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
Ninety-six schools in California,
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:
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):
J. L., & Scarpa, J. (2002). Encouraging
teens to adopt a safe, healthy lifestyle: A foundation for improving future
adult behaviors (Research brief).
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.
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,
information last updated 3/14/07