title: A public health vs a risk-based intervention to improve cardiovascular health in elementary school children: the Cardiovascular Health in Children Study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Nursing, University of North Carolina at Chapel Hill 27599-7460, USA. ioannesh@email.unc.edu
authors.forename: J S
authors.initials: JS
authors.lastname: Harrell
authors.forename: R G
authors.initials: RG
authors.lastname: McMurray
authors.forename: S A
authors.initials: SA
authors.lastname: Gansky
authors.forename: S I
authors.initials: SI
authors.lastname: Bangdiwala
authors.forename: C B
authors.initials: CB
authors.lastname: Bradley
mesh_terms: D000704:Analysis of Variance; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002648:Child; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D015999:Multivariate Analysis; D009657:North Carolina; D015397:Program Evaluation; D012044:Regression Analysis; D012307:Risk Factors; D012572:School Health Services