Building healthy communities: A comprehensive school health program to prevent obesity in elementary schools

Abstract

Obesity among children is highly prevalent and can lead to risk factors for chronic disease in adulthood. Key organizations have called on schools to play a larger role by increasing children's physical activity and nutrition by adopting an overall culture of health. This study examined the impact of a socioecological theory driven school-wide nutrition and physical activity intervention on 5th graders' central adiposity and obesity level. In 2015-2016, in the Midwest region of U.S., four treatment and two control schools, including 628 (377 treatment) 5th grade children participated in an eight-month intervention. Children in the treatment schools participated in a comprehensive healthy school transformation program consisting of six components. Waist-to-Height Ratio (WHtR) and Body Mass Index (BMI) was calculated and used as the measure of obesity. ANCOVA revealed a significant difference in WHtR among treatment and control groups at time two (T2) F_MI(1,6148.14) = 4.43, p = .035, R² = 0.64, R²_Treament = 0.01, with no significant differences based on age, sex, and race. Additionally, the ANCOVA for BMI revealed a marginally significant lower BMI among the treatment than comparison group students F_MI(1, 614) = 3.575, p = .059, R² = 0.01 (M_diff = -0.23, 95%CI upper boundary: -0.03). The healthy school intervention led to significant differences in obesity levels, regardless of age, sex, or race, across the 8-month program between 5th grade children in treatment and non-treatment schools. This supports the ability of schoolwide programs to significantly and positively impact student health and chronic disease prevention.

Keywords: Body Mass Index; Childhood obesity; Comprehensive school physical activity programs; Elementary school; Waist to Height Ratio; Whole of school approach.