HEART SMART SCHOOL HEALTH PROMOTION

OVERVIEW

The Heart Smart School Health Promotion is a multi-component school-based cardiovascular health promotion program for elementary school students.  In a random assignment study, two schools were assigned to implement the Heart Smart program and two schools were assigned to serve as controls.  Over the course of one school year, students from Heart Smart schools increased their high-density lipoprotein cholesterol levels to a greater extent than did students from control schools.  (High-density lipoprotein cholesterol is the “good cholesterol” that protects against cardiovascular diseases.)  Additionally, boys from Heart Smart schools improved their fitness levels to a greater extent than did control boys, as measured by times on the fitness run/walk, and students increased their health knowledge. 

DESCRIPTION OF PROGRAM

Target population: elementary school students

The Heart Smart School Health Promotion is a school-wide cardiovascular health promotion program for elementary school students.  The intervention seeks to improve student nutrition, exercise habits, and behavior skills relevant to a healthful lifestyle.  Program components include cardiovascular health screenings, a cardiovascular health curriculum, an aerobic physical education curriculum, and a modified school lunch program.

The Heart Smart cardiovascular health curriculum is designed to be taught as a general science course.  The curriculum covers cardiovascular anatomy and physiology, nutrition and eating behaviors, physical activity and exercise behavior, and behavioral and coping skills.  13-35 classroom hours are spent on the curriculum each year, with the complexity of health education as a science increasing each year.

The Heart Smart aerobic physical education curriculum (known as Superkids-Superfit) promotes knowledge, behavioral skills, and patterns of physical activity consistent with lifelong maintenance of cardiovascular health.  Twelve lessons gradually increase students’ level of fitness through personalized, noncompetitive activities, such as jogging, power walking, jump roping, and aerobic dancing.  Lessons teach students about the relationship between exercise and heart disease, the benefits and guidelines of exercise, the components of fitness, how heart rate and blood pressure respond to exercise, how to develop a fitness plan, and how to care for and prevent fitness-related injuries.  In addition to these 12 lessons, schoolwide fitness activities are implemented throughout the school year and teachers are provided with resources to help encourage parent and summer activity.

The Heart Smart school lunch program involve modifying school lunches so that they included less salt, simple sugar, fat, and saturated fat.  Students are provided heart-healthy lunch choices in addition to regular lunch choices.  These food choices offer students the opportunity to practice active decision-making in food selection.   

EVALUATION(S) OF PROGRAM

Evaluated population: 530 4^th and 5^th graders from four elementary schools in Jefferson Parish, Louisiana served as the study sample for this investigation.  The Jefferson Parish school district serves children from lower to upper-middle income families.  58% of Jefferson Parish students are white; 32% are black; and 10% are of other ethnicities.

Approach: The four elementary schools were randomly assigned – two schools to the treatment group and two schools to the control group.  The two schools assigned to the treatment group implemented the Heart Smart School Health Promotion in their schools.  To provide for optimal curriculum implementation, teachers underwent an intense two-day workshop on principles of cardiovascular health and attended bimonthly program booster sessions.  Cafeteria staff also attended a Heart Smart training program to prepare for program implementation.

At the beginning of the school year, students at all four schools completed baseline measures.  These measures included a physiological assessment, a test of cardiovascular health knowledge, and a timed fitness run/walk.  Physiological measurements were taken again midway through the school year and at the end of the school year.  Students also re-took the cardiovascular health knowledge test and participated in a fitness walk/run at the end of the school year.  Throughout the school year, students’ school lunch menu choices were recorded.

Results: Over the course of the intervention, students from Heart Smart schools increased their high-density lipoprotein cholesterol levels to a greater extent than did students from control schools.  (High-density lipoprotein cholesterol is the “good cholesterol” that protects against cardiovascular diseases.)

Additionally, boys from Heart Smart schools improved their fitness levels to a greater extent than did control boys, as measured by times on the fitness run/walk.  Compared with 5^th grade boys from control schools, 5^th grade boys from Heart Smart schools significantly improved their times.  (5^th grade girls from Heart Smart schools also improved their times, but not to a statistically significant extent.)  Fourth grade participants showed larger gains in knowledge when compared with students in control schools.

Note: Analyses were not designed to adjust for the effect of clustering within schools.

SOURCES FOR MORE INFORMATION

References:

Arbeit, M. L., Johnson, C. C., Mott, D. S., Harsha, D. W., Nicklas, T. A., Webber, L. S., & Berenson, G. S.  (1992).  The Heart Smart Cardiovascular School Health Promotion: Behavior Correlates of Risk Factor Change.  Preventive Medicine, 21, 18-32.

Program categorized in this guide according to the following:

Evaluated participant ages: 9-11

Evaluated participant grades: 4^th-5^th  

Program age ranges in the guide: Middle Childhood

Program components: School-based

Measured outcomes: Physical Health

Program information last updated on 11/8/07.

© Child Trends 2003