CHILD AND ADOLESCENT TRIAL FOR CARDIOVASCULAR HEALTH (CATCH)

OVERVIEW

The CATCH program is an middle school-based program that incorporates educational, behavioral, and school environment components. After the program, participants consumed less total and saturated fat, and participated in more physical activity. These behavioral effects were still found three years after the intervention's completion, though the impact on physical activity had declined for the oldest group of participants.

DESCRIPTION OF PROGRAM

Target population: School-age children

The Child and Adolescent Trial for Cardiovascular Health (CATCH) is one of the most extensively implemented and evaluated examples of a multicomponent, school-based program that includes an educational curriculum along with a behavioral component and school environmental change (Luepker, et al., 1996; Nader, et al., 1999). CATCH schools received school food service modifications and food service personnel training to improve the nutrition of school meals, PE interventions and teacher training to increase the amount of fun moderate-to-vigorous physical activity during PE classes, and classroom curricula to address eating habits, physical activity, and smoking.

EVALUATION(S) OF PROGRAM

Evaluated population: Analyses based on data from 3,714 middle-school students (73% of the initial cohort), who were 69% white, 14% Hispanic, 13% African American, and 4% other from 96 elementary schools in CA, LA, MN, and TX.

Ninety-six schools in California, Louisiana, Minnesota, and Texas were randomized to the CATCH intervention (56 schools) or control group (40 schools). Control schools received their usual food service, PE classes, and health curricula. Three years later, data were collected for 3,714 students. The experimental group differences observed in dietary behaviors at the end of the intervention (in elementary school) were maintained over the transition to middle school. When compared with the control group at the three-year follow up, the CATCH intervention group, on average, obtained a smaller proportion of dietary energy from total fat (30.6% vs. 31.6%) and from saturated fat (11.3% vs. 11.8%). Nader and colleagues (1999) note that, although these differences appear small in magnitude, they actually correspond to a practically relevant difference of one less dish of ice cream daily or a switch from regular to skim milk for a given student. Students from intervention schools also tended to consume less sodium than did students in the control group.

While the intervention group advantage with respect to physical activity behavior narrowed over time, the intervention group continued to average more minutes of daily vigorous activity. The narrowest difference was among 8th graders, with intervention group students averaging 30.2 minutes per day, compared with just 22.1 minutes among students in the control group. (Note: There were no significant program effects on smoking; the smoking component of the program was purely classroom-based.) Some of the CATCH intervention schools included a very minimal family component, which appeared to enhance knowledge and attitudes related to physical activity and nutrition, but did not enhance the program impact on behaviors (Leupker, et al., 1996; Nader, et al., 1996).

These findings suggest that a program that combines health education with behavioral components and school environmental modifications can improve physical activity and nutrition-related behaviors over three years after the end of the intervention. While the dissipating effects on physical activity behavior suggest that continued health promotion during junior and senior high school is warranted, further research is needed to identify the most effective programs to target these older adolescents (Nader, et al., 1999).

SOURCES FOR MORE INFORMATION

Link to program curriculum: http://www.epi.umn.edu/cyhp/r_catch.htm

References:

Luepker, R.V., Perry, C.L., McKinlay, S.M., Nader, P.R., Parcel, G.S., Stone, E.J., Webber, L.S., Elder, J.P., Feldman, H.A., Johnson, C.C., Kelder, S.H., & Wu, M. (1996). Outcomes of a field trial to improve children's dietary patterns and physical activity: The Child and Adolescent Trial for Cardiovascular Health (CATCH). Journal of the American Medical Association, 275(10), 768-776.

Nader, P.R., Stone, E.J., Lytle, L.A., Perry, C.L., Osganian, S.K., Kelder, S., Webber, L.S., Elder, J.P., Montgomery, D., Feldman, H.A., Wu, M., Johnson, C., Parcel, G.S., & Luepker, R.V. (1999). Three-year maintenance of improved diet and physical activity. The CATCH cohort. Archives of Pediatric and Adolescent Medicine, 153, 695-704.

Program also discussed in the following Child Trends publication(s):

Hatcher, J. L., & Scarpa, J. (2002). Encouraging teens to adopt a safe, healthy lifestyle: A foundation for improving future adult behaviors (Research brief). Washington , DC : Child Trends.

Hatcher, J. L. & Scarpa, J. (2001). Background for community-level work on physical health and safety in adolescence: Reviewing the literature on contributing factors. Washington, DC: Child Trends.

SUMMARY & CATEGORIZATION

Program categorized in this guide according to the following:

Evaluated participant ages: Middle school students / Program age ranges in the Guide: 12-14

Program components: School-based

Measured outcomes: Physical health

 KEYWORDS: Middle Childhood (6-11), Children (3-11), Adolescence (12-17), Elementary School, Middle School, Caucasian or White, African American or Black, Hispanic or Latino, Urban, Suburban, School-based, Home-based, Education, Life Skills Training, Substance Use, Tobacco Use, Physical Health, Nutrition, Overweight

Program information last updated 3/14/07

© Child Trends 2003