Measurement of obesity prevention in childcare settings: A systematic review of current instruments.

OBJECTIVE: The incidence of childhood obesity is highest among children entering kindergarten. Overweight and obesity in early childhood track through adulthood. Programs increasingly target children in early life for obesity prevention. However, the published literature lacks a review on tools available for measuring behaviour and environmental level change in child care. The objective is to describe measurement tools currently in use in evaluating obesity-prevention in preschool-aged children. METHODS: Literature searches were conducted in PubMed using the keywords "early childhood obesity," "early childhood measurement," "early childhood nutrition" and "early childhood physical activity." Inclusion criteria included a discussion of: (1) obesity prevention, risk assessment or treatment in children ages 1-5 years; and (2) measurement of nutrition or physical activity. RESULTS: One hundred thirty-four publications were selected for analysis. Data on measurement tools, population and outcomes were abstracted into tables. Tables are divided by individual and environmental level measures and further divided into physical activity, diet and physical health outcomes. Recommendations are made for weighing advantages and disadvantages of tools. CONCLUSION: Despite rising numbers of interventions targeting obesity-prevention and treatment in preschool-aged children, there is no consensus for which tools represent a gold standard or threshold of accuracy.

Addressing the needs of the whole child: what public health can do to answer the education sector's call for a stronger partnership.

Although the overall level of child health in the United States remains high, public health professionals know that racial and ethnic disparities in child and adolescent health persist and that lifestyle choices related to chronic disease in adults are often established in childhood and adolescence. And yet, those health needs are not the public health sector's alone to resolve. We have natural partners among educators. Improving graduation rates is one of the most cost-effective ways to reduce health disparities. This article provides strategies for how public health professionals can answer this call by educators to address the needs of the whole child.

Evaluation of the National School Health Coordinator Leadership Institute.

In 1999 the American Cancer Society (ACS) launched the National School Health Coordinator Leadership Institute, a groundbreaking initiative designed to enhance and invigorate school health in the nation's schools by training individual school health coordinators to act as change agents. The Institute consisted of three, week-long summer training sessions, and three, shorter midyear "booster" sessions, with the various sessions designed to assist one cohort of participants (n = 50) to build leadership capacities to coordinate school health. This evaluation examined the effects of the Institute as measured through a panel survey of participants - school health coordinators or their equivalents - over an 18-month period. Findings suggest that substantial progress was made in institutionalizing the school health coordination function in the target school districts. Specifically, in contrast to when the training began, clear, written position descriptions are common among program participants, most have functioning school health councils in their school districts, and program trainees appear to be moving aggressively to enhance the infrastructure for school health coordination through planning, setting priorities, and assessing needs. Program trainees report spending increased time on school health coordination, and they are active in spreading the word about coordinated school health programs. Trainees viewed the Institute as relevant to their needs, though not all aspects of the program are viewed as equally useful. As possible shortcomings, the training needed more emphasis on funding for school health coordination, and a low level of evaluation skills existed among coordinators.

The relationship between school health councils and school health policies and programs in US schools.

This study analyzed data from the School Health Policies and Programs Study (SHPPS) 2000 to examine the relationship between school health councils and selected school health policies and programs. SHPPS 2000 collected data from faculty and staff in a nationally representative sample of schools. About two-thirds (65.7%) of US schools have school health councils. Schools with councils were significantly more likely than schools without councils to report policies and programs related to health services, mental health and social services, faculty and staff health promotion, and family and community involvement. Schools with councils were as likely as schools without councils to report policies and programs related to health education, physical education, and food service. Although school health councils are associated with the presence of some key school health policies and programs, a council does not guarantee a school will have all important school health policies and programs in place.