INTRODUCTION: Studies have shown that school-based childhood obesity programs can be effective, however, little is known about the effects of policy and environmental changes on student health outcomes. This study assessed the policy, environmental, and BMI percentile changes of 32 Georgia elementary schools participating in HealthMPowers programming.
METHODS: This thesis used multilevel analysis to examine the changes to policy and environmental indicators within school participating in HealthMPowers and the extent to which these indicators predict BMI percentile change of 5th grade students. This research evaluated seven key indicators related to policy and environmental changes within 32 schools and the BMI percentile changes of 3458 students over the 2011-2012 academic year. Multilevel regression models were used to estimate the effects of school policy and environmental changes on mean BMI percentiles.
RESULTS: Only 12 schools experienced a decrease in mean BMI percentiles from baseline to post-test, whereas 17 schools experienced increases in mean BMI percentiles. Students who were at or above the 85th percentile did not change significantly from baseline to post-test. For physical activity, schools that reported positive or no change in this indicator reported statistically significant increases in mean BMI percentiles from baseline to post-test. Schools that increased their CITT scores for physical education, school health team, assessment, and environment and policy indicators experienced, on average, a non-statistically significant increase in mean BMI percentiles from baseline to post-test. Schools that increased their CITT scores for improvement plan and communication experienced, on average, a non-statistically significant decrease in mean BMI percentiles from baseline to post-test. Schools that reported no change to their CITT scores for physical education, assessment, and environment and policy indicators experienced, on average, a non-statistically significant increase in mean BMI percentiles from baseline to post-test. Schools that reported no change for CITT scores for the school health team, improvement plan, and communication indicators experienced, on average, a non-statistically significant decrease in mean BMI percentiles from baseline to post-test. Lastly, when the school health team, assessment, improvement plan, and communication indicators were combined, schools who reported positive or no changes experienced, on average, a non-statistically significant increase in mean BMI percentiles from baseline to post-test.
CONCLUSION: The findings of this study were inconclusive but do shed light on the importance of understanding system level policy and environmental change on individual level health outcomes. Additional research should be conducted to explore this relationship as well as evaluation of the Continuous Improvement Tracking Tool that HealthMPowers uses to help schools better capture the current state of their programs, policies, and environment in regards to student and staff health.
| Identifer | oai:union.ndltd.org:GEORGIA/oai:digitalarchive.gsu.edu:iph_theses-1287 |
| Date | 06 May 2013 |
| Creators | Sheldon, Erica R. |
| Publisher | Digital Archive @ GSU |
| Source Sets | Georgia State University |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | Public Health Theses |
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