A Middle School Intervention to Improve Health Behaviors and Reduce Cardiac Risk Factors

Study Questions:

What is the impact of Project Healthy Schools, a 10-week school-based multidisciplinary intervention program in which sixth-grade middle school students are exposed to healthful activity and nutrition habits through educational and environmental change?

Methods:

This was a prospective study of sixth-grade students from 23 middle schools in 12 cities in southeast and mid-Michigan with varying populations. The students served as historical controls in this 10-week program. The educational component of the program was delivered through 10 interactive, 20-minute long learning modules addressing the following five goals: 1) increasing intake of fruits and vegetables, 2) decreasing intake of high-sugar beverages, 3) performing at least 150 minutes of exercise per week, 4) decreasing intake of fast and fatty food, and 5) decreasing “screen” time with television and computer/video games. Learning modules were taught by advisory (or “homeroom”) teachers or Health Ambassadors. Environmental change involved significant modifications in the school cafeteria (e.g., addition of a salad bar). Health behaviors were assessed before and after participation through responses on the modified School-Based Nutrition Monitoring behavioral questionnaire. The authors also collected physiologic data before the 10-week program and again 1-3 months after program completion, collected data included body mass index, systolic and diastolic blood pressures, cholesterol panel, and random blood glucose.

Results:

A total of 2,118 students consented to complete the surveys and physiologic screening. Following participation in Project Healthy Schools, self-reported participation in moderate and vigorous exercise activities and consumption of fruits and vegetables increased; self-reported “screen” time also showed small, statistically significant reductions (2.27 hours per day at baseline vs. 2.08 hours per day at follow-up, p < 0.001). Program participants also had statistically significant reductions in total cholesterol, low-density lipoprotein cholesterol, triglycerides, and blood pressure at follow-up.

Conclusions:

Project Health Schools, a collaborative, customizable, and multidisciplinary middle-school intervention aimed at promoting healthy behaviors, led to significant reductions in cardiovascular risk factors.

Perspective:

Children with cardiovascular risk factors are at risk for becoming adults with cardiovascular disease. Accordingly, it is crucial to address obesity and risk factors at a young age. The authors presented promising results from a well-orchestrated school-based program that could be more broadly implemented to promote healthy habits among middle-school children.

Clinical Topics: Diabetes and Cardiometabolic Disease, Dyslipidemia, Prevention, Hypertriglyceridemia, Lipid Metabolism, Nonstatins, Exercise

Keywords: Students, Michigan, Cholesterol, LDL, Exercise, Beverages, Health Behavior, Goals, Television, Video Games, Cholesterol, Fruit, Body Mass Index, Vegetables, Blood Glucose, Schools, Obesity, Questionnaires, Triglycerides


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