title: Impact of a school-based interdisciplinary intervention on diet and physical activity among urban primary school children: eat well and keep moving.
abstract: OBJECTIVE
  To evaluate the impact of a school-based interdisciplinary health behavior intervention on diet and physical activity among children in grades 4 and 5.
  
  
  METHODS
  A quasiexperimental field trial with 6 intervention and 8 matched control schools. Outcomes were assessed longitudinally using preintervention (fall 1995) and follow-up (spring 1997) student survey food frequency and activity measures and follow-up 24-hour recall measures of diet and activity. Change was also assessed using yearly repeated cross-sectional surveys of all grade 5 students from 1995 through 1997.
  
  
  METHODS
  Longitudinal data were collected from 479 students initially in grade 4 in Baltimore, Md, public schools; 91% were African American. Repeated 24-hour recall measures in 1997 were collected for a random subsample of 336 students. Cross-sectional survey data were collected from all grade 5 students in 1995,1996, and 1997 (n = 2103).
  
  
  METHODS
  The Eat Well and Keep Moving Program was taught by classroom teachers over 2 years in math, science, language arts, and social studies classes. Materials provided links to school food services and families and provided training and wellness programs for teachers and other staff members. Intervention materials focused on decreasing consumption of foods high in total and saturated fat and increasing fruit and vegetable intake, as well as reducing television viewing and increasing physical activity.
  
  
  METHODS
  Dietary intake and physical activity measured via repeated 24-hour recall were primary end points, with additional food frequency and activity measures.
  
  
  RESULTS
  The 24-hour recall measures indicated that, after controlling for baseline covariates, the percentages of total energy from fat and saturated fat were reduced among students in intervention compared with control schools (-1.4%; 95% confidence interval [CI], -2.8 to -0.04; P = .04 and -0.60%; 95% CI, -1.2 to -0.01; P = .05). There was an increase in fruit and vegetable intake (0.36 servings/4184 kJ; 95% CI, 0.10-0.62; P=.01), in vitamin C intake (8.8 mg/4184 kJ; 95% CI, 2.0-16; P=.01), and in fiber consumption (0.7 g/4184 kJ; 95% CI, 0.0-1.4; P=.05). Television viewing was marginally reduced (-0.55 h/d; 95% CI, -1.04 to 0.04; P=.06). Analysis of longitudinal and repeated cross-sectional food frequency data indicated similar significant decreases in the percentages of total energy from fat and saturated fat.
  
  
  CONCLUSIONS
  Evaluation of the Eat Well and Keep Moving Program indicates effectiveness in improving dietary intake of students and reducing television viewing.
authors.affiliation: Department of Health and Social Behavior, Harvard School of Public Health, Boston, Mass. 02115, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Gortmaker
authors.forename: L W
authors.initials: LW
authors.lastname: Cheung
authors.forename: K E
authors.initials: KE
authors.lastname: Peterson
authors.forename: G
authors.initials: G
authors.lastname: Chomitz
authors.forename: J H
authors.initials: JH
authors.lastname: Cradle
authors.forename: H
authors.initials: H
authors.lastname: Dart
authors.forename: M K
authors.initials: MK
authors.lastname: Fox
authors.forename: R B
authors.initials: RB
authors.lastname: Bullock
authors.forename: A M
authors.initials: AM
authors.lastname: Sobol
authors.forename: G
authors.initials: G
authors.lastname: Colditz
authors.forename: A E
authors.initials: AE
authors.lastname: Field
authors.forename: N
authors.initials: N
authors.lastname: Laird
mesh_terms: D015142:Baltimore; D002648:Child; D003430:Cross-Sectional Studies; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012044:Regression Analysis; D012572:School Health Services