Nicole Naadu Ofosu, John Paul Ekwaru, Kerry Ann Bastian, Sarah A Loehr, Kate Storey, John C Spence, Paul J Veugelers
Long-term effects of comprehensive school health on health-related knowledge, attitudes, self-efficacy, health behaviours and weight status of adolescents
BMC public health
schools play role addressing childhood obesity implementing healthy eating physical activity strategies primary aim case study describe prevalence overweight obesity among elementary school students rural midwestern community 2006 2012 secondary aim use novel approach called population dose retrospectively evaluate impact dose strategy implemented estimated potential population level impact changes overweight obesity weight height directly measured annually beginning january 2006 assess weight status using bmi kgm2 kindergarten fifthgrade students n 2400 per year multiple evidencebased strategies implemented nine schools increase physical activity healthy eating behaviors bmi reporting revised school meal programs implemented districtwide comprehensive school physical activity programs school food environment supportivepromotional strategies implemented individual schools absolute change prevalence obesity bmi 95th percentile decreased 164 139 indicating 152 relative change prevalence obesity 6 years inverse relationship number strategies implemented prevalence overweight obesity time district schoollevel approaches potential impact childhood obesity schools successfully implement strategies address overweight obesity extent implementation schools may vary population dose analysis used estimate impact clusters strategies address overweightobesity