A Multicomponent, School-Based Intervention, the Shaping Healthy Choices Program, Improves Nutrition-Related Outcomes

Abstract

ObjectiveTo evaluate the effectiveness of the Shaping Healthy Choices Program (SHCP). DesignA clustered, randomized, controlled intervention lasting 1 school year. SettingSchools in northern and central California. ParticipantsFourth-graders (aged 9–10 years) at 2 control schools (n = 179) and 2 intervention schools (n = 230). InterventionGarden-enhanced education, family, and community partnerships; increased regionally procured produce in the lunchroom; and school-site wellness committees. Main Outcome MeasuresChanges in body mass index (BMI) percentiles/Z-scores; nutrition knowledge, science process skills, and vegetable identification and preferences; and reported fruit and vegetable intake. AnalysisStudent t test, chi-square, ANOVA of change, and multilevel regression mixed model to evaluate change in outcomes with school as a random effect to account for cluster design effects. Statistical significance was set at P < .05. ResultsThere was a greater improvement in BMI percentile (−6.08; P < 0.01), BMI Z-score (−0.28; P < .001), and waist-to-height ratio (−0.02; P < .001) in the intervention compared with the control schools. Conclusions and ImplicationsThe SHCP resulted in improvements in nutrition knowledge, vegetable identification, and a significant decrease in BMI percentiles. This supports the concept that the SHCP can be used to improve the health of upper elementary school students.