Participation in a School-Based Wellness Initiative Associated With Improved K-12 Student Body Mass Index Trends.

Abstract

Associations between school participation in an academic medical center-supported school-based wellness initiative and programmatic components implemented with change in average student body mass index (BMI) over time were examined. This was an observational study of 103 K-12 South Carolina schools over school years 2014-2018, classified as participating (n=87 schools, 27,855 students) or non-participating (n=16 schools; 3608 students). Associations between students' BMI z-score (BMIz) and school participation were evaluated by linear multilevel mixed-effects modeling using data from FitnessGram and the School Wellness Checklist© (SWC), respectively. One-third of the students had a BMI percentile ≥85. Average student BMIz decreased in participating schools (p=.026) and increased in non-participating schools (p=.004) over time. For schools that participated two or more years, there was an inverse relationship between SWC score and student BMIz (p=.002) that did not differ by school type, rural/urban location, Title 1 status, or student sex. Physical activity and stress management interventions for students, as well as employee wellness and establishing a wellness committee at the school level were significantly associated with decreased average student BMIz (all p < .05). Implementation of similar comprehensive school-based wellness programs focused on improving physical activity, stress management, and employee engagement may help prevent and reduce pediatric obesity in diverse communities.