Effects of a school-based intervention to reduce cardiovascular disease risk factors in elementary-school children: the Cardiovascular Health in Children (CHIC) study
Abstract
Objective To test a classroom-based intervention to reduce cardiovascular disease risk factors in elementary school children.Study design This was a randomized, controlled field trial in 12 schools across North Carolina, stratified by geographic region and urban/rural setting. Subjects were 1274 third and fourth graders (48% boys). The intervention, taught by regular classroom and physical education teachers, provided all children an 8-week exercise program and 8 weeks of classes on nutrition and smoking. Data were analyzed at the school level with survey regression models and at the individual level with multivariate analysis of variance and analysis of covariance models; 95% confidence intervals were computed.Results Children in the intervention group had significantly greater knowledge (7.9% more correct) and a significant increase in self-reported physical activity than children in the control group. Trends for the intervention group were a reduction in total cholesterol level (-5.27 mg/dl), an increase in aerobic power, a reduction in body fat, and smaller rise in diastolic blood pressure than control children.Conclusions This classroom-based, public health approach improved children's cardiovascular disease risk profiles; it is practical and fairly easy to incorporate into the school day. All children directly receive the potential benefits of the intervention without a risk of labeling. This program can improve health knowledge, habits, and health outcomes of young children at a time when health habits are being formed.
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School programs reach children across risk levels, including those lacking play space, and can reduce stigma for those at risk.
“Schools provide benefit to children from all risk groups (Harrell 1996;WHO 2004a), particularly those with limited or no access to play areas (McKenzie 1996); and avoids stigmatization of at-risk children (Harrell 1998).”
From School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18 (2013) · cites this paper as Harrell 1996
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- Authors
- Harrell, J. S., McMurray, R. G., Bangdiwala, S. I., Frauman, A. C., Gansky, S. A., & Bradley, C. B.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Venue
- The Journal of Pediatrics
- Publisher
- Elsevier BV
- Published
- 1996-06
- Volume
- 128
- Issue
- 6
- Pages
- 797-805
- ISSN
- 0022-3476 (ISSN-L)
- OpenAlex
- W1991704523
- Cited by
- 189
- References
- 42
- Citations by year
- 2025: 5 · 2024: 4 · 2023: 2 · 2022: 3 · 2020: 3 · 2019: 1 · 2018: 6 · 2017: 4 · 2016: 5 · 2015: 13 · 2014: 6 · 2013: 16 · 2012: 8
- FWCI
- 4.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Public Health Service (R01-1837)
- National Institute of Nursing Research (R01NR001837)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- cardiovascular risk factors, school-based intervention, elementary school students, physical activity, nutrition education, smoking prevention, cholesterol, aerobic power, fat mass, blood pressure, health knowledge
- MeSH terms
- Cardiovascular Diseases, Child, Cholesterol, Curriculum, Female, Health Education, Humans, Health Knowledge, Attitudes, Practice, Male, North Carolina, Risk Factors, Rural Population, Urban Population, Program Evaluation
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