiology
Pediatric Obesity / prevention & control*
Schools
Students / statistics & numerical data*