Evaluation of phase I of the Action Schools! BC - Healthy Eating pilot




Day, Meghan E.

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Background: The incidence of childhood obesity and associated risk factors is increasing. Schools are an ideal vehicle for the delivery of obesity prevention programs for children and adolescents. Action Schools! BC - Healthy Eating is a school-based obesity prevention initiative that utilizes an innovative whole-school approach to target fruit and vegetable consumption. Objective: To assess the effectiveness of Action Schools! BC - Healthy Eating in affecting positive change in: 1) students' intake of fruit and vegetables, 2) students' knowledge, attitudes and perceptions regarding fruit and vegetables and 3) students' willingness to try new fruit and vegetables. Methods: Five schools that represented geographic, socioeconomic and size variation were recruited as Action Schools! BC - Healthy Eating intervention schools. A second set of five schools were selected as matched healthy eating usual practice schools. Student outcomes were measured at baseline and at 6-month follow-up using the following self report questionnaires: 1) 24-hour recall, 2) Food Frequency Questionnaire, 3) Knowledge, Attitudes and Perceptions Survey, and 4) Food Neophobia Scale for Children. Classroom logs and progress reports were used to assess implementation dose and fidelity. Intervention: Intervention schools established an Action Team and developed an individualized Action Plan addressing healthy eating goals across six Action Zones. Schools received the Action Schools! BC - Healthy Eating resources, a comprehensive training workshop, and ongoing facilitator support throughout the school year. Teachers were asked to implement school-wide activities and to deliver a minimum of 2 healthy eating activities and 1 tasting activity in the classroom per week. Results: Outcomes.- Usual practice schools had significantly higher servings of fruit (p=.0001), total servings of fruit and vegetables (p=.004), variety of fruit and vegetables eaten p = .020), and number of fruit and vegetables tried from a fixed list (p=.000I ) at baseline. There was also a significant difference in student ages between conditions at baseline (p=.0001). Significant differences between conditions over time while controlling for baseline levels were found for servings of fruit, total servings of fruit and vegetables, variety of fruit and vegetables eaten, and percent of fruit and vegetables tried from a fixed list. Number of total servings of fruit and vegetables increased (+.18) in Action Schools! BC - Healthy Eating schools while it decreased in the usual practice schools (-.79). Implementation Fidelity: Teachers implemented a mean of 64% of requested classroom dose, and school Action Teams implemented activities across 80% of the whole-school model. Conclusion: The Action Schools! BC model had a modest impact on fruit and vegetable intake, and appeared to be feasible. Due to a short intervention period, further implementation and evaluation are necessary to fully understand the effectiveness of this initiative.



childhood obesity, health education, nutrition, British Columbia