As the rates of childhood obesity and related health consequences increase, researchers have been interested in how nutrition education curricula and wellness policy implementation change students’ eating and physical activity behaviors. Yet, there has been little research to compare curriculum and wellness policy individually versus when both are implemented together. This was the study design for the Food, Health & Choices trial.
The Food Health & Choices intervention used social cognitive theory and self-determination theory as its foundation. It had two components:
- Wellness Policy:includes guidelines for healthy foods to be provided in classrooms for snacks and celebrations as well as “Dance Breaks," an activity where students danced to videos during the school day
- Classroom Curriculum:students received 23 lessons that taught nutrition concepts through inquiry-based science explorations. Lessons encouraged students to choose more fruits and vegetables and choose less sweetened beverages, fast foods, and processed packaged snacks such as candy and chips. Students were also encouraged to choose more physical activity and choose less television and video games.
Twenty schools participated in the outcome evaluation conducted during the 2012-13 school year. Schools were placed in one of four groups: a) Wellness Policy only; b) Classroom Curriculum only, c) Both Wellness Policy and Classroom Curriculum, and d) delayed control (received standard science curriculum the intervention year, but received the “Both” condition the year after the intervention). Pre- and post- intervention, we assessed students’ heights, weights, percent body fat, eating and physical activity-related behaviors, and theory-based mediators of behavior change.
Related Publications:
Koch P, Contento IR, Gray HL, Burfermaster M, Bandellli LN, Abrams E, DiNoia J. Food, Health, & Choices: Curriculum and Wellness Interventions to Decrease Childhood Obesity in Fifth-Graders. Journal of Nutrition Education and Behavior. 2019;51(4):440-455
Burgermaster M, Contento IR, Koch P, Mamykina L. Behavior Change is Not One Size Fits All: Psychosocial Phenotypes of Childhood Obesity Prevention Intervention Participants. Translational Behavioral Medicine. 2018;8(5):799-807
Burgermaster M, Gray HL, Tipton E, Contento IR, Koch P. Testing an Integrated Model of Program Implementation: the Food, Health & Choices School-Based Childhood Obesity Prevention Intervention Process Evaluation. Prevention Science. 2017;18:71-82.
Burgermaster M, Koroly J, Contento IR, Koch P, Gray HL. A Mixed-Methods Comparison of Classroom Context During Food, Health & Choices, a Childhood Obesity Prevention Intervention. Journal of School Health. 2017;87(11):811-822.
Bandelli LN, Gray HL, Paul RC, Contento IR, Koch P. Associations Among Measures of Energy Balance Related Behaviors and Psychosocial Determinants in Urban Upper Elementary School Children. Appetite. 2017;108:171-182
Graziose M, Koch P, Wang YC, Gray HL, Contento IR. Cost-effectiveness of a Nutrition Education Curriculum Intervention in Elementary Schools. Journal of Nutrition Education and Behavior. 2017;49(8):684-691.
Gray HL, Burgermaster M, Tipton E, Contento IR, Koch P, DiNoia J. Intraclass Correlation Coefficients for Obesity Indicators and Energy Balance–Related Behaviors Among New York City Public Elementary Schools. Health Education & Behavior. 2016;43(2):172-181.
Gray HL, Koch P, Contento IR, Bandelli LN, Ang YI, DiNoia J. Validity and Reliability of Behavior and Theory-Based Psychosocial Determinants Measures, Using Audience Response System Technology in Urban Upper-Elementary Schoolchildren. Journal of Nutrition Education and Behavior. 2016;48(7):437-452
Related Abstracts:
Koch P, Lee H, Contento IR, Graziose M, Burgersmaster M, DiNoia J. Food, Health & Choices (FHC): A Retrospective Evaluation of Changes in Energy Balance Related Behaviors (EBRBs). Journal of Nutrition Education and Behavior. 2014;46(4 supplement):S147.
Abrams E, Koch P, Contento IR, Mull L, Lee H, DiNoia J, Burgermaster M. Food, Health & Choices: Using the DESIGN Stepwise Procedure to Develop a Childhood Obesity Prevention Program. Journal of Nutrition Education and Behavior. 2013;45(4 supplement):S13-S14.
Lee H, Mull L, Abrams E, Contento IR, Koch P, DiNoia J, Gallagher D. Food, Health & Choices: Understanding Body Fatness in Urban Elementary School Youth. Journal of Education and Behavior. 2013;45(4 supplement):S59-S60.
Lee H, Mull L, Contento IR, Abrams E, Koch P, DiNoia J. Food Health & Choices: Understanding Relationships Among Food and Activity Behaviors and Theory-Based Mediators. Journal of Nutrition Education and Behavior. 2013;45(4 supplement):S60.
Mull L, Koch P, Abrams E, Contento IR, Lee H. Food, Health & Choices: Development and implementation a classroom wellness intervention “Positively Healthful Classrooms”. Journal of Nutrition Education and Behavior. 2013;45(4 supplement):S60-S61
Lee H, Koch P, Contento IR, DiNoia J, Mull L, Abrams E. Food, Health & Choices: Validation of an Audience Response System (ARS)-delivered food and activity questionnaire for youth. Journal of Nutrition Education and Behavior. 2013;45(4 supplement):S59
Funding for this study was from a United States Department of Agriculture (USDA), Agriculture Food Research Initiative (AFRI) Grant.