title: Improving healthy dietary behaviors, nutrition knowledge, and self-efficacy among underserved school children with parent and community involvement.
abstract: BACKGROUND
  University–community partnerships through coordinated school health programs (CSHP) can play a key role in decreasing child obesity. The main objective of this study was to measure over a 1-year period whether a CSHP with parental, school, and home-based components to promote optimal nutrition will reduce BMI percentiles and z-scores and improve dietary behaviors in a sample of low-income, school-aged children.
  
  
  METHODS
  The intervention included, Kids Nutrition and Fitness, a 6-week nutrition, physical activity educational after-school program, and school activities, including creation of an Advisory Committee that made wellness policies. A randomized controlled pilot study evaluated the effectiveness of the intervention that contrasts 251 (n = 251) predominantly Mexican-American 8 to 12 year olds from low-income Los Angeles–based schools. A mixed model of repeated measures analysis assessed changes in BMI percentiles and z-scores, dietary behaviors, food preferences, knowledge, and self-efficacy measured by a reliable/valid questionnaire. These data were collected at baseline and at 4 and 12 months postintervention. Process measures, collected via focus groups with parents, evaluated parent/community involvement.
  
  
  RESULTS
  At the 12-month follow-up, children in the intervention group decreased their BMI on average by 2.80 (p = 0.04) and BMI z-scores on average by 0.48 (p = 0.03) and they increased their daily dietary intake of vegetables on average by 1.51 (p = 0.03), fruit on average by 2.00 (P = 0.001), and 100% fruit juice by 1.12 (p = 0.05). An increase of 1.02 (p = 0.03) was seen in self-efficacy of healthy food choices (p = 0.03). Parent (P = 0.04) and community (p = 0.001) involvement significantly increased to 100% participation by the 12-month follow-up.
  
  
  CONCLUSIONS
  A CSHP using parent and community involvement was effective in reducing the risk of obesity in school-aged Mexican- American children attending low-income schools. The findings need to be examined in a larger, more diverse sample of children.
authors.affiliation: Department of Nursing, Factor Building, Room 5-157, University of California, Los Angeles, 700 Tiverton Avenue, Los Angeles, CA 90095, USA. kwright@ucla.edu
authors.forename: Kynna
authors.initials: K
authors.lastname: Wright
authors.forename: Keith
authors.initials: K
authors.lastname: Norris
authors.forename: Joyce
authors.initials: J
authors.lastname: Newman Giger
authors.forename: Zulma
authors.initials: Z
authors.lastname: Suro
mesh_terms: D002648:Child; D004032:Diet; D005247:Feeding Behavior / Q000208:ethnology; D005260:Female; D005518:Food Preferences / Q000208:ethnology; D015438:Health Behavior / Q000208:ethnology; D006801:Humans; D015141:Los Angeles; D008297:Male; D017058:Mexican Americans; D009753:Nutritive Value; D009765:Obesity / Q000208:ethnology* / Q000517:prevention & control / Q000628:therapy; D010290:Parents; D011203:Poverty; D012572:School Health Services; D020377:Self Efficacy; D035862:Vulnerable Populations