title: From "best practice" to "next practice": the effectiveness of school-based health promotion in improving healthy eating and physical activity and preventing childhood obesity.
abstract: BACKGROUND
  In 2005, we reported on the success of Comprehensive School Health (CSH) in improving diets, activity levels, and body weights. The successful program was recognized as a "best practice" and has inspired the development of the Alberta Project Promoting active Living and healthy Eating (APPLE) Schools. The project includes 10 schools, most of which are located in socioeconomically disadvantaged areas. The present study examines the effectiveness of a CSH program adopted from a "best practice" example in another setting by evaluating temporal changes in diets, activity levels and body weight.
  
  
  METHODS
  In 2008 and 2010, we surveyed grade 5 students from approximately 150 randomly selected schools from the Canadian province of Alberta and students from 10 APPLE Schools. Students completed the Harvard Youth/Adolescent Food Frequency Questionnaire, questions on physical activity, and had their height and weight measured. Multilevel regression methods were used to analyze changes in diets, activity levels, and body weight between 2008 and 2010.
  
  
  RESULTS
  In 2010 relative to 2008, students attending APPLE Schools were eating more fruits and vegetables, consuming fewer calories, were more physically active and were less likely obese. These changes contrasted changes observed among students elsewhere in the province.
  
  
  CONCLUSIONS
  These findings provide evidence on the effectiveness of CSH in improving health behaviors. They show that an example of "best practice" may lead to success in another setting. Herewith the study provides the evidence that investments for broader program implementation based on "best practice" are justified.
authors.affiliation: School of Public Health, University of Alberta, 6-50 University Terrace, 8303-112 St, Edmonton, AB T6G 2 T4, Canada.
authors.forename: Christina
authors.initials: C
authors.lastname: Fung
authors.forename: Stefan
authors.initials: S
authors.lastname: Kuhle
authors.forename: Connie
authors.initials: C
authors.lastname: Lu
authors.forename: Megan
authors.initials: M
authors.lastname: Purcell
authors.forename: Marg
authors.initials: M
authors.lastname: Schwartz
authors.forename: Kate
authors.initials: K
authors.lastname: Storey
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Veugelers
mesh_terms: D000416:Alberta / Q000453:epidemiology; D001835:Body Weight; D002648:Child; D002652:Child Behavior; D004032:Diet / Q000592:standards*; D002149:Energy Intake; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006306:Health Surveys; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012574:Schools; D011795:Surveys and Questionnaires