A public health vs a risk-based intervention to improve cardiovascular health in elementary school children: the Cardiovascular Health in Children Study

• Published in: American journal of public health (1971) 1999-10, Vol.89 (10), p.1529-1535
• Main Authors: Harrell, J S, McMurray, R G, Gansky, S A, Bangdiwala, S I, Bradley, C B
• Format: Article
• Language: English
• Subjects: Age; Analysis of Variance; Biological and medical sciences; Blood pressure; Body fat; Body mass index; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - prevention & control; Child; Children & youth; Cholesterol; Classrooms; Elementary schools; Exercise; Health care; Health Promotion - methods; Heart; Humans; Intervention; Knowledge; Medical sciences; Multivariate Analysis; North Carolina; Nutrition; Obesity; Physical fitness; Prevention and actions; Program Evaluation; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Questionnaires; Regression Analysis; Risk Factors; School Health Services; Smoking; Specific populations (family, woman, child, elderly...); Students; Studies; Teachers; Trends; USA; Variables
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.89.10.1529

This study sought to determine the population effects of both classroom-based and risk-based interventions designed to reduce cardiovascular disease risk factors in children. Elementary school children (n = 2109; age range: 7-12 years) were randomized by school to a classroom-based intervention for all third and fourth graders, a risk-based intervention only for those with 1 or more cardiovascular disease risk factors, or a control group. The 8-week interventions involved both knowledge--attitude and physical activity components. School-level analyses showed that physical activity in the risk-based group and posttest knowledge in the classroom-based group were significantly higher than in the control group. With regard to trends shown by individual-level analyses, cholesterol dropped more in the classroom-based than in the control group, and skinfold thickness decreased 2.9% in the classroom-based group and 3.2% in the risk-based group (as compared with a 1.1% increase in the control group). Both classroom-based and risk-based interventions had positive effects on physical activity and knowledge, with trends toward reduced body fat and cholesterol. However, the classroom-based approach was easier to implement and evidenced stronger results than the risk-based intervention.