title: Pathways curriculum and family interventions to promote healthful eating and physical activity in American Indian schoolchildren.
abstract: BACKGROUND
  Pathways, a multisite school-based study aimed at promoting healthful eating and increasing physical activity, was a randomized field trial including 1704 American Indian third to fifth grade students from 41 schools (21 intervention, 20 controls) in seven American Indian communities.
  
  
  METHODS
  The intervention schools received four integrated components: a classroom curriculum, food service, physical activity, and family modules. The curriculum and family components were based on Social Learning Theory, American Indian concepts, and results from formative research. Process evaluation data were collected from teachers (n=235), students (n=585), and families. Knowledge, Attitudes, and Behavior Questionnaire data were collected from 1150 students including both intervention and controls.
  
  
  RESULTS
  There were significant increases in knowledge and cultural identity in children in intervention compared to control schools with a significant retention of knowledge over the 3 years, based on the results of repeating the third and fourth grade test items in the fifth grade. Family members participated in Family Events and take-home activities, with fewer participating each year.
  
  
  CONCLUSIONS
  A culturally appropriate school intervention can promote positive changes in knowledge, cultural identity, and self-reported healthful eating and physical activity in American Indian children and environmental change in school food service.
authors.affiliation: University of New Mexico, Albuquerque, NM 87131, USA. smdavis@unm.edu
authors.forename: Sally M
authors.initials: SM
authors.lastname: Davis
authors.forename: Theresa
authors.initials: T
authors.lastname: Clay
authors.forename: Mary
authors.initials: M
authors.lastname: Smyth
authors.forename: Joel
authors.initials: J
authors.lastname: Gittelsohn
authors.forename: Vivian
authors.initials: V
authors.lastname: Arviso
authors.forename: Hilary
authors.initials: H
authors.lastname: Flint-Wagner
authors.forename: Bonnie Holy
authors.initials: BH
authors.lastname: Rock
authors.forename: Richard A
authors.initials: RA
authors.lastname: Brice
authors.forename: Lauve
authors.initials: L
authors.lastname: Metcalfe
authors.forename: Dawn
authors.initials: D
authors.lastname: Stewart
authors.forename: Maihan
authors.initials: M
authors.lastname: Vu
authors.forename: Elaine J
authors.initials: EJ
authors.lastname: Stone
mesh_terms: D002648:Child; D002664:Child Nutritional Physiological Phenomena; D003479:Curriculum; D015444:Exercise; D005190:Family / Q000208:ethnology; D005247:Feeding Behavior / Q000208:ethnology; D005522:Food Services; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D009765:Obesity / Q000208:ethnology* / Q000517:prevention & control*; D011322:Primary Prevention / Q000458:organization & administration*; D016730:Program Development; D012307:Risk Factors; D012574:Schools; D014481:United States