title: Advancing School and Community Engagement Now for Disease Prevention (ASCEND).
abstract: To compare two intensity levels (standard vs. enhanced) of a nutrition and physical activity intervention vs. a control (usual programs) on nutrition knowledge, body mass index, fitness, academic performance, behavior, and medication use among elementary school students.
  
  
  
  Quasi-experimental with three arms.
  
  
  
  Elementary schools, students' homes, and a supermarket.
  
  
  
  A total of 1487 third-grade students.
  
  
  
  The standard intervention (SI) provided daily physical activity in classrooms and a program on making healthful foods, using food labels. The enhanced intervention (EI) provided these plus additional components for students and their families.
  
  
  
  Body mass index (zBMI), food label literacy, physical fitness, academic performance, behavior, and medication use for asthma or attention-deficit hyperactivity disorder (ADHD).
  
  
  
  Multivariable generalized linear model and logistic regression to assess change in outcome measures.
  
  
  
  Both the SI and EI groups gained less weight than the control (p < .001), but zBMI did not differ between groups (p = 1.00). There were no apparent effects on physical fitness or academic performance. Both intervention groups improved significantly but similarly in food label literacy (p = .36). Asthma medication use was reduced significantly in the SI group, and nonsignificantly (p = .10) in the EI group. Use of ADHD medication remained unchanged (p = .34).
  
  
  
  The standard intervention may improve food label literacy and reduce asthma medication use in elementary school children, but an enhanced version provides no further benefit.
authors.affiliation: 1 Yale University Prevention Research Center, Derby, Connecticut.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Treu
authors.affiliation: 3 Department of Public Health, Southern Connecticut State University, New Haven, Connecticut.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Doughty
authors.affiliation: 2 Yale Center for Analytical Sciences, New Haven, Connecticut.
authors.forename: Jesse S
authors.initials: JS
authors.lastname: Reynolds
authors.affiliation: 1 Yale University Prevention Research Center, Derby, Connecticut.
authors.forename: Valentine Y
authors.initials: VY
authors.lastname: Njike
authors.affiliation: 1 Yale University Prevention Research Center, Derby, Connecticut.
authors.forename: David L
authors.initials: DL
authors.lastname: Katz
mesh_terms: D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D015992:Body Mass Index; D000697:Central Nervous System Stimulants / Q000008:administration & dosage; D002648:Child; D004032:Diet; D004522:Educational Status; D015444:Exercise; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008297:Male; D010809:Physical Fitness; D012572:School Health Services / Q000458:organization & administration*; D012959:Socioeconomic Factors
chemical_list: D018927:Anti-Asthmatic Agents; D000697:Central Nervous System Stimulants
keywords: Asthma; Attention Deficit Disorder With Hyperactivity; Body Mass Index; Child; Exercise; Health focus: fitness/physical activity, nutrition; Humans; Manuscript format: research; Obesity; Outcome measure: cognitive, behavioral, biometric; Physical Fitness; Prevention Research; Research purpose: intervention testing/program evaluation; Setting: family, school, local community; Strategy: education, skill building/behavior change; Students; Study design: quasi-experimental; Target population age: youth; Target population circumstances: geographic location