Program

Aug 17, 2011

OVERVIEW

The “Know Your
Body” curriculum intervention is a program designed to teach healthy behaviors
(primarily good nutrition and smoking prevention) to students in fourth through
ninth grades, in order to reduce behaviors in adolescence shown to contribute to
the development of chronic illnesses such as cancer and coronary heart disease.
The intervention was delivered by trained teachers, two hours per week for five
years, and addressed the immediate and long-term effects of smoking, the
benefits of good nutrition, and strategies for dealing with some of the social
and psychological precursors of unhealthy behaviors. On average, after six
years, students in the intervention group smoked less and maintained a diet
lower in saturated fat and higher in carbohydrates and fibers than the one
followed by students in the control condition.

DESCRIPTION OF PROGRAM

Target population:
Elementary and middle school students

“Know Your Body” is
a school-based curriculum aimed at reducing the risk of developing chronic
disease by teaching healthy diet and other life-style choices. The nutrition
component promotes a reduced-fat diet high in complex carbohydrates and fiber.
The cigarette smoking prevention component targets health-related beliefs, and
psychological and social influences believed to contribute to adolescent smoking
decisions. This curricular component also includes biofeedback demonstrations of
the immediate health effects of smoking, information on the long-term health
effects of smoking, and discussion of the effects of smoking-related decisions
on self-image, values, stress and anxiety. Other components include
demonstration of healthy stress-management techniques, communication and
decision-making strategies and assertiveness skills. Classroom teachers (trained
and monitored by research staff) teach the curriculum in their classes for
approximately two hours per week. Cognitive development theory provides the
framework for the intervention. The intervention is designed to begin in the
fourth grade and lasts, with yearly progress assessments, until ninth grade.

EVALUATION(S) OF PROGRAM

Walter, H. J.,
Hofman, A., Vaughan, R. D., & Wynder, E. L. (1988). Modification of risk factors
for coronary heart disease: Five-year results of a school-based intervention
trial. The New England Journal of Medicine, 218,1093-1100.

Evaluated
population: 
The study involved two demographically dissimilar areas in the
New York City area. The first population included 2,283 elementary students (4th
graders in 1980) in all 22 elementary schools in a single school district in the
Bronx, a lower-income borough. The second population consisted of 1,105
students (4th graders in 1979) in all 15 elementary schools in four
school districts in Westchester County, a middle- and upper-income suburb.

Approach: Of
the 22 schools (2,283 students) in the Bronx who agreed to participate in the
study, 14 were randomly assigned to the intervention protocol (1,590 students),
and eight to the non-intervention treatment group (693 students). In
Westchester, of the 15 schools (1,105 students), eight schools were randomly
assigned to the intervention protocol (485 students), and seven schools to the
non-intervention treatment group (620 students). It was necessary to assign
students to a group based on their school district, because all elementary
schools in one district feed into the same high school. Intervention groups
only were taught the “Know Your Body” curriculum. Both intervention and
nonintervention groups were taught the state-mandated one-semester general
health education curriculum.

Biological risk
factors and health knowledge were measured in all populations by trained
professionals at base line (4th grade), and at four follow-up points
(5th, 6th, 7th, and 9th grades).
All students received by mail examination results with explanatory material and
healthy lifestyle recommendations. Students in the intervention group also
received their results (with additional classifications of health status) in the
classroom. Risk factors were assessed over time, to determine whether or not
they were affected by the intervention.

Of the original
sample in the Bronx (2,283 students), 66 percent overall (1,036 students) had
data recorded at both baseline and termination (six years later). Of the
original sample in Westchester County (1,105 students), 81 percent overall (733
students) had data recorded at both baseline study and termination (six years
later).

Results: The
intervention program appeared to be associated with favorable trends in total
cholesterol levels among school children in the two demographically dissimilar
populations. The impact appeared to be larger in Westchester than in the Bronx;
however, the reasons for this difference are unclear. There was also a
significant increase in prevention-related knowledge in both populations. Study
time was insufficient to tell if the intervention had any impact on cigarette
use. As for body mass, physical fitness or blood pressure, the intervention
program appeared to have no main impacts.

Walter, Vaughn,
& Wynder (1989). Primary prevention of cancer among children: Changes in
cigarette smoking and diet after six years of intervention. Journal of the
National Cancer Institute
, 81 (13.) 995-999.

Evaluated population:
The program involved 991 elementary students
(4th graders in 1979) in 15 schools in four Westchester, New York
school districts. Of the participants, 79.3 percent of were white, 13.8 percent
Black, 2.2 percent Hispanic and 4.7 percent Other (Asian & Pacific Islander).
The median family income was $55,904.

Approach:
Schools were randomly assigned to the intervention (eight schools, 485 students)
or control (seven schools, 620 students) groups. Researchers measured smoking
and dietary behaviors at 4th grade, and again 6 years later. The
intervention group received the “Know Your Body” curriculum beginning in the
fourth grade and continuing through the 9th grade. Classroom teachers
(trained by research staff) taught the curriculum for approximately two hours
per week.

Cigarette smoking
was measured at baseline and termination by testing for nicotine byproducts in
the blood and/or saliva (by termination, saliva-based testing only was used due
to its superior sensitivity). Subsamples of each group participated in a 24-hour
dietary recall interview, which researchers used to examine intake of various
food groups.

Of the original
sample, 65.1 percent of students (N=395) had data recorded at both baseline
study and termination (6 years later).

Results:
Students who attended schools in the intervention group had a significantly
smaller rate of smoking at study termination than students who attended schools
in the control group. At termination, 3.5 percent of the intervention group were
classified as current cigarette smokers. The percentage of the control group
classified as cigarette smokers, 13.1, was significantly higher. This impact
appeared to be stronger among males than females.

Students in the
intervention schools showed a significant net decrease (19.4percent) in
reported saturated fat intake and a significant net increase (9.5
percent) in reported carbohydrate intake, compared with students in the
nonintervention schools. When the data for the intervention schools were
analyzed by gender, males showed a significant net increase in total
carbohydrate intake and females showed a significant net decrease in saturated
fat intake, as well as a significant increase in carbohydrate and crude fiber
intake.

SOURCES FOR MORE INFORMATION

References

Walter, Vaughn, &
Wynder (1989). Primary prevention of cancer among children: Changes in cigarette
smoking and diet after six years of intervention. Journal of the National
Cancer Institute
, 81 (13), 995-999.

Walter, H. J.,
Hofman, A., Vaughan, R. D., & Wynder, E. L. (1988). Modification of risk factors
for coronary heart disease: Five-year results of a school-based intervention
trial. The New England Journal of Medicine, 218,1093-1100.

Contact information

Lisa M. Zenner

Senior Inside Sales
Representative

College Division

Kendall/Hunt
Publishing Company

4050 Westmark Drive

P.O. Box 1940

Dubuque, Iowa
52004-1840

800-247-3458
(phone)

563-589-1161 (fax)


lzenner@kendallhunt.com

Curriculum can
be purchased at:


http://www.kendallhunt.com/Store_Home.aspx

KEYWORDS:
Nutrition; Other Physical Health; Tobacco; Elementary; Children (3-11);
White/Caucasian; Co-ed; Middle-school; School-based; High School; Adolescents
(12-17), Manual.

Program
information last updated 8/17/2011.

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