Food, Health, & Choices: Curriculum and Wellness Interventions to Decrease Childhood Obesity in Fifth-Graders

Pamela Ann Koch, Isobel R. Contento, Heewon L. Gray, Marissa Burgermaster, Lorraine Bandelli, Emily Abrams, Jennifer Di Noia

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate Food, Health, & Choices, two 10-month interventions. Design: Cluster-randomized, controlled study with 4 groups: curriculum, wellness, curriculum plus wellness, and control. Setting: Twenty elementary schools (5/group) in New York City. Participants: Fifth-grade students (n = 1,159). At baseline, 44.6% were at the ≥85th body mass index (BMI) percentile for age and 86% qualified for free or reduced-price lunch. Intervention: Curriculum was 23 science lessons based on social cognitive and self-determination theories, replacing 2 mandated units. Wellness was classroom food policy and physical activity bouts of Dance Breaks. Main Outcome Measures: For obesity, age- and sex-specific BMI percentiles were used (anthropometric measures). The researchers also employed 6 energy balance-related behaviors and 8 theory-based determinants of behavior change (by questionnaire). Analysis: Pairwise adjusted odds in hierarchical logistic regression models were determined for >85th BMI percentile. Behaviors and theory-based determinants were examined in a 2-level hierarchical linear model with a 2 × 2 design for intervention effects and interactions. Results: Obesity showed no change. For behaviors, there was a negative curriculum intervention change in physical activity (P =.04). The wellness intervention resulted in positive changes for sweetened beverages frequency (P =.05) and size (P =.006); processed packaged snacks size (P =.01); candy frequency (P =.04); baked good frequency (P =.05); and fast food frequency (P =.003), size (P =.01), and combo meals (P =.002). Theory-based determinants demonstrated no change. Conclusions and Implications: The findings of the lack of a decrease in obesity, behavior changes only for the wellness intervention, and no changes in theory-based determinants warrant further research.

Original languageEnglish (US)
Pages (from-to)440-455
Number of pages16
JournalJournal of Nutrition Education and Behavior
Volume51
Issue number4
DOIs
StatePublished - Apr 1 2019

Fingerprint

Pediatric Obesity
Curriculum
Food
Health
Body Mass Index
Obesity
Logistic Models
Dancing
Exercise
Candy
Fast Foods
Nutrition Policy
Lunch
Snacks
Personal Autonomy
Beverages
Meals
Linear Models
Research Personnel
Outcome Assessment (Health Care)

Keywords

  • elementary school
  • nutrition education curriculum
  • obesity prevention
  • school-based
  • wellness policy

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Food, Health, & Choices : Curriculum and Wellness Interventions to Decrease Childhood Obesity in Fifth-Graders. / Koch, Pamela Ann; Contento, Isobel R.; Gray, Heewon L.; Burgermaster, Marissa; Bandelli, Lorraine; Abrams, Emily; Di Noia, Jennifer.

In: Journal of Nutrition Education and Behavior, Vol. 51, No. 4, 01.04.2019, p. 440-455.

Research output: Contribution to journalArticle

Koch, Pamela Ann ; Contento, Isobel R. ; Gray, Heewon L. ; Burgermaster, Marissa ; Bandelli, Lorraine ; Abrams, Emily ; Di Noia, Jennifer. / Food, Health, & Choices : Curriculum and Wellness Interventions to Decrease Childhood Obesity in Fifth-Graders. In: Journal of Nutrition Education and Behavior. 2019 ; Vol. 51, No. 4. pp. 440-455.
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