5-2-1-0 Goes to School: A Pilot Project Testing the Feasibility of Schools Adopting and Delivering Healthy Messages During the School Day

Abstract

OBJECTIVE. Our goal was to determine the feasibility of school staff voluntarily adopting strategies to deliver health-promotion messages to primary and middle school students during the school day.METHODS. During the 2006 -2007 school year, we provided a resource kit with strategies for promoting physical activity and healthy eating through use of the 5-2-1-0 message (encouraging Ն5 servings of fruits and vegetables daily, limiting screen time to Յ2 hours per day, promoting Ն1 hour of physical activity daily, and avoiding sugar-sweetened beverages) to 7 primary schools and 2 middle schools in southern Maine. Teachers and administrators voluntarily implemented resource-kit strategies in classrooms and schools. The resource kit included educational handouts that could be sent home to parents. Administrators, teachers, and parents were surveyed at the end of the school year to ascertain their level of awareness of the project, ease of implementation, and perceived usefulness of the resource kit. In small discussion groups with students, we assessed their level of awareness of and attitude toward the 5-2-1-0 message.RESULTS. Most administrators and teachers and half of the parents reported being more aware of the 5-2-1-0 message as a result of the project. Eighty percent of the teachers who reported using the resource kit found it easy or extremely easy to use. Ninety percent of the teachers reported that they would be willing to continue implementing strategies in the future; of those who would not, a lack of time was cited as the reason. All administrators reported that the project had been worthwhile for their district. Parents were less aware of the message than teachers and administrators; 2 in 5 parents reported receiving educational handouts. Most students responded positively to the messages.CONCLUSIONS. It is feasible for primary and middle schools to voluntarily deliver health-promotion messages during the school day through implementing strategies from the 5-2-1-0 resource kit. For school staff to fully implement the strategies, time constraints, both real and perceived, need to be addressed. Pediatrics 2009;123:S272-S276 D URING THE PAST 2 decades, the prevalence of obesity among children and adolescents in the United States has increased significantly. 1 Results from the 2003-2004 National Health and Nutrition Examination Survey indicated that 13.9% of children aged 2 to 5 years, 19% of children aged 6 to 11 years, and 17% of adolescents aged 12 to 19 years are at Ն95th percentile for BMI. 2 In Maine in 2002, 15.2% of kindergarteners were at Ն95th percentile for BMI, and 21.3% were between the 85th and 95th percentiles for BMI. 3 Among Maine high school students in 2007, 12.8% were at Ն95th percentile for BMI, and 13.1% were between the 85th and 95th percentiles for BMI. 4 There is evidence that overweight in children and associated comorbidities often persist into adulthood. 5,6 Medical problems associated with overweight include cardiovascular complications, type 2 diabetes, and psychosocial ...

Building Capacity for Childhood Obesity Prevention and Treatment in the Medical Community: Call to Action

“…20 Another group, which introduced the 5-2-1-0 (5 servings of fruit and vegetables per day, Ͻ2 hours of screen time per day, at least 1 hour of physical activity per day, and no sugarsweetened beverages) message to schools used surveys of parents and providers to evaluate their success. 49 Last, a group from the University of Washington collaborated with other organizations to educate providers. In addition to using chart review, the group required its clinic teams to maintain a patient registry that facilitated tracking data.…”

Relationship Between Adherence to Individual Goals Within the 5‐2‐1‐0 Guidelines for Obesity Prevention and Number of PACER Laps in Adolescents

“…18 The 5-2-1-0 messages state that children should eat at least 5 servings of fruits and vegetables per day, limit recreational screen time to less than 2 hours a day, engage in 1 hour of daily physical activity, and drink no sugary beverages. 18 …”

“…Program effectiveness, findings from initial studies show positive outcomes related to increased awareness of healthy habits among parents, increased prevalence of healthy habits among children, increased fruits and vegetables consumption, and decreased hours of screen time. 18,20,21 …”

“…Rogers and Motyka 18 revealed that only 0.4% of US adolescents met all 4 goals represented within 5-2-1-0 recommendations. BMI or skinfold test may be simple and good measurements to explain students’ health affected by adherence of 5-2-1-0 recommendations due to inexpensive and easy-to-perform method; 22 however, it has its limitations.…”

Responding to the Childhood Obesity Epidemic: From the Provider Visit to Health Care Policy—Steps the Health Care Sector Can Take

“…Several of the articles (Polacsek et al, 8 Oetzel et al, 9 Rogers and Motyka, 10 and Pomietto et al 11 ) are program reports that describe the programs and include some level of formative evaluation-experience in implementation, perception of "clients," and largely self-reported changes in clinician behaviors. Appropriate for this type of report, these articles provide information on context and illustrative data rather than abstract, independently assessed trial data.…”