Abstract Over the past three decades the proportion of students classified as overweight has almost tripled. This trend in childhood obesity is a cause for concern. Stakeholders have come together to stem growth and implement healthy habits in childhood to not only prevent obesity, but also future cardiovascular risk. School‐based health interventions have proven to be an effective medium to reach youth. Sustainable practices remain the largest determinant of long‐term success of these programs. Project Healthy Schools, a community–university collaborative school‐based health intervention program, sustainable practices have led to positive changes in participating middle schools. This collaborative has provided important insight on key factors needed for long‐term sustainability for a school‐based wellness program. These key factors are described under leadership, policy, finances, and reproducibility. Future school‐based programs may plan for success with sustainability while drawing from our experience.
Background: Previous studies have found that children and adolescents who skip breakfast are at greater risk of developing obesity and other chronic diseases. This study seeks to examine the relationship between breakfast consumption and cardiovascular disease risk factors in middle school children involved in Project Healthy Schools (PHS), a school-based wellness program. Methods: Data was collected from 1,651 sixth-grade students who consented to a health screening which collected physiologic data including blood pressure (BP), heart rate, lipids, and body mass index (BMI). Students also completed a survey evaluating their diet and other health behaviors. This study used data from the follow-up screening post-PHS intervention. Though PHS does not encourage students to fast on the day of the health screening, some students reported to be fasting. Based on this question, students were divided into two cohorts: breakfast eaters (non-fasting) and non-breakfast eaters (fasting). Results: Of the students in the study, 85.4% (1410 of 1651) had eaten breakfast on the day of the screening. Students who ate breakfast had lower BMIs than non-breakfast eaters (20.87 vs. 22.24) (p≤0.001). Breakfast eaters reported healthier diet choices, consuming less regular soda (p≤0.001) and high-fat meat (p=0.003), while eating more servings of fruits (p=0.010), vegetables (p≤0.001), and milk (p≤0.001). These students also reported higher levels of various physical activity sessions (p<0.05), and less time in front of the television (p≤0.001) and computer (p=0.016) screen. Students who ate breakfast also had significantly lower BP and LDL-cholesterol (Figure). Conclusions: Students who ate breakfast had lower BMIs, were more active, and made better diet choices. These students also had lower BP and LDL-cholesterol. These results suggest that students who eat breakfast may be at lower risk of developing cardiovascular disease, and the importance of breakfast as part of a healthy lifestyle should be emphasized among children and adolescents.
BACKGROUND/INTRODUCTION: Childhood obesity has more than doubled in children and tripled in adolescents in the past 30 years, potentially leading to dangerous problems in heart health in later years. Project Healthy Schools (PHS) aims to improve the wellness of students during adolescence by promoting healthy lifestyle changes. PHS incorporates 10 educational lessons into 6th grade students’ curricula. Each of these lessons emphasizes the PHS goals of healthy eating, regular exercise, and less sedentary behavior and are designed to be interactive, hands on, and fun. This report describes the students’ assessment of the educational model used in PHS. METHODS: Upon completion of the education module, participating students received a process survey. The purpose of this survey was to gather feedback from the students on the educational component of PHS. Results from the process survey were compiled from 4 separate school districts over the years 2008-2013. Five questions regarding the educational activities and resultant behavior changes are reported. RESULTS: 1793 students completed the survey. After completing the 10 lessons, 71% of students reported learning that was consistent with the PHS goals and25% reported liking all 10 PHS activities. Students enjoyed the activities for the following reasons: 45% because they were fun; 16% enjoyed moving around and/or playing games; and 36% enjoyed learning about being healthy. Furthermore, students reported the following lifestyle changes after the program was completed: 43% eating more fruits/vegetables, 38% increasing minutes of physical activity, 27% decreasing screen time, 30% choosing healthier drinks, 38% eating less fast food, with 29% making no changes. Lastly, when being tested on specific material from the course, 46% of students selected the correct answer. DISCUSSION/CONCLUSIONS/FUTURE DIRECTIONS: The majority of students successfully learned the content of the lessons and made at least one positive healthy lifestyle change. The process survey has allowed PHS leaders to assess real-time feedback from participating students, make content changes accordingly and will continue to guide future revisions of the program.
To compare cardiovascular disease (CVD) risk factors of black and non-black children participating in Project Healthy Schools (PHS), a school-based wellness program.Participants were surveyed and participated in physiological screenings pre- and post-PHS intervention.Middle schools in 4 Michigan communities of varying socioeconomic status.A total of 3813 sixth-grade students comprised the survey sample, and 2297 sixth-grade students comprised the screening sample.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.Physical examination, blood test, and self-reported survey data on dietary habits, physical activity, and sedentary behaviors were collected pre- and post-PHS.Paired and independent t tests were used for physiologic variables. Wilcoxon sign-rank and rank-sum tests were used for survey variables.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.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.
Background: Prior research has shown that dietary beliefs and activity levels of parents significantly mediate dietary and physical behaviors of their children. However, there is limited research regarding the influence of parental education on children’s health. This study analyzes the differences in dietary and lifestyle behaviors of 6th grade students with more educated parents compared to those with less educated parents. Methods: Data were taken from 6048 students in 41 schools involved in Project Healthy Schools (PHS), a middle school-based intervention program in Michigan. Students were divided into two groups based on their parents’ education levels, as selected in a health behavior survey given to the students. Students were included in the “More Educated” group if they had at least one parent with a college or Master’s/Professional degree. Students with neither parent having completed a college degree were classified as the “Less Educated” group. Students’ baseline survey responses to nutritional and lifestyle questions were compared using a Wilcoxon rank-sum test. Results: Students with more educated parents reported eating more fruits and vegetables per day, exercising more frequently, and spending less time in front of a screen. The more educated group were more likely to eat breakfast (0.70 vs. 0.53 on a 0-3 scale p<.0001), less likely to eat school lunch (1.11 vs 1.39 on a 0-2 scale; p<.0001), and less likely to have a TV in their bedroom (0.53 vs. 0.70 on a 0-1 scale; p<.0001). Conclusions: It was observed that students with more educated parents made healthier dietary choices, exercised more often, spent less time in front of screens, and participated more often in other healthy lifestyle choices. These observations may be partially attributed to higher income levels in more educated parents, which may increase students’ access to healthier resources; however, this study certainly highlights the importance of parental influence on a child’s health. Future efforts will encourage more parental involvement in Project Healthy Schools.
