Pathways: a school-based, randomized controlled trial for the prevention of obesity in American Indian schoolchildren
- 1 November 2003
- journal article
- clinical trial
- Published by Elsevier BV in The American Journal of Clinical Nutrition
- Vol. 78 (5), 1030-1038
- https://doi.org/10.1093/ajcn/78.5.1030
Abstract
Background: Childhood obesity is a major public health problem in the United States, particularly among American Indian communities. Objective: The objective was to evaluate the effectiveness of a school-based, multicomponent intervention for reducing percentage body fat in American Indian schoolchildren. Design: This study was a randomized, controlled, school-based trial involving 1704 children in 41 schools and was conducted over 3 consecutive years, from 3rd to 5th grades, in schools serving American Indian communities in Arizona, New Mexico, and South Dakota. The intervention had 4 components: 1) change in dietary intake, 2) increase in physical activity, 3) a classroom curriculum focused on healthy eating and lifestyle, and 4) a family-involvement program. The main outcome was percentage body fat; other outcomes included dietary intake, physical activity, and knowledge, attitudes, and behaviors. Results: The intervention resulted in no significant reduction in percentage body fat. However, a significant reduction in the percentage of energy from fat was observed in the intervention schools. Total energy intake (by 24-h dietary recall) was significantly reduced in the intervention schools but energy intake (by direct observation) was not. Motion sensor data showed similar activity levels in both the intervention and control schools. Several components of knowledge, attitudes, and behaviors were also positively and significantly changed by the intervention. Conclusions: These results document the feasibility of implementing a multicomponent program for obesity prevention in elementary schools serving American Indian communities. The program produced significant positive changes in fat intake and in food- and health-related knowledge and behaviors. More intense or longer interventions may be needed to significantly reduce adiposity in this population.Keywords
This publication has 34 references indexed in Scilit:
- Estimation of body fat from anthropometry and bioelectrical impedance in Native American childrenInternational Journal of Obesity, 2000
- Prevalence of overweight and obesity in American Indian school children and adolescents in the Aberdeen area: A population studyInternational Journal of Obesity, 1999
- Pathways: a school-based program for the primary prevention of obesity in american indian childrenThe Journal of Nutritional Biochemistry, 1998
- Use of Ethnographic Methods for Applied Research on Diabetes Among the Ojibway-Cree in Northern OntarioHealth Education Quarterly, 1996
- Nutrition and Physical Activity Program to Attenuate Obesity and Promote Physical and Metabolic Fitness in Elementary School ChildrenObesity Research, 1996
- Effects of decreasing sedentary behavior and increasing activity on weight change in obese children.Health Psychology, 1995
- Height, weight, and body mass index of American Indian schoolchildren, 1990–1991Journal of the American Dietetic Association, 1993
- Project SPARKAnnals of the New York Academy of Sciences, 1993
- School‐Based Cardiovascular Health Promotion: The Child and Adolescent Trial for Cardiovascular Health (CATCH)Journal of School Health, 1990
- Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty.Archives of Disease in Childhood, 1976