Impact of a school-based interdisciplinary intervention on diet and physical activity among urban primary school children - Eat well and keep moving

Objective: To evaluate the impact of a school-based interdisciplinary healt h behavior intervention on diet and physical activity among children in gra des 4 and 5. Design: A quasiexperimental field trial with 6 intervention and 8 matched c ontrol schools. Outcomes were assessed longitudinally using preintervention (fall 1995) and follow-up (spring 1997) student survey food frequency and activity measures and follow-up 24-hour recall measures of diet and activit y. Change was also assessed using yearly repeated cross-sectional surveys o f all grade 5 students from 1995 through 1997. Participants: Longitudinal data were collected from 479 students initially in grade 4 in Baltimore, Md, public schools; 91% were African American. Rep eated 24-hour recall measures in 1997 were collected for a random subsample of 336 students. Cross-sectional survey data were collected from all grade 5 students in 1995, 1996, and 1997 (n = 2103). Intervention: The Eat Well and Keep Moving Program was taught by classroom teachers over 2 years in math, science, language arts, and social studies c lasses. Materials provided links to school food sen ices and families and p rovided training and wellness programs for teachers and other staff members . intervention materials focused on decreasing consumption of foods high in total and saturated fat and increasing fruit and vegetable intake, as well as reducing television viewing and increasing physical activity. Main Outcome Measures: Dietary intake and physical activity measured via re peated 24-hour recall were primary end points, with additional food frequen cy and activity measures. Results: The 24-hour recall measures indicated that, after controlling for baseline covariates, the percentages of total energy from fat and saturated fat were reduced among students in intervention compared with control scho ols (-1.4%; 95% confidence interval [CI], -2.8 to -0.04; P = .04 and -0.60% ; 95% CI, -1.2 to -0.01; P = .05). There was an increase in fruit and veget able intake (0.36 servings/4184 kJ; 95% CI, 0.10-0.62; P = .01), in vitamin C intake (8.8 mg/4184 kJ; 95% CI, 2.0-16; P = .01), and in fiber consumpti on (0.7 g/4184 kJ; 95% CI, 0.0-1.4; P = .05). Television viewing was margin ally reduced (-0.55 h/d; 95% CI, -1.04 to 0.04; P = .06). Analysis of longi tudinal and repeated cross-sectional food frequency data indicated similar significant decreases in the percentages of total energy from fat and satur ated fat. Conclusion: Evaluation of the Eat Well and Keep Moving Program indicates ef fectiveness in improving dietary intake of students and reducing television viewing.