BACKGROUND: Despite the high rates of overweight and obesity among rural children, there have been limited interventions reported to improve the diet quality of rural, low-income children in the United States. OBJECTIVE: Our aim was to evaluate students' diet quality at baseline and after implementing the CHANGE (Creating Healthy, Active and Nurturing Growing-Up Environments) study, a 2-year (2007-2009) randomized, controlled, community- and school-based intervention to prevent unhealthy weight gain among rural school-aged children. DESIGN: We used a school and community-based group randomized, controlled design. PARTICIPANTS/ SETTING: Data were collected in eight rural communities in California, Kentucky, Mississippi, and South Carolina (one elementary school per community). Children in grades 1 to 6 participated in the study (n=432; mean age=8.65 years ± 1.6 years). Students' diets were assessed at baseline (spring or early fall 2008) and post intervention (spring 2009) using the Block Food Screener for ages 2 to 17 years. STATISTICAL ANALYSES: Mixed-model analysis of variance was used to examine the effect of the CHANGE study intervention on students' diets. Results were adjusted for corresponding baseline dietary values, sex, age, grade, race/ethnicity, and state, with school included as a random effect nested within condition. RESULTS: At the end of 1 year, students enrolled in the CHANGE study intervention schools consumed significantly more vegetables (0.08 cups/1,000 kcal/day; P=0.03) and combined fruits and vegetables (0.22 cups/1,000 kcal/day; P<0.05) compared with students in control schools. Students in the intervention schools also showed a reduction in the average daily dietary glycemic index (GI=-1.22; P<0.05) and a trend toward more fruit consumption (0.15 cups/1,000 kcal/day; P=0.07). There were no significant differences in students' consumption of whole grains, legumes, dairy, potatoes/potato products, saturated fat, added sugars, or dietary fiber consumption. CONCLUSIONS: The CHANGE study enhanced some aspects of rural students' dietary intake. Implementing similar interventions in rural America can be promising to support vegetable consumption.
RCT Entities:
BACKGROUND: Despite the high rates of overweight and obesity among rural children, there have been limited interventions reported to improve the diet quality of rural, low-income children in the United States. OBJECTIVE: Our aim was to evaluate students' diet quality at baseline and after implementing the CHANGE (Creating Healthy, Active and Nurturing Growing-Up Environments) study, a 2-year (2007-2009) randomized, controlled, community- and school-based intervention to prevent unhealthy weight gain among rural school-aged children. DESIGN: We used a school and community-based group randomized, controlled design. PARTICIPANTS/ SETTING: Data were collected in eight rural communities in California, Kentucky, Mississippi, and South Carolina (one elementary school per community). Children in grades 1 to 6 participated in the study (n=432; mean age=8.65 years ± 1.6 years). Students' diets were assessed at baseline (spring or early fall 2008) and post intervention (spring 2009) using the Block Food Screener for ages 2 to 17 years. STATISTICAL ANALYSES: Mixed-model analysis of variance was used to examine the effect of the CHANGE study intervention on students' diets. Results were adjusted for corresponding baseline dietary values, sex, age, grade, race/ethnicity, and state, with school included as a random effect nested within condition. RESULTS: At the end of 1 year, students enrolled in the CHANGE study intervention schools consumed significantly more vegetables (0.08 cups/1,000 kcal/day; P=0.03) and combined fruits and vegetables (0.22 cups/1,000 kcal/day; P<0.05) compared with students in control schools. Students in the intervention schools also showed a reduction in the average daily dietary glycemic index (GI=-1.22; P<0.05) and a trend toward more fruit consumption (0.15 cups/1,000 kcal/day; P=0.07). There were no significant differences in students' consumption of whole grains, legumes, dairy, potatoes/potato products, saturated fat, added sugars, or dietary fiber consumption. CONCLUSIONS: The CHANGE study enhanced some aspects of rural students' dietary intake. Implementing similar interventions in rural America can be promising to support vegetable consumption.
Authors: Charlotte E L Evans; Meaghan S Christian; Christine L Cleghorn; Darren C Greenwood; Janet E Cade Journal: Am J Clin Nutr Date: 2012-09-05 Impact factor: 7.045
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Authors: Rebecca K Hodder; Kate M O'Brien; Fiona G Stacey; Flora Tzelepis; Rebecca J Wyse; Kate M Bartlem; Rachel Sutherland; Erica L James; Courtney Barnes; Luke Wolfenden Journal: Cochrane Database Syst Rev Date: 2019-11-07
Authors: Rebecca K Hodder; Fiona G Stacey; Kate M O'Brien; Rebecca J Wyse; Tara Clinton-McHarg; Flora Tzelepis; Erica L James; Kate M Bartlem; Nicole K Nathan; Rachel Sutherland; Emma Robson; Sze Lin Yoong; Luke Wolfenden Journal: Cochrane Database Syst Rev Date: 2018-01-25
Authors: Jayne A Fulkerson; Melissa L Horning; Daheia J Barr-Anderson; Jennifer A Linde; Abbey C Sidebottom; Rebecca Lindberg; Sarah Friend; Colleen Flattum; Rebecca L Freese Journal: Contemp Clin Trials Date: 2020-09-28 Impact factor: 2.226
Authors: Rebecca K Hodder; Kate M O'Brien; Fiona G Stacey; Rebecca J Wyse; Tara Clinton-McHarg; Flora Tzelepis; Erica L James; Kate M Bartlem; Nicole K Nathan; Rachel Sutherland; Emma Robson; Sze Lin Yoong; Luke Wolfenden Journal: Cochrane Database Syst Rev Date: 2018-05-17