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Multi-component school-based obesity prevention interventions

Health Factors: Diet & Exercise
Decision Makers: Educators Public Health Professionals & Advocates
Evidence Rating: Scientifically Supported
Population Reach: 10-19% of WI's population
Impact on Disparities: No impact on disparities likely

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Multi-component school-based obesity prevention programs seek to increase physical activity and improve nutrition before, during, and after school. Programs combine educational, behavioral, environmental, and other components such as health and nutrition education classes, enhanced physical education and activities, promotion of healthy food options, and family education and involvement. Specific components vary by program.

Expected Beneficial Outcomes

Increased physical activity
Improved weight status
Improved dietary habits
Reduced obesity rates

Evidence of Effectiveness

There is strong evidence that multi-component school-based obesity prevention programs increase physical activity (Nixon 2012, Cochrane-Dobbins 2013, Demetriou 2012), improve weight status (Khambalia 2012, Cochrane-Waters 2011, Katz 2008), and improve dietary habits (Kropski 2008, Van Cauwenberghe 2012, Cawley 2011). However, there is significant variability in program design and effect (Brown 2009, Harris 2009a, CG-Obesity). Additional evidence is needed to confirm effects on body mass index (BMI) and characteristics of successful programs.

In general, multi-component school-based obesity prevention programs are more successful than single component programs (Cochrane-Waters 2011, Katz 2008, Khambalia 2012, Van Cauwenberghe 2012, Dunton 2010, Townsend 2011). School-based obesity prevention programs that target both sides of the energy balance, including healthy food and physical activity, appear more effective than one-sided programs (De Bourdeaudhuij 2011). Specific components of school-based obesity prevention programs may be more effective for some age groups than others (Dunton 2010). The effect of such programs on BMI varies substantially, with many programs showing significant positive effects (Cochrane-Waters 2011, Kropski 2008, Brown 2009), others showing no effect (Cochrane-Dobbins 2013, Brown 2009, Harris 2009a), and in rare instances, programs with negative effects (Demetriou 2012).

In the short-term, school-based obesity prevention programs can reduce the prevalence of childhood obesity; additional evidence is needed to determine long-term effects (Gonzalez-Suarez 2009). In a Texas-based study, for example, the CATCH program reduced the rate of increase in overweight children in low income, Hispanic communities (Coleman 2005).


United States

Obesity prevention programs that use health education classes, enhanced physical education, and promotion of healthy food options are used in all 50 states. Examples include PATH, SPARK, and Eat Well and Keep Moving.

Implementation Resources

Brain Breaks - Educational Materials Center (EMC). Brain breaks: A physical activity idea book for elementary classroom teachers. Accessed on March 15, 2016
CDC-Nutrition policies 2010 - Division of Nutrition, Physical Activity, and Obesity (DNPAO). DNPAO state program highlights: Applying nutrition policies in child care, school, and worksite settings. Atlanta: Centers for Disease Control and Prevention (CDC); 2010. Accessed on December 7, 2015
CDC-School-based obesity prevention - National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Adolescent and School Health (DASH). School-based obesity prevention strategies for state policymakers. Atlanta: Centers for Disease Control and Prevention (CDC). Accessed on February 16, 2018

Citations - Evidence

Brown 2009 - Brown T, Summerbell C. Systematic review of school-based interventions that focus on changing dietary intake and physical activity levels to prevent childhood obesity: An update to the obesity guidance produced by the National Institute for Health and Clinical Excellence. Obesity Reviews. 2009;10(1):110-41. Accessed on December 7, 2015
Cawley 2011* - Cawley J, Cisek-Gillman L, Roberts R, et al. Effect of HealthCorps, a high school peer mentoring program, on youth diet and physical activity. Childhood Obesity. 2011;7(5):364–71. Accessed on December 1, 2015
CG-Obesity - The Guide to Community Preventive Services (The Community Guide). Obesity. Accessed on March 1, 2018
Cochrane-Dobbins 2013* - Dobbins M, Husson H, DeCorby K, LaRocca RL. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database of Systematic Reviews. 2013;(2):CD007651. Accessed on January 10, 2018
Cochrane-Waters 2011* - Waters E, de Silva-Sanigorski A, Burford BJ, et al. Interventions for preventing obesity in children. Cochrane Database of Systematic Reviews. 2011;(12):CD001871. Accessed on January 10, 2018
Coleman 2005 - Coleman KJ, Tiller CL, Sanchez J, et al. Prevention of the epidemic increase in child risk of overweight in low-income schools. Archives of Pediatrics & Adolescent Medicine. 2005;159(3):217–24. Accessed on December 14, 2015
De Bourdeaudhuij 2011* - De Bourdeaudhuij I, Van Cauwenberghe E, Spittaels H, et al. School-based interventions promoting both physical activity and healthy eating in Europe: A systematic review within the HOPE project. Obesity Reviews. 2011;12(3):205-16. Accessed on December 8, 2015
Demetriou 2012* - Demetriou Y, Höner O. Physical activity interventions in the school setting: A systematic review. Psychology of Sport and Exercise. 2012;13(2):186-96. Accessed on January 10, 2018
Dunton 2010* - Dunton GF, Durand CP, Riggs NR, Pentz MA. School-based obesity-prevention programs. In: Bagchi D, ed. Global perspectives on childhood obesity: Current status, consequences, and prevention. Waltham: Academic Press; 2010:319–31. Accessed on January 10, 2018
Gonzalez-Suarez 2009* - Gonzalez-Suarez C, Worley A, Grimmer-Somers K, Dones V. School-based interventions on childhood obesity: A meta-analysis. American Journal of Preventive Medicine. 2009;37(5):418–27. Accessed on February 16, 2016
Harris 2009a - Harris KC, Kuramoto LK, Schulzer M, Retallack JE. Effect of school-based physical activity interventions on body mass index in children: A meta-analysis. Canadian Medical Association Journal. 2009;180(7):719–26. Accessed on February 6, 2018
Katz 2008* - Katz D, O’Connell M, Njike V, Yeh M-C, Nawaz H. Strategies for the prevention and control of obesity in the school setting: Systematic review and meta-analysis. International Journal of Obesity. 2008;32(12):1780-9. Accessed on May 23, 2017
Khambalia 2012* - Khambalia AZ, Dickinson S, Hardy LL, Gill T, Baur LA. A synthesis of existing systematic reviews and meta-analyses of school-based behavioural interventions for controlling and preventing obesity. Obesity Reviews. 2012;13(3):214-33. Accessed on February 24, 2016
Kropski 2008 - Kropski JA, Keckley PH, Jensen GL. School-based obesity prevention programs: An evidence-based review. Obesity. 2008;16(5):1009-18. Accessed on January 10, 2018
Nixon 2012 - Nixon CA, Moore HJ, Douthwaite W, et al. Identifying effective behavioural models and behaviour change strategies underpinning preschool- and school-based obesity prevention interventions aimed at 4-6-year-olds: A systematic review. Obesity Reviews. 2012;13(Suppl 1):106-17. Accessed on February 6, 2018
Townsend 2011* - Townsend N, Murphy S, Moore L. The more schools do to promote healthy eating, the healthier the dietary choices by students. Journal of Epidemiology & Community Health. 2011;65(10):889–95. Accessed on November 24, 2015
Van Cauwenberghe 2012 - Van Cauwenberghe E, Maes L, Spittaels H, et al. Effectiveness of school-based interventions in Europe to promote healthy nutrition in children and adolescents: Systematic review of published and “grey” literature. British Journal of Nutrition. 2010;103(6):781-97. Accessed on January 10, 2018

Citations - Implementation

Eat Well and Keep Moving - Eat Well & Keep Moving. An interdisciplinary curriculum for teaching upper elementary school nutrition and physical activity. Accessed on December 15, 2015
PATH - Healthy San Bernadino County. Physical activity and teenage health (PATH) program. Accessed on May 20, 2016
SPARK - Sports, Play and Active Recreation for Kids (SPARK). Countering childhood obesity since 1989. Accessed on February 6, 2018

Page Last Updated

January 18, 2014

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