Title: D.C. School Nutrition Program Works to Stem the Obesity Trend
Author:
Section/SPIG: School Health Education and Services
Issue Date:
Research studies and health statistics continue to underscore the link between obesity in both children and adults and the onset of many serious and chronic health conditions, such as heart disease and diabetes. With the problem reaching what some call epidemic proportions, state and local jurisdictions have been challenged to look for cost-effective and innovative ways to introduce more nutrition and physical education into already beleaguered school systems. But in the nation’s capital, where in 2003, 16.8 percent of students were at risk of becoming overweight and 13.5 percent were already overweight, help has come through what some might consider an unlikely source: the city’s free health insurance program, D.C. Healthy Families (DCHF).
An existing Memorandum of Understanding between DCHF and the D.C. Public School System paved the way for the insurance program to extend its commitment from getting families insured, to promoting healthy lifestyles among the city’s youth. The goal: to develop a sustainable, replicable and culturally competent school-based health program that would positively influence students’ perceptions about nutrition and physical activity and increase the proportion of D.C. youth engaged in healthy behaviors. The program would target adolescents as the budding consumer, both increasingly independent and choice-conscious. School system professionals worked on their end to identify the most appropriate middle and junior high schools that benefit from this intervention most.
In the development phase, focus groups with seventh and eighth grade students and their parents were held to assess their existing attitudes, opinions, and beliefs about nutrition and physical activity, as well as their habits. Program planners also discovered an existing curriculum designed by the United States Department of Agriculture (USDA), specifically for adolescents, called Team Nutrition. Findings from the focus groups were used to tailor the Team Nutrition curriculum to better fit D.C. youth, and what resulted was the Fit For A Lifetime: School Nutrition Program, a social marketing approach to helping adolescents adopt healthier lifestyles.
It was important, however, that the curriculum complement the standards of learning set forth by the school system through the use of reading, mathematic, analytical, and verbal skills. A Team Nutrition educational kit and other age-appropriate and culturally specific materials were used to meet this requirement. The materials were intended to assist seventh and eighth grade students in learning to make healthy food and physical activity choices. For instructors, the program employed graduate students enrolled in local universities studying in health-related fields. Each completed a mandatory four-day training session and was responsible for lesson plan delivery, activity development, and classroom evaluation.
The initiative finally launched in March 2002, during National Nutrition Month. Now, three years later, DCHF staff are training science teachers to deliver the curriculum themselves, in their own classrooms. Currently, the initiative is in 20 schools throughout the District. DCHF has enjoyed support from many partners along the way, such as the WIC Food Stamp Nutrition Education Program and local grocery store chain, Safeway Food Stores, Inc., which have made possible numerous classroom activities, field trips and food demonstrations. Additionally, each year students compete for the Presidential Active Lifestyle Award, through the Presidents Council on Physical Fitness and Sports, and receive pedometers and award certificates/badges as incentives. To date, 4,500 seventh and eighth grade students have participated in the Fit For A Lifetime school nutrition program.
Students are assessed on their nutrition-related knowledge and behaviors and their self-reported level of physical activity prior to the intervention and afterward through the use of pre- and post-tests. Overall, year after year, participating schools have shown significant increases in scores – an average of 11 percent -- from pre- to post-test. Moreover, student awareness has continued to increase in all five assessment categories, with the highest student performance in general nutrition knowledge and self-reported physical activity levels.
Schools provide a great opportunity to enhance the future health and well-being of children. They offer continual regular contact with children and opportunities for nutrition education and promotion of physical activity both within the formal curriculum and informally through a supportive school and community environments. School-based healthy eating and physical activity programs can reach almost all children and may enhance learning and provide social benefits, enhance health during critical periods of growth and maturation, lower the risk for chronic diseases in adulthood, and help to establish healthy behaviors at an early age that will lead to life-long healthy habits.
Currently there is limited quality data on the effectiveness of obesity prevention programs, and few trials have investigated school-based primary prevention programs directed at obesity. This evaluation has shown that risk factors for obesity can be successfully aimed at and implemented in D.C. middle and junior high public schools and that change can be achieved in the school environment and in children’s knowledge base with relatively few additional resources. A broader implementation of and investment in school-based health initiatives has a high potential to reduce childhood obesity and, in the longer term, comorbid conditions and health care spending.
Note: D.C. Healthy Families is funded by the District of Columbia and the federal government, and is administered by the D.C. Department of Health, Medical Assistance Administration and Department of Human Services, Income Maintenance Administration through its outreach contractor, Houston Associates, Inc.
Additional Resources:
CDC Reports and Guidelines for Overweight and Obesity
http://www.cdc.gov/health/obesity.htm
Dietary Guidelines for Americans
http://www.health.gov/dietaryguidelines
5-A-DAY for Better Health
National Cancer Institute
http://dccps.nci.nih.gov/5aday/
Healthy People 2010 Initiative
http://www.health.gov/healthypeople
Nutrition.gov
http://www.nutrition.gov
Physical Activity and Health: A Report of the Surgeon General
http://www.cdc.gov/nccdphp/sgr/sgr.htm
President’s Council on Physical Fitness and Sports
http://www.fitness.gov
Promoting Better Health for Young People Through Physical Activity and Sports
http://www.cdc.gov/nccdphp/dash/presphysactrpt/index.htm
Team Nutrition
USDA Food and Nutrition Service
Child Nutrition Division
http://www.fns.usda.gov/cnd