Choice, Control & Change (C3) Middle-school Obesity Prevention Intervention | Teachers College Columbia University

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Laurie M. Tisch Center for Food, Education & Policy

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Choice, Control & Change (C3) Middle-school Obesity Prevention Intervention

As the levels of childhood obesity increased through the 1990s and 2000s, researchers began to develop and evaluate school-based interventions aimed at changing behaviors that would decrease obesity rates. The Choice, Control & Change trial was developed to determine if a standards-based curriculum could be effective at changing students’ “energy balance related behaviors” (i.e. food and physical activity behaviors) to ultimately decrease obesity risk. The curriculum served as a replacement for a required 7th grade science unit on “dynamic equilibrium."

C3 is a 20-lesson theory-based curriculum that utilizes both social cognitive theory and self-determination theory. The inquiry-based science lessons explore key questions such as, “How can we use scientific evidence to help us maintain energy balance?” Students participate in activities such as measuring out teaspoons of sugar in common sweetened beverages and then assessing how sugar can build up in our blood causing type two diabetes if we take in too many total calories and do not engage in enough physical activity. Students also set personal goals and monitor their progress attaining their goals, discussing triumphs and challenges and working together to increase confidence and success.

The C3 trial took place during the 2006-2007 school year and involved 10 New York City middle schools, matched in pairs that were similar in terms of ethnicity/race of students, percent of students who qualified for free or reduced price lunch, and academic achievement levels of students. One school in each pair was randomly assigned to receive C3 and the other to receive the standard science curriculum on dynamic equilibrium. The students who received C3 got around 30 total sessions (many lessons took multiple sessions to complete) over 3 months. Students who received C3 reported drinking fewer sweetened beverages, eating fewer snacks such as chips, candy, and packaged baked goods, and eating healthier options at fast food restaurants. They also increased walking for exercise and decreased recreational screen-time.

During the dissemination phase in 2007-09 the curriculum was taught in several sites in Michigan, in Hayward, CA, and in Philadelphia, PA, and an implementation trial in Michigan showed similar results to the NYC trial.

Choice, Control & Change: Using Science to Make Food and Activity Decisions is the third book of the LiFE curriculum series. The development, evaluation, and dissemination of Choice, Control & Change was funded by a National Institutes of Health Science Education Partnership Award and extra online resources were funded by a stimulus grant.

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