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School-based health education programs can be maintained over time: results from the CATCH Institutionalization
Deanna M Hoelscher1, Henry A Feldman, Carolyn C Johnson
1Center for Health Promotion and Prevention Research, The University of Texas-Houston School of Public Health, Houston, TX 77030, USA. Deanna.M.Hoelscher@uth.tmc.edu
Preventive Medicine
|April 7, 2004
Summary
School programs promoting healthy choices can be sustained long-term, especially with continued staff training. This study evaluated the Child and Adolescent Trial for Cardiovascular Health (CATCH) program
Area of Science:
- School-based health promotion
- Public health interventions
- Behavioral science in education
Background:
- School-based health promotion research often overlooks program sustainability.
- Few studies examine the long-term viability of organizational implementation of health programs.
Purpose of the Study:
- To determine the maintenance of school-level changes from the Child and Adolescent Trial for Cardiovascular Health (CATCH) program 5 years post-intervention.
- To assess the institutionalization of CATCH program components in former intervention and comparison schools.
Main Methods:
- Assessed macronutrient content of school lunch menus, physical education (PE) class time and activity levels, and health instruction.
- Developed an institutionalization score based on program maintenance variables.
- Compared former intervention schools (n=56), former comparison schools (n=20), and unexposed control schools (n=12).
Main Results:
- 50% of former intervention cafeterias met "Eat Smart" guidelines for fat, compared to 10-17% of control/unexposed schools.
- No significant differences in CATCH physical education goals implementation.
- Former intervention schools showed higher institutionalization scores and more CATCH-related instruction time.
- Staff training significantly impacted program maintenance.
Conclusions:
- School environmental changes supporting healthy behaviors can be maintained over time.
- Staff training is crucial for the institutionalization of health programs in schools.