PATHWAYS - A SCHOOL-BASED PROGRAM FOR THE PRIMARY PREVENTION OF OBESITY IN AMERICAN-INDIAN CHILDREN

This report describes the proposed intervention and outcome measuremen t procedures for the Pathways study. Pathways is a multicenter school- based study aimed at reducing the alarming increase in the prevalence of obesity in American Indian children. It is designed as a randomized clinical trial, involving approximately 2,000 third grade children in 40 schools in seven different American Indian communities. During a 3 -year feasibility phase, which was just completed, the major component s of the intervention (school food service, classroom curriculum, phys ical education program, and family involvement) were developed and pil ot-tested. The measurement instruments for body composition; physical activity; dietary intake; and knowledge, attitudes, and behavior were also developed and validated. Comprehensive process evaluation procedu res also were defined. As of this writing, the full-scale intervention program is being initiated and is scheduled to be completed in the sp ring of 2000. The primary aim of the Pathways intervention is to reduc e average percent body fat in intervention-school children by at least 3% compared with control-school children by the end of the 3-year int ervention. This goal is to be achieved primarily by an increase in phy sical activity and a reduction in the percent of dietary fat intake. T he program does not seek to seduce dietary energy intake. Rather, it i s based on the assumption that a healthier, lower-fat diet, combined w ith an increase in energy expenditure by increased physical activity, will result in fewer excess calories deposited as body fat. (J. Nutr. Biochem. 9:535-543, 1998) (C) Elsevier Science Inc. 1998.