Multi-Level, Multi-Sector, School-Based Obesity Prevention

¶ … Multi-level, Multi-sector, School-based Obesity Prevention Programming Improves Weight, Blood Pressure, and Academic Performance, Especially among Low-Income, Minority Children

This research project conducted by Hollar et. al (2010) assesses the effectiveness of multiple interventions in addressing childhood onset obesity. The authors describe the project, Healthier Options for Public School Children/Organ Wise Guys (HOPS/OWG), as a quasi-experimental pilot study as being designed to keep children at normal, healthy weight, and improve health status and academic performance. The study involved five elementary schools in Florida, four intervention schools and one control school, and 3,769 subjects. It was conducted over a two-year period from 2004 to 2006.

The HOPS/OWG interventions included (1) modified dietary offering, (2) nutritional / lifestyle education, (3) a physical activity component, and wellness projects. Data collected over the course of the study included demographic, anthropometric (body mass index [BMI]), blood pressure, and academic progress. The authors concluded that "holistic school-based obesity interventions can improve health outcomes and academic performance in particular among high risk populations" (Hollar et.al 2010 p. 93-94).

Discussion

Thought the study incorporated a large number of research subjects it was limited by geography, involving just one school district in Florida, and only one control school. Extended periods of time out of school, such as holidays and summer vacation, compromised study control over eating and physical activity, making consistent implementation of interventions impossible.

Another factor compromising the quality of collected data is the inconsistency in calibration of blood pressure measuring equipment and the variation of expertise of the technicians collecting this data. Poor equipment and/or inaccurate readings in one location may have skewed the data, rendering comparisons with other locations meaningless.

Furthermore, the nutritional and healthy lifestyle curriculum and physical activity components did not gather information with regards to intervention exposure. This compromise's the assessment of its effectiveness in comparison to the curriculum received in the control school as part of the regular education program.

A number of additional factors may have led to the academic gains of the students. Under the current provisions of No Child Left Behind (NCLB) all schools are required to maintain continuous improvement in all academic areas in order to meet state and federal standards. Knowing that students in minority and low socio-economic groups have in the past traditionally scored lower on state adopted achievement tests, most school districts allot extra time and resources to improve their test scores. Furthermore, variation in teacher competencies from facility to facility and even year to year may also compromise accurate assessment of the effectiveness of the interventions in this area.

Conclusion

Many factors contribute to obesity including activity levels, diet, genetic, metabolic, environmental, social, economic, psychological, behavioral and biological. According to Martin et.al (2009) inactivity and poor diet are the two most important contributing factors to excessive weight gain. In order to successfully decrease the prevalence of childhood obesity, community and family-based intervention programs that include the promotion of physical activity, parent training/modeling, behavioral counseling, and nutritional education are necessary. Children learn eating and physical activity behavior primarily from their parents and siblings. For a number of reasons parental and family involvement is essential for successful obesity intervention. Obesity tends to run in families, and attempting to intervene with only one family member while the others are exhibiting contradictory behaviors is unrealistic. Parental behaviors that enable overeating and inactivity are detrimental. Furthermore, parental support in changing a child's behaviors may be fundamental to a successful intervention. For these reasons the reliability of this study, as well as the outlook for long-term success in changing eating and activity behaviors without total family and school support are questionable.