Design, implementation, and quality control in the Pathways American-Indian multicenter trial.

Area of Science:

• Public Health
• Pediatric Obesity Prevention
• Health Promotion in Schools

Background:

• The Pathways study was the first multicenter, American-Indian school-based initiative to evaluate an obesity prevention program.
• The program focused on promoting healthy eating habits and increasing physical activity among students.

Purpose of the Study:

• To assess the effectiveness of a school-based obesity prevention program on children's health outcomes.
• To evaluate the program's impact on body fat, dietary intake, physical activity, and health-related knowledge and behaviors.

Main Methods:

• Utilized a nested cohort design with 41 schools randomized to intervention or control groups.
• Followed 1,704 third-grade students, measuring percent body fat, school lunch composition, physical activity, and knowledge/attitudes/behaviors.
• Implemented rigorous quality control (QC) measures, including standardized data management, training, and process evaluations.

Main Results:

• No significant difference in mean percent body fat was observed between intervention and control groups by fifth grade.
• Intervention schools showed significant reductions in dietary fat and saturated fat content in school lunches and total energy intake.
• Students in intervention schools reported increased physical activity levels and enhanced knowledge of healthy behaviors.

Conclusions:

• Schools can play a vital role in public health promotion, particularly in childhood obesity prevention.
• The study's design, quality control systems, and procedures offer valuable models for future school-based health studies.