title: Long-term student outcomes of the Integrated Nutrition and Physical Activity Program.
abstract: OBJECTIVE
  To examine the long-term effects of the Integrated Nutrition and Physical Activity Program (INPAP), a school-based nutrition education program.
  
  
  METHODS
  Quasi-experimental design comparing intervention and comparison cohorts at 3-6 years after delivery of the INPAP intervention on nutrition- and physical activity-related outcomes.
  
  
  METHODS
  This study was conducted in 1 school district in a low-income rural county of ∼15,000 residents in south-central Colorado.
  
  
  METHODS
  In second grade, intervention and comparison cohorts included 173 (fall 2000) and 190 (fall 1999) students, respectively. Approximately 60% of these students completed assessments in eighth grade.
  
  
  METHODS
  INPAP is an experiential school-based nutrition education program, grounded in social cognitive theory and Piaget's cognitive development theory and adapted for use in a rural setting.
  
  
  RESULTS
  Nutrition and physical activity knowledge, self-efficacy, attitudes and behaviors, body mass index.
  
  
  METHODS
  Wilcoxon signed rank test, chi-square test for proportions, and t test for means.
  
  
  RESULTS
  Long-term effects were observed in nutrition-related knowledge and attitudes but not self-efficacy or behavior change. The effects that did occur were attenuated over time.
  
  
  CONCLUSIONS
  This study found that INPAP implemented in elementary school had limited lasting effects by the end of middle school, a time when students have increased autonomy to make food choices.
authors.affiliation: Rocky Mountain Prevention Research Center, University of Colorado Denver, Colorado School of Public Health, Aurora, CO. Electronic address: jini.puma@ucdenver.edu.
authors.forename: Jini
authors.initials: J
authors.lastname: Puma
authors.forename: Catherine
authors.initials: C
authors.lastname: Romaniello
authors.forename: Lori
authors.initials: L
authors.lastname: Crane
authors.forename: Sharon
authors.initials: S
authors.lastname: Scarbro
authors.forename: Elaine
authors.initials: E
authors.lastname: Belansky
authors.forename: Julie A
authors.initials: JA
authors.lastname: Marshall
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D015444:Exercise; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D009747:Nutritional Physiological Phenomena; D009752:Nutritional Status; D012574:Schools; D018709:Statistics, Nonparametric; D013334:Students / Q000706:statistics & numerical data*
keywords: child; elementary school; nutrition education; overweight; physical activity; rural