The objective of this study was to compare the impact of two intervention approaches on the prevalence of child overweight and obesity: (i) Coordinated Approach To Child Health BasicPlus (CATCH BP), in which schools were provided evidence-based coordinated school health program training, materials, and facilitator support visits, and (ii) CATCH BP and Community (BPC), in which BP schools received additional promotion of community partnerships with the aim of integrating community members and organizations into schools, local decision making and action, and best practices workshops. Schools (n = 97) in four central Texas districts were recruited to participate in the 4-year project. Of the low-income schools (n = 58), 15 schools were selected to receive the BPC intervention and matched with 15 schools in the BP condition. A serial cross-sectional design was used, in which 4th grade student BMI, physical activity, and diet were assessed in the 30 schools in spring 2007 and 2008. Measurements in spring 2007 included 1,107 students, with 53% female; 61% Hispanic, and 14% African American; and mean age of 9.9 years. Adjusted prevalence of overweight/obesity (≥85th percentile) was 42.0 and 47.4% in spring 2007 for the BP and BPC students, respectively. From spring 2007 to spring 2008, the percent of students classified as overweight/obese decreased by 1.3 percentage points (P = 0.33) in BP schools, compared to a decrease of 8.3 percentage points (P < 0.005) in students from BPC schools; the difference between conditions was significant (P = 0.05). CATCH BPC students also reported more positive trends in related behaviors. Implementation of a community-enhanced school program can be effective in reducing the prevalence of child overweight in low-income student populations.obeSity | VOLUME 18 SUPPLEMENT 1 | FEBRUARY 2010 S37

Weight perceptions and weight control behaviors have been documented with underweight and overweight adolescents, yet limited information is available on normal weight adolescents. This study investigates the prevalence of overweight misperceptions and weight control behaviors among normal weight adolescents in the U.S. by sociodemographic and geographic characteristics. We examined data from the 2003 Youth Risk Behavior Survey (YRBS). A total of 9,714 normal weight U.S. high school students were included in this study. Outcome measures included self-reported height and weight measurements, overweight misperceptions, and weight control behaviors. Weighted prevalence estimates and odds ratios were computed. There were 16.2% of normal weight students who perceived themselves as overweight. Females (25.3%) were more likely to perceive themselves as overweight than males (6.7%) (p < 0.05). Misperceptions of overweight were highest among white (18.3%) and Hispanic students (15.2%) and lowest among black students (5.8%). Females (16.8%) outnumbered males (6.8%) in practicing at least one unhealthy weight control behavior (use of diet pills, laxatives, and fasting) in the past 30 days. The percentage of students who practiced at least one weight control behavior was similar by ethnicity. There were no significant differences in overweight misperception and weight control behaviors by grade level, geographic region, or metropolitan status. A significant portion of normal weight adolescents misperceive themselves as overweight and are engaging in unhealthy weight control behaviors. These data suggest that obesity prevention programs should address weight misperceptions and the harmful effects of unhealthy weight control methods even among normal weight adolescents.

No abstract

In 2001, the 77 th Texas legislature passed Senate Bill 19 (SB19) requiring elementary school children in publicly funded schools to participate in physical activity (PA) and schools to implement a coordinated school health program (CSHP) by September 1, 2007. We report on awareness of and adherence to SB19 in a statewide sample of elementary schools and a subsample in two public health regions located along the Texas/Mexico border. Statewide, structured interviews with principals indicated high awareness of SB19's requirements, but lower awareness of the need for parental involvement. Only 43% of Texas schools had adopted their coordinated program at one year or less prior to implementation deadline. Principals reported an average of 179 minutes of PE per week, higher than the 135 minute mandate. Among subsample border schools, principal PA reports triangulated with teacher logs and student reports. Further, direct observation of PE indicated 50% of class time was spent in MVPA, meeting the recommended level of PA intensity defined by Healthy People 2010. Differences observed by public health NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript regions included: greater PA minutes in Region 10 (231 minutes compared to 217 minutes in Region 11), higher adoption CSHP (92% compared to 75%), more school health advisory committees (SHAC) (58% vs. 38%) and school-level SHACs (83% compared to 25%), and a lower prevalence of obesity in fourth grade students (21% compared to 32%). Differences by region suggest SB19 is not being adhered to equally across the state, and some regions may require further support to increase implementation. Results underscore the importance of continued monitoring of enacted legislation, that school-based legislation for child health requires funding and refinement to produce the original intent of the law.

Background: Despite the importance of social support in promoting physical activity, little is known about the relative influence of the type or source of social support on adolescent girls' physical activity and sedentary behaviors. This study examined the associations of two types of social support (social participation in and social encouragement for physical activity) and two social support sources (family and friends) with self-reported daily minutes of physical activity and sedentary behavior among sixth-grade girls in Texas.

Findings mirror regional variations previously observed in adult PA. We need to understand factors that contribute to lower PA in youth living in the South and in urban settings.

Purpose-In 2005, the Texas state legislature passed Senate Bill 42 (SB42) that required public middle school students (grades 6-8) to participate in 30 minutes of daily structured physical activity. The purpose of this study was to assess awareness of and adherence to SB42 in Texas middle schools, and to assess the impact of SB42 on the frequency and quality of structured physical activity.Methods-Key informant (school principals, physical education [PE] instructors, nurses, or designated personnel) telephone interviews on the implementation of SB42 were conducted from a statewide representative sample of public middle schools (n=112). Direct observation, key informant, and student report of physical activity in PE classes at 17 Texas-Mexico border middle schools assessed the frequency and quality of structured physical activity.Results-State level (94% ± 4.5%) and border district (94% ± 13.5%) key informants reported a high level of overall awareness of SB42. Post-implementation of SB42 border districts reported a minimum of four days per week of PE instruction and >58 minutes per PE class, exceeding the 30 minute minimum of structured physical activity per day or 135 minutes per week as required by SB42 Conclusions-Implementation of SB42 appears to have impacted the frequency of school PE in Texas and the prevalence of child self-reported physical activity behaviors along the Texas-Mexico border. General awareness of and adherence to SB42 was high in both statewide and among the border districts. Our mixed findings on adherence to specific components of the legislation suggest the need for further investigation of the factors that both facilitate and inhibit local leadership around school policy and the mechanisms to ensure the school policy is being implemented.

Objectives: From 2017 to 2018, electronic cigarette (e-cigarette) use increased 78% among high school students and 48% among middle school students in the United States. However, few e-cigarette prevention interventions have been evaluated. We determined the feasibility and initial effectiveness of “CATCH My Breath,” an e-cigarette prevention program, among a sample of middle schools in central Texas. Methods: Twelve middle schools in Texas (6 intervention schools and 6 control schools) participated in the CATCH My Breath pilot program during 2016-2017. CATCH My Breath is rooted in social cognitive theory, consists of 4 interactive in-class modules, and is collaboratively administered via classroom and physical education teachers, student–peer leaders, and social messaging (eg, school posters). We collected 3 waves of data: baseline (January 2017), 4-month follow-up (May 2017), and 16-month follow-up (May 2018). Using school as the unit of analysis, we tested a repeated cross-sectional, condition-by-time interaction on e-cigarette ever use, psychosocial determinants of use, and other tobacco use behaviors. Analyses controlled for school-level sociodemographic characteristics (eg, sex, race/ethnicity, and percentage of students eligible for free or reduced-price lunch). Results: From baseline to 16-month follow-up, increases in ever e-cigarette use prevalence were significantly lower among intervention schools (2.8%-4.9%) than among control schools (2.7%-8.9%), controlling for covariates ( P = .01). Intervention schools also had significantly greater improvements in e-cigarette knowledge (β = 0.71; 95% confidence interval [CI], 0.21-1.21; P = .008) and perceived positive outcomes (β = –0.12; 95% CI, –0.23 to –0.02; P = .02) than control schools, controlling for covariates from baseline to 16-month follow-up. Conclusion: Ever e-cigarette use was lower among middle schools that implemented the CATCH My Breath program than among those that did not. Replication of findings among a larger sample of schools, using a group-randomized, longitudinal study design and a longer follow-up period, is needed.