Differences in Cardiovascular Disease Risk Factors and Health Behaviors Between Black and Non-Black Students Participating in a School-Based Health Promotion Program.

PURPOSE: To compare cardiovascular disease (CVD) risk factors of black and non-black children participating in Project Healthy Schools (PHS), a school-based wellness program. DESIGN: Participants were surveyed and participated in physiological screenings pre- and post-PHS intervention. SETTING: Middle schools in 4 Michigan communities of varying socioeconomic status. PARTICIPANTS: A total of 3813 sixth-grade students comprised the survey sample, and 2297 sixth-grade students comprised the screening sample. INTERVENTION: Project Healthy Schools is a school-based intervention designed to reduce the risk of obesity and CVD in children through the promotion of healthy eating and physical activity. MEASURES: Physical examination, blood test, and self-reported survey data on dietary habits, physical activity, and sedentary behaviors were collected pre- and post-PHS. ANALYSIS: Paired and independent t tests were used for physiologic variables. Wilcoxon sign-rank and rank-sum tests were used for survey variables. RESULTS: At baseline, blacks had a higher percentage of overweight/obese students (43% vs 34%; P < .0001) and demonstrated poorer health habits than non-blacks; however, non-blacks had poorer lipid profiles. At follow-up (post-PHS intervention), both groups demonstrated significant improvements in physiological measures and health behaviors. CONCLUSION: Despite disparities between the groups at both baseline and follow-up, changes seen post-PHS intervention were beneficial in both groups. These results suggest that early intervention for risk factor modification is possible and may be of great importance in the prevention of CVD, particularly in high-risk groups.

Changes in School Health Program Improve Middle School Students' Behaviors.

OBJECTIVE: The purpose of this study was to evaluate the effectiveness of environmental activities in a school-based health program among 6th grade students (N = 2315). METHODS: Students enrolled in Project Healthy Schools, a school-based health program designed to reduce childhood obesity and improve cardiovascular health, completed a health questionnaire on recent lifestyle choices including diet, physical activity, and sedentary behaviors. Baseline and follow-up data were compared between students who received educational lessons and students who received educational lessons and additional activities in the schools' environment. We calculated descriptive and one-way ANOVA statistics. RESULTS: Students at schools with educational lessons and environmental activities reported more fruit intake (p = .046), fewer sugary beverages (p = .054) and servings of fatty/sugary foods (p = .002), and more moderate physical activity (p = .009) compared to students with educational lessons only. No beneficial effect was observed in decreasing TV viewing time. Mobile device time increased in both groups. CONCLUSIONS: The present study suggests school-based health programs combining educational lessons and additional environmental activities may improve diet and physical activity in middle school children to a greater degree than educational lessons alone.

The Relationship between Childhood Obesity, Low Socioeconomic Status, and Race/Ethnicity: Lessons from Massachusetts.

BACKGROUND: Previous studies have shown race/ethnicity, particularly African American and/or Hispanic status, to be a predictor of overweight/obese status in children. However, these studies have failed to adjust for low socioeconomic status (SES). This study assessed whether race/ethnicity remained an independent predictor of childhood obesity when accounting for variations in SES (low-income) among communities in Massachusetts. METHODS: This study was based on 2009 summarized data from 68 Massachusetts school districts with 111,799 students in grades 1, 4, 7, and 10. We studied the relationship between the rate of overweight/obese students (mean = 0.32; range = 0.10-0.46), the rate of African American and Hispanic students (mean = 0.17; range = 0.00-0.90), and the rate of low-income students (mean = 0.27; range = 0.02-0.87) in two and three dimensions. The main effect of the race/ethnicity rate, the low-income rate, and their interaction on the overweight and obese rate was investigated by multiple regression modeling. RESULTS: Low-income was highly associated with overweight/obese status (p < 0.0001), whereas the effect of race/ethnicity (p = 0.27) and its interaction (p = 0.23) with low-income were not statistically significant. For every 1% increase in low-income, there was a 1.17% increase in overweight/obese status. This pattern was observed across all African American and Hispanic rates in the communities studied. CONCLUSIONS: Overweight/obese status was highly prevalent among Massachusetts students, varying from 10% to 46% across communities. Although there were higher rates of overweight/obese status among African American and Hispanic students, the relationship disappeared when controlling for family income. Our findings suggest low SES plays a more significant role in the nation's childhood obesity epidemic than race/ethnicity.