Coordinated Approach To Child Health Research Articles

A Mixed-Method Evaluation of a Rural Elementary School Implementing the Coordinated Approach to Child Health (CATCH) Program.

Despite children living in rural US areas having 26% greater odds of being affected by obesity compared to those living in urban areas, the implementation of evidence-based programs in rural schools is rare. We collected quantitative data (weight and height) from 272 racially and ethnically diverse students at baseline, and qualitative data from students (4 focus groups), parents, and school staff (16 semi-structured interviews and 29 surveys) to evaluate program outcomes and perceptions. At the 2-year follow-up, paired data from 157 students, represented by racial/ethnic groups of 59% non-Hispanic White, 31% non-Hispanic Black, and 10% Hispanic, showed an overall mean change (SD) in BMI z-score of -0.04 (0.59), a decrease of -0.08 (0.69) in boys, and a significant -0.18 (0.33) decrease among Hispanic students. Boys had a mean decrease in obesity prevalence of 3 percentage points (from 17% to 14%), and Hispanic students had the largest mean decrease in BMI percentile. Qualitative data showed positive perceptions of the CATCH program and its implementation. This community-engaged research, with collaboration from an academic institution, a health department, a local wellness coalition, and a rural elementary school, demonstrated successful CATCH program implementation and showed promising outcomes in mean BMI changes.

Qualitative Evaluation of University Students' Experience Delivering an Obesity Prevention Programme in Elementary Schools.

The Coordinated Approach to Child Health (CATCH) programme is an accredited obesity prevention programme in the United States, teaching children about nutrition, physical activity, and screen time limits. This study aimed to evaluate the perceptions of undergraduate and graduate student leaders' about their experience delivering the CATCH programme in elementary schools in Northern Illinois school districts during the 2019-2020 school year and its impact on their personal and professional skills and on programme participants. An email questionnaire was sent to eligible students. Grounded theory was used to analyze the students' responses. Two researchers assigned codes to the data and identified themes. Twenty-one students responded (50% response rate). Six identified themes include "purpose of CATCH programme," "school facilities and resources," "university students experience with CATCH lessons and activities," "benefits to university student," "benefits to children and teachers," and "identified weaknesses and suggested improvements to CATCH." University students delivering the CATCH programme appreciated the opportunity to practice in a real-world setting, gained transferable professional skills, increased programme content knowledge, identified CATCH programme benefits/strengths, and planned to apply lessons learned to future practice.

Evaluation of the Coordinated Approach to Child Health (CATCH) Program in Third through Fifth Graders in Northern Illinois

Evaluation of the Coordinated Approach to Child Health (CATCH) Program in Third through Fifth Graders in Northern Illinois

Design for a cluster randomized controlled trial to evaluate the effects of the CATCH Healthy Smiles school-based oral health promotion intervention among elementary school children

BackgroundThe top two oral diseases (tooth decay and gum disease) are preventable, yet dental caries is the most common childhood disease with 68% of children entering kindergarten having tooth decay. CATCH Healthy Smiles is a coordinated school health program to prevent cavities for students in kindergarten, 1st, and 2nd grade, and is based on the framework of Coordinated Approach to Child Health (CATCH), an evidence-based coordinated school health program. CATCH has undergone several cluster-randomized controlled trials (CRCT) demonstrating sustainable long-term effectiveness in incorporating the factors surrounding children, in improving eating and physical activity behaviors, and reductions in obesity prevalence among low-income, ethnically diverse children. The aim of this paper is to describe the design of the CATCH Healthy Smiles CRCT to determine the effectiveness of an oral health school-based behavioral intervention in reducing incidence of dental caries among children. MethodsIn this CRCT, 30 schools serving low-income, ethnically-diverse children in greater Houston area are recruited and randomized into intervention and comparison groups. From which, 1020 kindergarten children (n = 510 children from 15 schools for each group) will be recruited and followed through 2nd grade. The intervention consists of four components (classroom curriculum, toothbrushing routine, family outreach, and schoolwide coordinated activities) will be implemented for three years in the intervention schools, whereas the control schools will be offered free trainings and materials to implement a sun safety curriculum in the meantime. Outcome evaluation will be conducted at four time points throughout the study period, each consists of three components: dental assessment, child anthropometric measures, and parent survey. The dental assessment will use International Caries Detection and Assessment System (ICDAS) to measures the primary outcome of this study: incidence of dental caries in primary teeth as measured at the tooth surface level (dfs). The parent self-report survey measures secondary outcomes of this study, such as oral health related behavioral and psychosocial factors. A modified crude caries increment (mCCI) will be used to calculate the primary outcome of the CATCH Healthy Smiles CRCT, and a two-tailed test of the null hypothesis will be conducted to evaluate the intervention effect, while considering between- and within-cluster variances through computing the weighted-average of the mCCI ratios by cluster. ConclusionIf found to be effective, a platform for scalability, sustainability and dissemination of CATCH already exists, and opens a new line of research in school oral health. Clinical trials identifierAt ClinicalTrials.gov - NCT04632667.

Implementation of a Coordinated Approach to Child Health Program at a Rural Elementary School During the COVID-19 Pandemic

ObjectivesA Coordinated Approach to Child Health (CATCH) is an evidence-based school health program focusing on increasing healthy eating and physical activity and reducing screen time. This project aimed to determine if CATCH program will have significant effects on self-rated knowledge, habits of physical activity, healthy eating (fruit and vegetable consumption), and screen time among 3rd and 5th-grade students at a rural elementary school during the 2020–2021 school year. MethodsTo evaluate this 4-month project, a pre- and post-intervention School Physical Activity and Nutrition (SPAN) survey was distributed to 51 3rd and 5th-grade students. The program included six 30-minute education sessions specific to grade level and healthy snacks including fruits and vegetables. A family fun event (virtual 2K walk/run due to COVID-19) was organized. Prizes (i.e., water bottles, jump ropes) were given to students for participating in the family fun event and at Track and Field day to encourage healthy behavior. ResultsA dependent paired samples t-tests and an exact McNemar test determined participants who completed both the pre and post intervention survey (n = 15) did not experience a significant change in healthier food choices, fruit consumption, vegetable consumption, screen time, and physical activity. Mean responses of students who completed the pre survey (n = 27) and post survey (n = 22) found a 28% increase in exercising for at least 30 minutes the day prior, a 22% increase in 2 hours or less of screen time the day prior, a 12% increase in eating vegetables 3 or more times the day prior, and a 6% increase in eating fruit 2 or more times the day prior. A Qualtrics survey found that 100% of teachers who completed the survey (n = 7) were satisfied with the program and 5 out of 7 teachers were interested in participating in the program the following school year, with one maybe and one not applicable (i.e., leaving district) response. ConclusionsAlthough the results of this project were not statistically significant, there were beneficial findings and lessons learned. Students reported an increase in favorable responses to recommended habits of physical activity, diet, and screen time following implementation of the CATCH program. Funding SourcesDeKalb County Community Foundation Community Needs Grant.

Examining the Effects of Movement Activities of Coordinated Approach to Child Health (CATCH) Program on Locomotor and Manipulative Skills of 4-5 Years Old Children

The main objective of the research is to examine the impact of regular implementation of Education Program made of CATCH Program Movement Activities on the locomotor and manipulative skills of preschool children. Implementation of Education Program made of CATCH Program Movement Activities was carried out in an independent preschool located in Kadıköy District in Anatolian Side of İstanbul Province, Turkey. Purposeful sampling method was used to determine the school where the experimental designed study will be conducted. The study group of the research consists of 64 children, 32 in experiment group and 32 in control group. To determine the efficiency of Education Program made of CATCH Program Movement Activities, education program was implemented with experiment groups for two days a week during 9 weeks. According to the results of pre-test and post-test measurements of experiment and control groups, no significant difference was determined between the locomotor subdimension, manipulative subdimension of the measurement instrument and measurement instrument total scores in pre-test measurements of the children (p>.05). According to the analysis results of post-test measurements following movement program, it was determined that there is a significant difference in locomotor subdimension, manipulative subdimension of the measurement instrument and measurement instrument total scores of both 4 and 5 years old children in favour of the experiment group (p<.05).

Qualitative Evaluation of University Students’ Experience Delivering the Coordinated Approach to Child Health (CATCH) Program

Abstract Objectives The purpose of this research was to explore the perception of Northern Illinois University (NIU) students regarding delivery and benefits of the Coordinated Approach to Child Health (CATCH) program in northern Illinois elementary schools. Methods The Coordinated Approach to Child Health (CATCH) program is a nationally accredited obesity prevention program that teaches children about nutrition, physical activity, and decreasing screen time. Every semester, undergraduate and graduate students from Northern Illinois University (NIU) participate in an experiential learning rotation with CATCH and deliver the program in elementary schools. After undergraduate and graduate NIU students delivered the CATCH program in local elementary schools during the 2019–2020 school year, they were sent an email questionnaire to probe their experience with CATCH and to seek suggestions for program improvement. This questionnaire consisted of 5 demographic prompts, followed by 10 open-ended questions. Grounded theory was used to analyze the responses. Two researchers assigned codes to each meaningful segment of data. From these codes, six common themes were identified. Results A total of 21 students responded (50% response rate) to the email questionnaire. The six identified themes include ‘Purpose of CATCH program’, ‘School facilities and resources’, ‘NIU students experience with CATCH lessons and activities’, ‘Benefits to NIU student’, ‘Benefits to children and teachers’, and ‘Identified weaknesses and suggested improvements to CATCH’. Each theme summarizes the NIU students’ responses relevant to that theme, including quotes from respondents. Conclusions University students that delivered the CATCH program appreciated the opportunity to practice in a real world setting, gained transferable professional skills, and learned CATCH program knowledge. Reflections on program content, delivery, and benefits to children can be used to strengthen CATCH and other future nutrition education programs for children. Funding Sources No funding sources were acquired or needed for this research project.

Evaluation of the Coordinated Approach to Child Health (CATCH) Program in Third Through Fifth Graders in Northern Illinois

ObjectivesConducting evaluations of health promotion programs are imperative to determine the program’s impact and explore possible improvements in content and delivery. This study’s objective was to evaluate the effectiveness of CATCH program, delivered by dietetic interns and Northern Illinois University (NIU) students, to third through fifth graders in Northern Illinois, in increasing their nutrition knowledge and healthy choices behavior. MethodsIn total, 167 elementary school children in grades third through fifth in Northern Illinois participated in a non-experimental program evaluation study. We delivered six CATCH lessons throughout the academic year to five elementary schools. Lessons were focused on ‘Go, Slow, Whoa’ food categories to help children understand healthier food choices. Validated questionnaires from the CATCH Global Foundation were administered in classrooms and online pre- and post-intervention to assess nutritional knowledge and healthy choices behavior. ResultsChildren in third through fifth grades significantly increased their knowledge about nutrient-dense foods (P < .001 for each grade). Fourth and fifth graders exhibited a significant increase in their ability to make healthier food choices, P = .03 and P = .007 respectively. As grade level increased from third to fifth grade, improvement in nutrition knowledge and adoption of healthy food choices did not increase significantly; third to fourth grade, P = .973 and fourth to fifth grade, P = .637. ConclusionsWe conclude that children in grades third through fifth who participated in the six lessons of the CATCH program expanded their nutritional knowledge and improved their ability to make healthier choices. This study demonstrates the potential benefits of communiversity collaborations for nutrition education in schools. However, higher grades did not show a greater increase in knowledge or more improvement in making healthy choices than lower grades. Future research should examine the same cohort of children over three years of participation to determine the accumulation of knowledge and behavior improvement. Funding SourcesNorthwestern Medicine Kishwaukee Health Center in DeKalb, IL and Northern Illinois University provided funds to procure supplies and cover printing cost of evaluation surveys.

Culinary Health Education and Fitness (C.H.E.F.): A Large-Scale Program to Reduce Rural Health Disparity Through Networking and Relationship Building

Abstract Objectives The Culinary Health Education and Fitness (C.H.E.F.) program is a 3-year program designed to help children and families in three Oregon counties (Lincoln, rural Benton and East Linn) achieve higher-quality lives through the promotion of physical activity and nutrition. The program utilized nutrition-focused culinary education that included cooking classes and tasting tables to empower families to be self-sufficient in the kitchen, make healthy food choices and increase exposure to fruits and vegetables. The program also sought to strengthen relationships among health-advocacy stakeholders, train future physicians to deliver nutrition education, and to integrate the Coordinated Approach to Child Health (CATCH) program at school sites as a sustainable program for increasing physical activity in school-aged children. Methods Quantitative and qualitative data were gathered from classes, schools and stakeholders through pre- and post-surveys, interviews, program records, and observation to assess program reach, process evaluation, cooking self-efficacy, physical activity and change in nutrition knowledge. Our mixed methods approach was organized around the concepts of Exposure, Integrity and Intensity (for the process evaluation) and Outcomes. Results The program had extensive reach with &amp;gt;3200 children served at tasting tables, &amp;gt;800 participants in culinary education classes, and &amp;gt;2500 students participated in CATCH at their schools. Nearly 100 community partners, medical students and volunteers were trained to deliver the evidence-based culinary education. The implementation of CATCH increased vigorous physical activity in children. Culinary education courses effectively introduced children to new vegetables and fruits and raised confidence in their ability to prepare healthy foods at home. Relationships flourished through the various meetings, trainings and conferences related to the program. A robust network of health advocacy stakeholders continues to grow across the tri-county area through various activities related to this program work. Conclusions Through a wide array of relationships and community partnerships, the C.H.E.F. program promotes healthy lifestyles and a culture of health in rural Oregon communities. Funding Sources HRSA Rural Network Development Grant.

P62 Leveraging Partnerships to Implement Policy, Systems, & Environmental Initiatives in Two Rural Counties of California

Objective To implement UC CalFresh policy, systems, and environmental (PSE) initiatives across limited resource settings. Use of Theory or Research Social-Ecological Model (SEM). Target Audience Preschoolers, youth, parents, and seniors across preschools, schools, after school programs, and community settings in Tulare/Kings counties of California. Program Description In collaboration with community partners during FY2017-18, trained nutrition educators implemented USDA funded UC CalFresh PSE initiatives such as school wellness policy, preschool and school gardens, physical activities such as Coordinated Approach to Child's Health (CATCH), walking club, dance exercise, healthy school farmer's market, smarter lunchrooms movement, and food distribution. Evaluation Methods Nutrition educators completed PSE Site Activity Tracking Form that recorded PSE reach, sites, implementation stages, PSE changes adopted, partnerships, and sustainability plan. Evaluation data analyses was completed using the Program Evaluation and Reporting System (PEARS). Results Results indicated: PSE reached preschoolers, youth, parents, seniors, and community members (n = 28,217), total PSE sites with one or more PSE changes adopted (n = 43), total PSE sites by setting for all stages of implementation (n = 35), total sites with sustainability plan (n = 46), total number of type of PSE changes identified (n = 76), and approximately 40 partnerships were reported. PSE changes included established or improved food and beverage, physical activity and/or wellness-related policies, initiated or improved point-of-purchase, decision, and/or distribution prompts (including information intended to influence choices at the point of decision), improved quality of structured physical activity, initiated or expanded use of the garden for nutrition education, and improve access to fresh fruits, vegetables, and/or other healthy foods. Conclusions Results provide essential insight into PSE strategies at the SEM levels to promote healthy food and physical activity messages. Implications of this evaluation suggest that local implementing agencies can successfully deliver PSE strategies by leveraging community partnerships. Funding SNAP-Ed.

Examining Second Graders' Healthy Food Choices: Through Literacy and Active Learning.

The purpose of this study was to investigate the implementation of a nutrition module and activities (Go, Slow, Whoa) in a literacy environment through an active learning approach. Second graders (N = 85) from diverse socioeconomic status (SES) areas completed the 12-week program. The participants’ perceptions of healthy food choices were measured both pre- and post-intervention. Students met for 30 minutes twice a week, to complete 5-lessons from a Coordinated Approach to Child Health (CATCH) nutrition module and activities (Go, Slow, Whoa). Measures were taken both pre- and post-intervention (Food Fury Quiz) to distinguishing between healthy and unhealthy foods (images). There was a statistically significant improvement (t = 12.16, df =84, P = .000) from pretest (M = 19.06, SD = 3.13) and posttest (M = 23.34, SD = 0.48) scores. Administering a healthy food choice curriculum through literacy and active learning provides an alternative approach to improving health knowledge among second grade students.

Abstract IA09: Realizing the promise of prevention (at the personal and population levels)

Abstract IA09: Realizing the promise of prevention (at the personal and population levels)

Impact of school-based vegetable garden and physical activity coordinated health interventions on weight status and weight-related behaviors of ethnically diverse, low-income students: Study design and baseline data of the Texas, Grow! Eat! Go! (TGEG) cluster-randomized controlled trial.

BackgroundCoordinated, multi-component school-based interventions can improve health behaviors in children, as well as parents, and impact the weight status of students. By leveraging a unique collaboration between Texas AgriLife Extension (a federal, state and county funded educational outreach organization) and the University of Texas School of Public Health, the Texas Grow! Eat! Go! Study (TGEG) modeled the effectiveness of utilizing existing programs and volunteer infrastructure to disseminate an enhanced Coordinated School Health program. The five-year TGEG study was developed to assess the independent and combined impact of gardening, nutrition and physical activity intervention(s) on the prevalence of healthy eating, physical activity and weight status among low-income elementary students. The purpose of this paper is to report on study design, baseline characteristics, intervention approaches, data collection and baseline data.MethodsThe study design for the TGEG study consisted of a factorial group randomized controlled trial (RCT) in which 28 schools were randomly assigned to one of 4 treatment groups: (1) Coordinated Approach to Child Health (CATCH) only (Comparison), (2) CATCH plus school garden intervention [Learn, Grow, Eat & Go! (LGEG)], (3) CATCH plus physical activity intervention [Walk Across Texas (WAT)], and (4) CATCH plus LGEG plus WAT (Combined). The outcome variables include student’s weight status, vegetable and sugar sweetened beverage consumption, physical activity, and sedentary behavior. Parents were assessed for home environmental variables including availability of certain foods, social support of student health behaviors, parent engagement and behavior modeling.ResultsDescriptive data are presented for students (n = 1369) and parents (n = 1206) at baseline. The sample consisted primarily of Hispanic and African American (53 % and 18 %, respectively) and low-income (i.e., 78 % eligible for Free and Reduced Price School Meals program and 43 % food insecure) students. On average, students did not meet national guidelines for vegetable consumption or physical activity. At baseline, no statistical differences for demographic or key outcome variables among the 4 treatment groups were observed.ConclusionsThe TGEG study targets a population of students and parents at high risk of obesity and related chronic conditions, utilizing a novel and collaborative approach to program formulation and delivery, and a rigorous, randomized study design.

Elementary school lunch categorisation and correlations with dietitian recommendations.

Numerous interventions have been designed to impact children's diet in the elementary school setting. One popular strategy is to label foods in the elementary cafeteria as more or less healthy. An example is the Coordinated Approach To Child Health (CATCH) labels of 'go', 'slow', or 'whoa' foods. In many respects, this has been successful, as food purveyors have responded by offering more healthy versions of popular foods (e.g. hamburgers with a high soy content) in an effort to avoid the less healthy, 'whoa' label. While this provides an obvious benefit to children's dietary choices and overall risk of obesity, it may have the unintended consequence of not setting up youth to make healthy choices in the environment outside of schools where these foods have not been altered. In response, the current study was designed to compare school labels and registered dietitian (RD) recommendations of common elementary lunch options. In the spring of 2010, 28 RDs provided their recommendation of 'generally healthy, choose often'; 'generally less healthy, choose less often'; and 'generally unhealthy, choose rarely' for 48 common school lunch options. RDs were not told how schools categorised each selection. Kappa analyses were used to determine agreement between school labels and RD recommendations. Results indicate some disagreement between school labels and RD recommendations, with higher fat/calorie entrées showing greater discrepancies. Given these inconsistencies, nutrition education in schools should be designed to help children and their parents understand how foods offered in school may differ from those outside the school environment.

Retrospective Evaluation of Factors That Influence the Implementation of CATCH in Southern Illinois Schools

Coordinated Approach to Child Health (CATCH) is a school health program implemented in southern Illinois that focuses on physical activity and nutrition and consists of a classroom curriculum, physical education framework, and cafeteria guidelines. Though many schools agreed to implement CATCH, some schools implemented it better than others. This study examined implementation practices of classroom and physical education teachers and cafeteria supervisors. We surveyed 284 school employees at 36 elementary schools located in southern Illinois. Attention focused on organizational readiness, commitment to change, school leadership, implementation barriers, and innovation perceptions concerning degree of implementation of CATCH. Organizational readiness and implementation barriers were significant predictors of degree of implementation for school employees. Additionally, organizational readiness was reported a significant predictor of classroom teacher degree of implementation whereas leadership was a significant predictor of degree of implementation by physical education teachers. Data from this study can be used to enhance implementation of CATCH as well as other school health programs. This study provides educators evidence of why school employees have different implementation practices, evidence of what constructs influence degree of implementation most, and some explanation of school employee degree of implementation.

An examination of a school-based nutrition program

In response to concerns associated with childhood obesity, researchers have sought to develop nutrition and exercise programs to promote healthy living. One way to prevent obesity and improve the health of children is to provide healthy foods and nutrition education in elementary schools. The purpose of this study was to evaluate the effectiveness of the Coordinated Approach to Child Health (CATCH) nutrition program on elementary students (N = 271). Pretest and posttest data were analyzed using multivariate analyses of variance, independent samples t-tests, and paired samples t-tests. Students who participated in the nutrition program were appreciably different in their posttest scores from students in the control group (p < 0.05). Concerning matched groups, students in the intervention group improved on four out of five components (p < 0.05 to p < 0.001), whereas students in the control group had no statistically significant change (p>0.05). The answer to childhood health is multifaceted, but programs such as CATCH may offer a solution.

Summer Migrant Students Learn Healthy Choices Through Videography

The purpose of this single-group pre- and posttest intervention pilot study was to teach middle school migrant farmworker children the benefits of healthy eating and activity using a multimedia and ethnic-tailored health curriculum, embedded in a 7-week summer Migrant Education Program. Conceptual frameworks were from transcultural nursing, education, and child development. Student-made video productions enhanced classroom learning and content retention. Outcomes were health infomercials, body mass index (BMI), BMI percentile, muscle strength and flexibility, and We Can! and Coordinated Approach To Child Health (CATCH) surveys. Sixty-four students were enrolled (girls n = 31, boys n = 33), 96% Latino, and 65% were overweight or obese. Students had significant improvement in 12 knowledge and attitudes measures with significant gender differences in 11 measures. Although not statistically significant, trends toward healthier weight were seen. Five student infomercials were produced. The school environment effectively delivered health promotion to migrant children and will serve as a prototype for middle school health interventions.

Is frequency of family meals associated with parental encouragement of healthy eating among ethnically diverse eighth graders?

The purpose of the present study was to explore the relationship between family meals and parental encouragement of healthy eating overall and by ethnicity. Family meal frequency was measured with one item asking how many times in the past 7 d all or most of the family ate a meal together, which was then categorized to represent three levels of family meals (≤2 times, 3-6 times and ≥7 times). Parental encouragement of healthy eating assessed how often parents encouraged the student to eat fruits and vegetables, drink water, eat wholegrain bread, eat breakfast and drink low-fat milk (never to always). An overall scale of parental encouragement of healthy eating was created. Mixed-effect regression analyses were run controlling for gender, ethnicity, age and socio-economic status. Moderation by ethnicity was explored. Middle schools. Participants included 2895 US eighth grade students participating in the Central Texas CATCH (Coordinated Approach To Child Health) Middle School Project (mean age 13·9 years; 24·5 % White, 52·7 % Hispanic, 13·0 % African-American, 9·8 % Other; 51·6 % female). Eating more family meals was significantly associated with having parents who encouraged healthy eating behaviours (P for trend <0·001). The number of family meals was positively associated with encouragement of each of the healthy eating behaviours (P for trend <0·0001). There were no differences in the relationships by ethnicity of the students. Families who eat together are more likely to encourage healthy eating in general. Interventions which promote family meals may include tips for parents to increase discussions about healthy eating.

Farm to School and Nutrition Education: Positively Affecting Elementary School-Aged Children's Nutrition Knowledge and Consumption Behavior

Good nutrition is crucial. School-aged children battle social and health issues such as poor nutrition, childhood obesity, and minimal nutrition knowledge. This study was a quasi-experimental design analyzing the effects of the Coordinated Approach to Child Health (CATCH) nutrition curriculum with a Farm to School program to assess nutrition knowledge of 3(rd) grade students, and to increase fruit and vegetable consumption behavior. Third grade boys and girls (n=65) participated in this study. The intervention consisted of two nutrition education classes and a farm tour. Data were collected at baseline and postintervention. Surveys assessed nutrition knowledge, fruit and vegetable consumption behavior, and awareness of farms and farmers. Chi-squared tests of independence were performed to examine the relation between the baseline and postintervention responses. Significant differences were found concerning knowledge of fiber (p<0.001). Knowledge of vitamins and minerals, reported vegetable consumption behavior at school, and farm exposure were also significant (p<0.05). These findings suggest that CATCH nutrition education and farm tours can positively affect school-aged children's nutrition knowledge and fruit and vegetable consumption behavior.

Promoting Energy-Balance Behaviors Among Ethnically Diverse Adolescents

The Central Texas Coordinated Approach To Child Health (CATCH) Middle School Project is a 3.5-year school-based project aimed at promoting physical activity (PA), healthy eating, and obesity prevention among public middle school students in Texas. This article describes the CATCH intervention model and presents baseline findings from spring 2009. CATCH comprises six core components: CATCH Team, CATCH PE, CATCH Classroom, CATCH Eat Smart Cafeteria, CATCH Family, and CATCH Social Marketing. A group randomized serial cross-sectional design is being employed to test the effect of three program support conditions (n = 10 schools each) on energy-balance behaviors: Basic (training and curriculum only), Basic Plus (training and curriculum plus CATCH facilitator support), and Basic Plus Social Marketing (all inputs plus social marketing component). The study sample is composed of a cross-sectional sample of eighth-grade students (primary outcome evaluation sample) and sixth- and seventh-grade students (PE process evaluation sample) who are selected and measured each year. At baseline, 37.9% of eight-grade students (n = 2,841; 13.9 years) were overweight/obese and 19.2% were obese. Eighth-grade students reported, on average, consuming sugar-sweetened beverages more than two times on the previous day and fruits and vegetables roughly three times on the previous day; only two of five school districts surpassed the recommended 50% cut-point for class time spent in moderate-and-vigorous PA as measured in classes of sixth- and seventh-grade students. Additional behavioral findings are reported. Body mass index and behaviors were comparable across conditions. Baseline findings underscore the need to promote student energy-balance behaviors.