A School-Based Intervention Using Health Mentors to Address Childhood Obesity by Strengthening School Wellness Policy

Abstract

Purpose and ObjectivesThe objective of our study was to strengthen wellness policy in Title 1 schools by implementing a mentored behavior-change model that extends the continuum of care from academic to community settings and mobilizes existing public resources in accordance with US Preventive Services Task Force screening guidelines for childhood obesity management.Intervention ApproachTeam Kid POWER! (KiPOW!) health mentors (students and trainees in medical and health-related fields) in 2 geographically and demographically distinct school districts, the District of Columbia and Orange County, California, delivered standardized health curricular modules to fifth grade classrooms, modeled healthy eating behaviors during school lunchtime, and engaged in active play at recess.Evaluation MethodsInitial interventions in the the District of Columbia and Orange County delivered 10 sessions in which all participants received the intervention. Two subsequent interventions in Orange County, for 5 weeks (Lite) and 10 weeks (Full), included controls. Pre–post measurements of body mass index (BMI) and blood pressure were documented in all participants. A mixed linear regression model, which included a random effect for each school, estimated differences between Full and Lite interventions compared with controls, adjusting for site, sex, and baseline status of the dependent variable.ResultsKiPOW! Full, but not KiPOW! Lite, was associated with a modest reduction in BMI percentile compared with control (KiPOW! Full, P = .04; KiPOW! Lite, P = .41), especially in Orange County (P < .001). Systolic blood pressure improved in Full (P < .046) more than in Lite interventions (P = .11), and diastolic blood pressure improved in both Full (P = .02) and Lite (P = .03) interventions. Annual renewal of the school and volunteer commitment needed to maintain KiPOW! was found to be sustainable.Implications for Public HealthKiPOW! is a generalizable academic–community partnership promoting face-to-face contact between students and trusted health mentors to reinforce school wellness policies and foster youth confidence in decision-making about nutrition- and activity-related behaviors to achieve reduced BMI percentile and lowered blood pressure.

Describing South Carolina Public School Administrators' Perceptions and Experiences Related to School‐Based Interventions and Strategies to Promote Healthy Physical Activity and Eating Behaviors: A Qualitative Study

“…Many barriers and facilitators to school‐based healthy PA and eating interventions and strategies identified by participants aligned with findings from previous studies 18‐51 . However, participants shared perspectives that are valuable to minimize barriers and maximize facilitators.…”

“…A semistructured interview guide was developed based on a literature review, 18‐51 the SEM, 56‐60 and the first two steps of the 6SQuID Model 61,62 . Questions addressed the following areas: (1) demographic information, (2) schools' roles in students' weight‐related health and concerns or experiences with weight‐related terminology or stigma, and (3) experiences with school‐based healthy PA and eating interventions and strategies with associated barriers and facilitators.…”

“…Thematic analysis of interview transcripts was conducted to discover patterns within the data 27,32,66,67 . A codebook with a priori codes was developed based on a literature review, 18‐51 the SEM, 56‐60 and the first two steps of the 6SQuID Model 61,62 . Emergent codes were added during Level 2 coding.…”

“…Recent studies explored the barriers and facilitators to school‐based healthy PA and eating interventions and strategies in primary and elementary schools from the viewpoints of students, school personnel, family members, and community stakeholders 18‐51 . However, there are literature gaps on system‐wide barriers and facilitators regarding these types of school‐based programs from the perspectives of public school administrators at all academic levels.…”

Survey of South Carolina Public School Personnel Perspectives on Barriers and Facilitators to Regular Physical Activity and Healthy Eating Behaviors in Schools

“…Recent studies examined elements affecting the implementation of school‐based interventions addressing regular PA and healthy eating behaviors in primary and elementary schools 19‐52 . Information is warranted on the barriers and facilitators to these interventions from the perspectives of school personnel at secondary schools as well.…”