Project FIT: A School, Community and Social Marketing Intervention Improves Healthy Eating Among Low-Income Elementary School Children

Abstract

Project FIT was a two-year multi-component nutrition and physical activity intervention delivered in ethnically-diverse low-income elementary schools in Grand Rapids, MI. This paper reports effects on children's nutrition outcomes and process evaluation of the school component. A quasi-experimental design was utilized. 3rd, 4th and 5th-grade students (Yr 1 baseline: N = 410; Yr 2 baseline: N = 405; age range: 7.5-12.6 years) were measured in the fall and spring over the two-year intervention. Ordinal logistic, mixed effect models and generalized estimating equations were fitted, and the robust standard errors were utilized. Primary outcomes favoring the intervention students were found regarding consumption of fruits, vegetables and whole grain bread during year 2. Process evaluation revealed that implementation of most intervention components increased during year 2. Project FIT resulted in small but beneficial effects on consumption of fruits, vegetables, and whole grain bread in ethnically diverse low-income elementary school children.

Evaluation of complex community‐based childhood obesity prevention interventions

“…Figure describes the search results – 33 interventions were entered into the data corpus as meeting all inclusion criteria. Each intervention took place across multiple community settings and focused on systems change to promote healthy behaviours at the individual level applying a range of study designs . The interventions were participatory in nature, with a foundational component built on community engagement, empowerment and capacity building.…”

Systematic review of control groups in nutrition education intervention research

“…Sessions focused on nutrition knowledge, skills, making healthy food choices. N  = 43 at posttestAttrition: Not reportedTreatment: None reportedKatz et al, 2011 [70] N  = 628 at baselineAttrition: Not reportedTreatment: 2nd to 4th grade children received 4 20-min Nutrition Detectives group sessions taught by physical education teachers using Powerpoint presentations and demonstrations, and hand-on activities about selecting healthy foods (minimally processed, nutrient dense, low in added sugars and trans-fat, and rich in desirable constituents, such as fiber) and a booster session 3 months later. N  = 552 at baselineAttrition: Not reportedTreatment: NoneKeihner et al, 2011 [96] N  = 703 at baseline; varied with measure at posttest highest n  = 698Attrition: 11%Treatment: 4th and 5th grade children received 10 50-min group Power Play sessions on nutrition and physical activity taught by trained teachers over 8 weeks using lesson plans, student workbooks, cookbooks, parent brochures, songs, posters, and stickers. Teachers completed tracking forms to document implementation. N  = 451 at baseline; varied with measure at posttest highest n  = 448Attrition:14%Treatment: NoneBackman et al, 2011 [67] N  = 186 at baseline; 156 at post-testAttrition:16%Treatment: Low-income African American women received 6 1-h group sessions, tailored to their culture, selected from the Toolbox of Tailored Educational Lessons to Improve F/v and Physical Activity Behaviors, handouts, and resource materials weekly for 6 weeks, taught by trained health educators; sessions included presentations, discussion, and problem solving; staff attended all sessions to ensure fidelity and quality of session delivery. N  = 199 at baseline; 171 post-testAttrition:14%Treatment: NoneRoofe et al, 2011 [97] N  = 79Attrition: Not reportedTreatment: Kindergarteners received 30-min nutrition lessons over a period of 1 month on My Pyramid, calcium, F/V, and nutritional health by trained college students; lesson consisted of a story, game, and coloring sheet to take home; printed parent education materials were provided. N  = 77Attrition: Not reportedTreatment: NoneMcCarthy et al, 2012 [98] N  = 613 completed at least pre or posttest; 454 completed both pre and posttest a Attrition: Not reportedTreatment: Low-income middle school children received face-to-face instruction using the Harvest of the Monthexposure-based nutrition education intervention that promotes F/V intake with monthly in-class F/V tasting activities, informational materials provided to teachers, parent newsletters, promotional posters and banners, related books in the school library, informative pages in the students’ day planners, and school bulletin announcements; program lasted 7 months. N  = 396 completed at least pre or posttest; 276 completed both pre and post-test a Attrition: Not reportedTreatment: NoneAlaimo et al, 2015 [69]Year 1: N  = 320 baseline, 281 posttest. Year 2: 367 baseline, 281 posttestAttrition: 12% (year 1), 23% (year 2)Treatment: 3rd, 4th, and 5th grade teachers were trained and encouraged to offer 20 h of classroom-based nutrition education per year to their students; teachers were given nutrition education resources/support including newsletter...…”

Nutrition for the Next Generation: Older Children and Adolescents

“…A recent systematic review reported that compliance to treatment and self-monitoring has been shown to improve with the use of this technology; however, the effect on outcomes such as BMI was limited [60]. A combination of various platforms such as schools, community, and media has been successful in implementing healthy dietary patterns in elementary-school children [61]. The combination of various settings can be proposed as one of the solutions to effectively address nutritional interventions in older children and adolescents.…”