Independent Evaluation of Physical Activity and Nutrition Programs Reveal that Strong School-Based Interventions are Effective at Improving Health
OAKLAND, California, February 5, 2013 –For millions of students, teachers and staff, the school campus provides a setting for a whole host of activities centered around daily living, learning and working. The Institute of Medicine recently issued a call to strengthen schools as the “heart of health” in its 2012 report, “Accelerating Progress in Obesity Prevention.” That call to action has been further supported in recent findings announced this week from Kaiser Permanente showing that community-based health interventions focused in and around schools are proving to be an effective way of improving the overall health of communities.
Researchers examined a series of Kaiser Permanente community-based obesity prevention interventions in adults and children and found that the more effective obesity prevention interventions were those that were“high dose” – reaching large populations with greater strength – and those that focused particularly on changing child behaviors within the school environment.
Kaiser Permanente has been tracking the impact of obesity prevention efforts as part of its Community Health Initiatives to improve population health. The recent findings confirm that the high dose interventions in and around school settings can make positive, measurable impacts on health behaviors.
“These findings underscore what we’ve always known – that schools are a natural locus for focusing our prevention efforts and that we can change people’s behaviors when we make the healthy choice the easy choice,” explains Loel Solomon, PhD, vice president, Community Health, Kaiser Permanente. “One in five Kaiser Permanente members spends most of his or her day in a school, either as a student or as a teacher of staff member. These new results make a compelling case for us continuing our work in schools, and redoubling those efforts.”
Behavior changes for healthy eating and active living
Researchers from the Center for Community Health Evaluation looked at the results from three comprehensive community-based collaboratives in Northern California and funded by 5-year grants from Kaiser Permanente. The results, recently published in the American Journal of Health Promotion, showed children’s physical activity behaviors could be improved as a result of such health interventions as increasing active minutes during school physical education classes, increasing minutes of activity in after-school programs, and increasing walking and biking to school. Physical activity in children is shown to improve bone health, heart health, mental health and to support healthy weight.
Further findings from community initiatives in Colorado, not yet published, showed that changes made in the school cafeteria lunch menu to offer more fresh produce resulted in improvements in kids’ perception of healthy lunches and in kids eating more fruits and vegetables.
Researchers also tracked and evaluated the number of people reached by community interventions with the strength of those interventions. They found that the more people reached through various health promotion programs and the stronger the impact on each person reached, the more likely there was to be an observable difference in behavior at the population level. The strength of the impact might be measured by the frequency that a given intervention is employed, the intensity of exposure to a particular intervention, and/or any additional efforts that amplify and support that intervention.
“Kaiser Permanente and our partners have been at this work for a long time and it is exciting to see that we are having an impact!” explains Pamela Schwartz, MPH, director of program evaluation at Kaiser Permanente. “The concept of dose, in particular, has really galvanized our organization and served to clarify what we must do to have even greater impacts moving forward.”
Population dose provides a standard for comparing diverse community health projects and a way to measure interventions in aggregate. An article about the population dose findings was recently published in the American Journal of Evaluation.
“Community change is hard to do and even harder to measure,” explains Allen Cheadle, director of the Center for Community Health and Evaluation. “Our thinking around dose can enable public health leaders to better capture the impact that community health initiatives are having on community environments and individual behaviors.”
Kaiser Permanente’s Community Health Initiatives aim to increase healthy eating and active living in communities with Kaiser Permanente facilities. Active in over 40 communities, including 13 in California and 25 in Colorado, the program focuses on environmental and policy change, including work in neighborhoods, schools, workplaces and the health sector.
With school-based health interventions showing promising results in improving community health, Kaiser Permanente is making plans to expand its school health efforts in the coming months.[divider scroll_text=”SCROLL_TEXT”] Authors on the American Journal of Health Promotion paper on evaluation findings and lessons learned in Northern California communities include: Allen Cheadle, PhD; Suzanne Rauzon, MPH, RD; Rebecca Spring, MPH; Pamela M. Schwartz, MPH; Scott Gee, MD; Esmeralda Gonzalez, BS; Jodi Ravel, MPH; Coire Reilly, BA; Anthony Taylor, BA; Dana Williamson, MPH.
Authors on the American Journal of Evaluation paper on the dose evaluation methods include: Allen Cheadle, PhD; Pamela M. Schwartz, MPH; Suzanne Rauzon, MPH, RD; Emily Bourcier, MPH, MHA; Sandra Senter, MN, MPH; Rebecca Spring, MPH.