Nicole Corriveau

Baystate Medical Center

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Kim A. Eagle

Michigan Medicine

Elizabeth A. Jackson

University of Alabama at Birmingham

Eva Kline‐Rogers

Michigan Medicine

Jean DuRussel‐Weston

Michigan Medicine

Caren S. Goldberg

University of Michigan–Ann Arbor

Roopa Gurm

Michigan Medicine

Susan Aaronson

Michigan Medicine

Taylor Eagle

University of Saskatchewan

Qingmei Jiang

Michigan Medicine

Robert F. Rogers

NOAA Atlantic Oceanographic and Meteorological Laboratories

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University of Michigan–Ann Arbor

Michigan Medicine

Rogers (United States)

Michigan United

University of Massachusetts Chan Medical School

Vall d'Hebron Hospital Universitari

Baystate Medical Center

Washington University in St. Louis

Massachusetts General Hospital

C. S. Mott Children's Hospital

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SustainedBenefitOverFour-YearFollow-UpofMichigan's ProjectHealthySchools

Nicole Corriveau Taylor Eagle Qingmei Jiang Robert F. Rogers Roopa Gurm

Objectives. We determined the sustainability of effects of a school-based intervention to improve health behaviors and cardiovascular risk factors among middle school children. Methods. We administered a questionnaire and health screenings to 5 schools in Ann Arbor and 2 schools in Ypsilanti, Michigan. We assessed demographics, physiological factors, diet, physical activity, and sedentary behaviors from 1126 students who received a health curriculum (Project Healthy Schools) in the fall of sixth grade in 2005, 2006, and 2007. We administered the questionnaire and screening again in the spring and each subsequent spring through ninth grade to all available, consenting students. Results. In the 4 years following the school-based intervention, total cholesterol, low-density lipoprotein cholesterol, and triglycerides improved, and for most years systolic and diastolic blood pressure improved. Serum glucose and body mass index did not change. Physical activity increased and sedentary behaviors diminished. Conclusions. Project Healthy Schools is associated with sustainable improvements in both cardiovascular parameters and healthy behaviors. (Am J Public Health. 2015;105:e19–e25. doi:10.2105/AJPH.2015.302835)

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Abstract P211: Response to a School-based Health Intervention in High- and Low-income Communities

Circulation (2014)

Robert F. Rogers Nicole Corriveau Alexander Lee Alexandra Pew Wen-Ching Wei

Introduction: Childhood obesity is associated with increased cardiovascular disease risk and is a major health issue in the United States. Previous studies show higher rates of obesity in low socioeconomic status (SES) communities. The efficacy of school-based interventions in these communities is not as well documented. Hypothesis: We hypothesized that low SES would be less healthy at baseline and show greater improvement than high SES. Methods: Project Healthy Schools (PHS) is a school-based intervention targeted at middle-school students in lower Michigan. We studied body mass index (BMI), blood pressure (BP), lipid profiles, resting and recovery heart rate (HR), and behavioral characteristics in 3147 middle-school students. Students were stratified into 2 groups: high SES and low SES. Ann Arbor (median family income=$53,377) students were included in the high SES cohort (n=1840) while Ypsilanti ($33,699) and Detroit ($27,862) were considered low SES (n=1307). Chi-square, Wilcoxon, and t-tests were conducted to compare baseline and baseline-to-follow-up data. Median household income was based on US Census Bureau data. Results: At baseline, those students in the low SES cohort performed significantly worse than the students in the high SES cohort in nearly every category, most notably: BMI, systolic and diastolic BP, resting and recovery HR, fried food consumption, exercise, and screen time. Upon follow-up, post-intervention examination, low SES improved recovery HR, screen time, fried meat and snacks, and sugary beverages significantly more than high SES. High SES improved fruit, BP, and total cholesterol significantly more than low SES. Conclusions: The PHS intervention was more efficacious in a number of categories in higher-risk, low SES communities. This suggests a need for the implementation of similar school-based programs in low SES areas.

10.1161/circ.129.suppl_1.p211

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Abstract 144B: Racial Differences in Physiological and Behavioral Response to School Based Wellness Program

Circulation Cardiovascular Quality and Outcomes (2012)

Taylor A. Jamerson Roopa Gurm Cydni Smith Nicole Corriveau Eva Kline‐Rogers

Background: Racial differences in cardiovascular (CV) risk factors have been shown to exist in children. However, much of this data was obtained decades ago in a rural cohort of children in Bogalusa, LA. Given the growing epidemic of childhood obesity, we sought to examine CV risk factors in black and non-black 6 th grade students prior to and seven months after implementation of a school-based wellness program targeting both inner city and suburban children in Southeast Michigan. Methods: Data from 1,979 middle-school students enrolled in Project Healthy Schools (PHS) were used to compare health behaviors and physiologic markers including lipids, blood pressure (BP), and BMI. PHS is designed to promote physical activity, consumption of fruits and vegetables, decrease consumption of fast/fatty foods and leisure screen time and encourage healthier beverage choices. Pre/post assessments included surveys of diet and physical activity. A Mann-Whitney, non-parametric test was used to compare the differences. Results: Among the 1,979, 504 (25.5%) were black. At baseline, % overweight/obese was significantly different between blacks and non-blacks (39.9% vs. 33.0%, p=0.003. Blacks had poorer diets and were less active than non-blacks (p< 0.001). BP and low-density lipoprotein (LDL) cholesterol were similar, while high-density lipoprotein (HDL) was higher in blacks (55 mg/dL vs. 52 in non-blacks) (p=0.004), and triglycerides were higher in non-blacks (92 vs.122 mg/dL) (p<0.001). Seven months after PHS was initiated, blacks improved their diets and physical activity more (p< 0.02). Blacks had a significant decrease in LDL cholesterol (10 mg/dL vs. 1) (p<0.001) whereas non-blacks had significant reduction in triglycerides (3 vs. 16 mg/dL) (p=0.041). Conclusion: Black 6 th grade students show higher rates of obesity, poor dietary habits, and less physical activity at baseline. This data suggests that school-based wellness programs such as PHS can improve dietary, physical behavior and cholesterol profile. Early intervention for risk factor modification is not only possible but may be of great importance to the prevention of CV disease in adults, particularly in high risk groups like blacks.

10.1161/circoutcomes.5.suppl_1.a144b

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SPINAL CORD ISCHEMIA IN SURGICALLY TREATED ACUTE AORTIC DISSECTION: WHO'S AT RISK?

Journal of the American College of Cardiology (2011)

Anton Camaj Santi Trimarchi Daniel Montgomery Elise M. Woznicki Christoph A. Neinauber

10.1016/s0735-1097(11)61523-4

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JOHN RITTER SYNDROME – ACUTE TYPE A DISSECTION CAUSING ACUTE MYOCARDIAL INFARCTION: INSIGHTS FROM THE INTERNATIONAL REGISTRY OF ACUTE AORTIC DISSECTION (IRAD)

Journal of the American College of Cardiology (2012)

Lindsay Hagan Kevin L. Greason Artur Evangelista Masip Daniel Montgomery Patrick O apos Gara

10.1016/s0735-1097(12)61902-0

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Abstract 143: Behavioral Factors as Predictors of Poor Cardiovascular Health in Middle-School Students: Results from Project Healthy Schools (PHS)

Circulation Cardiovascular Quality and Outcomes (2013)

Michelle March Ashley Stasiak Anne Jones Rachel Sylvester Nicole Corriveau

Cardiovascular Health

10.1161/circoutcomes.6.suppl_1.a143

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Abstract 17505: The Relationship Between Childhood Obesity, Low Socioeconomic Status, and Race/ Ethnicity

Circulation (2013)

Taylor Eagle Qingmei Jiang Anne Sheetz Alan C. Woodward Robert Leibowitz

Introduction: Previous studies have shown race/ethnicity, particularly African American and/or Hispanic status, to be a predictor of overweight/obese status in children. However, these studies have...

Race and health

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RESPONSE TO A SCHOOL-BASED WELLNESS INTERVENTION PROGRAM IN FOUR COMMUNITIES WITH DIFFERING RESOURCES

Journal of the American College of Cardiology (2012)

Sathish Mohan Roopa Gum Nicole Corriveau Taylor Eagle Eva Kline‐Rogers

10.1016/s0735-1097(12)61853-1

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IMMEDIATE IMPACT OF A 10-WEEK MIDDLE SCHOOL INTERVENTION TO IMPROVE HEALTH BEHAVIORS AND REDUCE CARDIOVASCULAR RISK FACTORS – PROJECT HEALTHY SCHOOLS IN MICHIGAN

Journal of the American College of Cardiology (2012)

Taylor Eagle Roopa Gurm Cydni Smith Nicole Corriveau Jean DuRussel‐Weston

10.1016/s0735-1097(12)61798-7

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Sustainable Practices Within a School‐Based Intervention: A Report from Project Healthy Schools

World Medical & Health Policy (2012)

Sathish Mohan Cydni Smith Nicole Corriveau Eva Kline‐Rogers Elizabeth A. Jackson

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.

10.1002/wmh3.6

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Citations (4)