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Prevention of the Epidemic Increase in Child Risk of Overweight in Low-Income Schools
The El Paso Coordinated Approach to Child Health
Karen J. Coleman, PhD;
Claire Lola Tiller, MA;
Jesus Sanchez, BS;
Edward M. Heath, PhD;
Oumar Sy, MS;
George Milliken, PhD;
David A. Dzewaltowski, PhD
Arch Pediatr Adolesc Med. 2005;159:217-224.
Objective To assess the impact on children’s health of translating an evidence-based national intervention trial (Child and Adolescent Trial for Cardiovascular Health [CATCH]) to low-income elementary schools with primarily Hispanic students.
Design An untreated, matched control group design with repeated dependent pretest and posttest samples was used.
Setting Four El Paso CATCH and 4 control elementary schools in El Paso, Tex, along the US-Mexico border region. All had Title I status (most were low-income students).
Participants Participants were 896 third-grade children (473 control schools [224 girls and 249 boys] and 423 CATCH schools [199 girls and 224 boys]); 93% were Hispanic.
Intervention Community-based implementation of the national CATCH program.
Main Outcome Measures Risk of overweight or overweight, body mass index, waist-to-hip ratio, yards run in 9 minutes, passing rates for Fitnessgram national mile standards, moderate to vigorous physical activity and vigorous physical activity in physical education class, and percentage of fat and sodium in school lunches.
Results Girls in control schools had significant increases in percentage of risk of overweight or overweight from third (26%) to fifth (39%) grades, as did girls in CATCH schools (30%-32%); however, the rate of increase for girls in the CATCH schools was significantly lower (2%) compared with the rate for control girls (13%). A similar pattern was seen for boys, with a rate of increase for boys in CATCH schools of 1% (40%-41%), which was significantly less than the 9% increase (40% to 49%) for control boys.
Conclusions The translation of the national CATCH program to low-income schools with Hispanic students successfully slowed the epidemic increase in risk of overweight or overweight seen in control school children. An emphasis should be placed on community organizing and evaluation feedback when implementing evidence-based school health programs in low-income Hispanic communities.
Author Affiliations: Graduate School of Public Health, San Diego State University, San Diego, Calif (Dr Coleman); Psychology Department, University of Texas at El Paso (Ms Tiller and Mr Sanchez); Department of Health, Physical Education, and Recreation, Utah State University, Logan (Dr Heath); and Community Health Institute (Mr Sy and Drs Milliken and Dzewaltowski) and Department of Statistics (Mr Sy and Dr Milliken), Kansas State University, Manhattan.
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