al., 2001; Puska et al., 2002). This study, being long-term and multifocal, may be the best model for childhood obesity prevention efforts.

MHHP’s Class of 1989 Study provides some insights into the potential impact of community-based programs focused on children and youth (Kelder et al., 1993, 1995). This study examined changes in nutrition and aerobic activity among groups of students, starting when they were sixth-graders and extending through 12th grade. Interventions included a school-based curriculum and a number of other community-based approaches that were not designed specifically for children (including labeling of heart-healthful restaurant and grocery store items; media campaigns; and screening for heart disease risk factors). Positive changes were seen in the young people’s levels of physical activity and their nutritional knowledge and decision-making.

Community campaigns aimed at preventing tobacco use by children and youth also provide evidence of the feasibility of using this approach for addressing major public health problems. The Midwestern Prevention Project, the North Karelia Youth Project, and MHHP’s Class of 1989 Study each found reductions in youth smoking rates that were maintained over time (IOM, 1994). It should be stressed that each of these studies had a strong school-based prevention intervention that complemented a community-wide program, and isolating the effects of the community-wide program was not possible.

Community programs for children and youth. Programs involving specific community-based organizations have also been found to aid health promotion efforts. Studies with civic, faith-based, and social organizations have established the feasibility of developing programs in a variety of settings that can be effective in improving nutritional knowledge and choices, increasing physical activity, and in some cases in reducing body weight or

BOX 6-1

Girls on the Run

Girls on the Run is a nonprofit organization that works with local volunteers and community-level councils to encourage preteen girls to develop self-respect and healthful lifestyles through running (Girls on the Run, 2004). A 12-week, 24-lesson curriculum has been developed for use in after-school programs and at recreation centers and other locations. Evaluation of the program has found improvements in participants’ self-esteem, body-size satisfaction, and eating attitudes and behaviors (DeBate, 2002).

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