BOX 7-2

Selected School-Based Interventions

Child and Adolescent Trial for Cardiovascular Health (CATCH)—Designed as a health behavior intervention for the primary prevention of cardiovascular disease, CATCH was evaluated in a randomized field trial in 96 elementary schools in California, Louisiana, Minnesota, and Texas (Luepker et al., 1996).CATCH schools received school food service modifications and food service personnel training, physical education (PE) interventions and teacher training, and classroom curricula that addressed eating behaviors, physical activity, and smoking (Luepker et al., 1996). The primary individual outcome examined was change in serum cholesterol concentration; school-based outcomes were also examined.

Pathways—Designed to reduce obesity in American-Indian children in grades three through five, a randomized trial was conducted in 41 schools serving American-Indian communities in Arizona, New Mexico, and South Dakota (Caballero et al., 1998; Davis et al., 1999). This multicomponent program involved incorporation of high-energy activities in PE classes and recess; food service training and nutritional educational materials; classroom curricula enhancements; and family efforts including family fun nights, take-home action- and snack-packs, and family advisory councils. The primary outcome measure was the mean difference between intervention and control schools in percentage of body fat at the end of the fifth grade.

Planet Health—A curriculum-based health intervention, Planet Health lessons were integrated into the math, language arts, social studies, science, and PE curricula of grades six through eight. The lessons focus on teaching better dietary

ronmental interventions, which target reduced consumption of high-fat foods and greater intake of fruits and vegetables through variations in availability, pricing, and promotion in the school environment (Whitaker et al., 1993, 1994; Luepker et al., 1996; Caballero et al., 1998; Perry et al., 1998, 2004; Reynolds et al., 2000; French et al., 2001, 2004; French and Stables, 2003) may have a particularly significant independent effect on food choices (French et al., 2001; French and Stables, 2003). But their impacts are perhaps smaller in magnitude than when deployed as part of a multicomponent intervention program (Perry et al., 1998, 2004; French et al., 2001; French and Stables, 2003).

Because classroom education/behavioral skills curricula, for example, have typically been embedded in a multicomponent program, the effectiveness of this intervention component is difficult to evaluate as an isolated strategy. Furthermore, caution is needed in interpreting studies of self-reports of dietary intakes, which may be subject to reporting errors and bias.

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