Evaluation of a community-based participatory physical activity promotion project: effect on cardiovascular disease risk profiles of school employees.

BACKGROUND: The efficacy of physical activity in improving cardiovascular disease (CVD) risk profiles has been well established. However, the effectiveness of health promotion programs implemented at the community level remains controversial. This study evaluated a school-based work-site physical activity program. METHODS: Using a community-based participatory research model, a work-site wellness intervention was implemented in a rural public school system in Southwestern Oklahoma. During the 2005-2006 school year, 187 participants (mean age 45 years) completed a pre intervention screening for CVD risk factors followed by a physical activity promotion program. Post intervention screening was conducted after a 6 month period. During both screening sessions, body composition, blood pressure, lipids, glucose and self-reported physical activity levels were assessed. The focus of the intervention was on promoting physical activity. Opportunities for in school physical activity were created by marking hallways, adding a treadmill in each school, and allowing teachers to use planning periods for physical activity. RESULTS: During the post intervention screening, compared to pre intervention levels, participants had lower total, low, and high density lipoprotein-cholesterol (t = 5.9, p < 0.0001, t = 2.6, p = 0.01, and t = 13.2, p < 0.0001 respectively), lower systolic blood pressure (t = 2.9, p = 0.004), and higher self-reported physical activity levels (Sign t = -1.901, p = 0.06). CONCLUSIONS: A successful participatory program was associated with improvements in several CVD risk factors among school employees. Limitations of this study such as seasonal variation in the outcome variables and lack of a control group limit our ability to draw solid conclusions about the effectiveness of the intervention.

The Healthy Adults Project in rural Oklahoma.

CONTEXT: Screening to identify individuals at risk for cardiovascular disease is sorely needed in rural areas of Oklahoma. OBJECTIVE: The Healthy Adults Project was started as a screening program for public school employees in a rural school district in southwest Oklahoma. DESIGN, SETTING, AND PARTICIPANTS: The screening project is a collaborative effort between the Anadarko Public School district and the University of Oklahoma Prevention Research Center. Two hundred twenty-four (224) employees participated in the screening in 2004, and 206 employees participated in 2005. FINDINGS: Approximately 50% of females and 80% of males had two or more modifiable risk factors for cardiovascular disease in 2004 and 2005. CONCLUSIONS: Worksite screening is a valuable tool to raise awareness of risk factors for cardiovascular disease, particularly in less densely populated areas where wages are low and few preventive services are available. Knowledge of individual risk is the first step in improving health outcomes.

Blood pressure screening of school children in a multiracial school district: the Healthy Kids Project.

BACKGROUND: There are few studies of the prevalence of elevated blood pressure (BP) that include American Indian school children. Therefore, the intent of this study was to examine the relationships between BP and risk factors in a multiracial, predominantly American Indian, school district. METHODS: A total of 1,829 American Indian, white, Hispanic, and African American students, 5-17 years old, were included in this study. The mean of two BP measurements, taken at the initial screening with an electronic BP monitor, were categorized as normal, prehypertensive, or hypertensive using the 2004 Fourth Report BP screening recommendations. Prevalence of prehypertensive and hypertensive BP measurements by race, gender, age, and body mass index (BMI) were determined, and their associations analyzed with logistic regression. RESULTS: The prevalence of prehypertensive measurements was 16.7% and prevalence of hypertensive measurements was 13.8% at first screen. Obesity was a risk factor for elevated BP for females and males (adjusted odds ratio (OR) = 4.01 and 4.33, respectively). Older age was also significantly associated with prehypertensive and hypertensive BP measurements, especially among males (adjusted OR = 6.91). Among females, American Indian race was protective against elevated BP (adjusted OR = 0.61). CONCLUSIONS: Obesity was consistently associated with an increased risk for elevated BP. American Indian race was associated with decreased risk of elevated BP measurements in females. The high prevalence of obesity-related hypertensive measurements in this population that includes American Indian children was similar to levels found in other multiracial populations of school children when using BP measurements from a single assessment.

Overweight and obesity in an ethnically diverse rural school district: the Healthy Kids Project.

OBJECTIVE: Data on Native American children and adolescents are rarely reported along with other racial and ethnic groups. The Healthy Kids Project is part of an effort to describe the prevalence of overweight and obesity in a racially mixed rural area where Native American, Hispanic, African American, and white children reside. METHODS AND PROCEDURES: We measured height and weight of students in Anadarko, Oklahoma public schools (n = 1,980) in 2002-2003. All available students (95.7%) whose parents had not opted out of school health assessments were included. From these data, we calculated BMI (weight (kg) / height (m(2))) and used the International Obesity Task Force reference to classify children into BMI categories. RESULTS: Native American, Hispanic, African American, and white children who live and attend school in the same surroundings are at risk of overweight and obesity. White children had the lowest combined prevalence of overweight and obesity (37.6%), and Native American children had the highest (53.8%) followed closely by African American (51.7%) and Hispanic children (50.5%). DISCUSSION: The childhood obesity epidemic includes all racial and ethnic groups to different degrees. In a rural public school, Native American, Hispanic, and African children had higher rates of overweight/obesity than white children.