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Childhood obesity is a global concern. The objectives of this meta-analytical study were to evaluate the effectiveness of school-based childhood obesity prevention programs, and to examine program components (moderators). The methods included searching databases (PubMed, Google Scholar, and the university's EBSCOhost Web service) as well as handsearching reference lists of articles published in English. Selection criteria for studies to be included in the meta-analysis were limited to studies that reported body mass index (BMI) or skinfold thickness as outcome measures and were school-based obesity prevention interventions; cross-sectional design studies were excluded. We hypothesized the meta-analysis would yield a summary effect size of magnitude which would indicate that school-based interventions have been effective in improving children's BMI or skinfold thickness values. A total of 26 114 children from 27 school-based childhood obesity prevention programs provided 54 effect sizes. A random-effects model calculated a small summary effect size of 0.039 (95% confidence interval -0.013 to 0.092). Heterogeneity among studies was observed which disappeared after pooling studies that used a randomized controlled trial design with one program moderator (physical activity or nutrition). We failed to accept our hypothesis and concluded that overall, school-based interventions have not been effective for improving body mass index or skinfold thickness to curb childhood obesity; however, randomized controlled trials that focused on physical activity or nutrition appeared to produce promising results.

Objective: This study aimed to project the societal cost and benefit of an expansion of a water access intervention that promotes lunchtime plain water consumption by placing water dispensers in New York school cafeterias to all schools nationwide. Methods: A decision model was constructed to simulate two events under Markov chain processes – placing water dispensers at lunchtimes in school cafeterias nationwide vs. no action. The incremental cost pertained to water dispenser purchase and maintenance, whereas the incremental benefit was resulted from cases of childhood overweight/obesity prevented and corresponding lifetime direct (medical) and indirect costs saved. Results: Based on the decision model, the estimated incremental cost of the school-based water access intervention is $18 per student, and the corresponding incremental benefit is $192, resulting in a net benefit of $174 per student. Subgroup analysis estimates the net benefit per student to be $199 and $149 among boys and girls, respectively. Nationwide adoption of the intervention would prevent 0.57 million cases of childhood overweight, resulting in a lifetime cost saving totalling $13.1 billion. The estimated total cost saved per dollar spent was $14.5. Conclusion: The New York school-based water access intervention, if adopted nationwide, may have a considerably favourable benefit–cost portfolio.

Introduction and Background Childhood obesity affects 17% of children in the United States (Whooten et al., 2018). It is well understood that many social determinants contribute to the manifestation and improvement of this disease. Purpose Statement I aim to compare the impact of increased health education through medical professional to families and obese/overweight children compared to implemented physical activity in social and personal settings on BMI improvement among the obese/overweight children. Literature Review Searches performed through the Sherrod Library data base at East Tennessee State University included the following key words: social determinants, long-term study, physical activity, clinical, community and family. Research was not limited to the United States population. Findings Review of these studies showed marked improvement in BMI for physical activity programs in association with schools. These activities resulted in BMI z-score improvements of -0.22, when 60 minutes of physical activity was implemented 3-day/week prior to school (Whooten et al., 2018). Studies surrounding medical counseling and education alone reported minimal improvements to BMI and limited sustainable of these results at follow-up. However, frequent routine meeting with medical profession and obese children and their family resulted in increased Pediatric Quality of Life scores. Conclusions While implantation of multiple discipline may be required to improved BMI in obese/overweight children, physical activity in the public social setting shows to be promising compared to increased education and counseling from medical professionals alone in reducing BMI.

Childhood obesity has increased due to factors such as more television time, less outside play, parents' lack of education about nutritious meals, and eating more fast food versus home cooked meals. Research has been performed on many school-aged children; however, there is a gap in research as it pertains to preschool children. Preschool age learning is when children are most receptive to habit-forming activities. The purpose of this transcendental phenomenological study was to assess the parental perceptions of 11 preschool parents in rural Northeastern North Carolina of 4-year-old children who have been told by a health care professional that their children are overweight or obese. This qualitative study used the health belief model as its theoretical foundation. Responses were manually transcribed and uploaded into NVivo 10 software. The researcher performed horizonalization of the data to determine the themes and subthemes used for data analysis. Participants revealed that they recognized childhood obesity and overweight as an issue in their child and were knowledgeable on how to combat their child's diagnosis. As a result of this research, parents revealed that working and a lack of affordable resources played viable roles in why childhood obesity and overweight exists in their children. Parents shared that they felt safe in their neighborhoods, but acknowledged that affordability of healthy foods and other family members' impact on their child's eating habits play a role in their child's weight concerns. This study will lead to positive social change by providing local public health workers with an increased understanding of the experiences of parents of overweight and obese preschool-aged children, which may assist in stronger program development for the targeted population.

Background: Community-based participatory research (CBPR) has been recommended as an effective approach to engage communities in implementing research projects relevant to their needs and interests.  Following this approach, the Dan River Partnership for a Healthy Community was formed to address regional obesity concerns in the Dan River Region, a health disparate area located in south central Virginia and north central North Carolina.  Community gardens were identified as a priority, and the development and implementation of this study continues previous collaborative efforts in evaluating the effectiveness of community gardens within this region. Objectives: The primary aim of this study was to determine if applying the Social Cognitive Theory (SCT) to an adapted curriculum throughout a 10-week gardening and nutrition education intervention would increase youths' willingness to try fruits and vegetables (FV), self-efficacy for eating and asking for FV and gardening, knowledge of nutrition and gardening, and outcome expectations for FV.  Secondary aims were to determine if age groups or attendance rates would positively influence outcome measures and to qualitatively evaluate youths' perceptions about their experiences and opinions about the program. Methods: Utilizing a pre-post design, researchers delivered this program once weekly with 60 minutes of interactive nutrition or gardening education and 30 minutes of experiential gardening.  Questionnaires included validated and novel measures.  Repeated measure ANOVA analyses were used to determine changes in outcome measures.  Post-program interviews were conducted with youth and qualitative data was coded and analyzed. Results: Of the 43 enrolled youth, 42 were African American.  Although willing to try FV did not change significantly, there were significant improvements in self-efficacy for asking for FV from 1.70 (0.34) to 1.83 (0.29) (F=7.07; p=.013) and overall gardening knowledge from 14.53 (3.45) to 15.74 (3.90) (F=7.67; p=.01).  There were also significant improvements in some of the knowledge subcategories for gardening and nutrition, including plant parts and my plate (p<0.05).  Qualitative findings indicated the majority of the participants expressed positive perceptions of the program with the most liked components including food sampling, games and gardening experiences. Discussion and Implications: Our findings demonstrate the feasibility of developing and implementing an adapted theory-driven community gardening and nutrition education program for low socioeconomic youth in public housing.  It implicates the need for future research on youth community gardens using the CBPR approach.  Findings were shared with community partners and future efforts will expand this program. / Master of Science

This study is a retrospective evaluation of the Coordinated Approach To Child Health (CATCH) coordinated school health program. An abundant amount of research has been conducted concerning CATCH, but no data exist that represents the characteristics and attitudes of individuals implementing the program. This study looked to examine organizational readiness, commitment to change, leadership, implementation barriers, innovation perceptions and their influence on the diffusion of CATCH. The primary purpose of this study is to describe and explain why schools in the same area that receive the same CATCH training result in different implementation practices. This study included a retrospective evaluation that evaluated school employees' motivation of CATCH implementation over the 2011-2012 school year. A survey of 284 school employees and health department partners consisting of 33 school administers, 197 classroom teachers, 27 physical education teachers, 21 cafeteria supervisors, and 6 health department partners at elementary school located in the southernmost counties of southern Illinois was conducted. Particular attention was focused upon the differences between classroom teachers, physical education teachers, cafeteria supervisors, and health department partners. Degree of CATCH implementation was the best among cafeteria supervisors and physical education teachers while classroom teachers implemented roughly 50% of the CATCH classroom curriculum. Organizational readiness was a significant predictor of classroom teacher degree of implementation while school leadership served as a significant predictor of degree of implementation by physical education teachers. The study utilizes CATCH; however, this study could be helpful concerning other school health programs to enhance program implementation practices and delivery. The significance of these data provide health educators with evidence of why schools have different implementation practices, what constructs influence degree of implementation, and how addressed constructs that influence implementation can be rectified through school preparation and training protocols to enhance degree of implementation. Additional variables are also discussed that could account for further variation in school employee degree of implementation.

abstract: Food insecurity and childhood obesity are both major public health concerns in the United States of America. Research has not found a definite relationship between childhood obesity and food insecurity to date, with conflicting results being found due to differences in sample sizes and protocol for measuring key variables. Preschoolers (children aged 2-5 years) are a population of particular interest as there tends to be improved health behaviors and greater adaptability to change at this period of growth and development. This study aims to evaluate if there is a relationship between food insecurity and childhood obesity with diet quality as a mediator among preschoolers in the Phoenix area. A secondary data analysis from participants (n=154) from the SAGE (Sustainability via Active Garden Education) research project was used to evaluate food insecurity status, diet quality components (kcal, saturated fat, added sugars, and servings of juice, fruits, and vegetables), and anthropometrics (waist circumference and BMI percentile). No significant associations between food insecurity status, diet quality components, and anthropometric data were found. There was an increased rate of food insecurity and childhood overweight/obesity in this sample compared to state and national averages. Further research of high quality is necessary to determine whether a relationship exists between childhood obesity and food insecurity exists and in what context. Additionally, practice and policy will need to be implemented to decrease rates of food insecurity and childhood obesity among Phoenix preschoolers. / Dissertation/Thesis / Masters Thesis Nutrition 2020

Childhood obesity has become epidemic in the United States. One of the best places to combat this problem is within the school system. The purpose of this study was to examine changes in exercise self-efficacy, science interest, and science knowledge of children who participated in a school-based anatomy and healthy lifestyle intervention called Anatomy Academy. In this pilot study, 212 study participants were recruited from 5th and 6th grade children enrolled in one of three charter schools who participated in our 7-week intervention, Anatomy Academy. Children completed four questionnaires pre and post intervention: (1) a science knowledge questionnaire, (2) a science interest questionnaire, (3) an exercise self-efficacy questionnaire, and (4) a demographic questionnaire. A statistically significant difference was found in participants’ pre and post test scores on the science knowledge questionnaire. Anatomy Academy was well received by children, parents, and faculty and provides helpful curriculum for science and physical education classes.