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
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: A total of 530 4th and 5th
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 5th grade boys from
control schools, 5th grade boys from Heart Smart schools significantly
improved their times. (5th 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
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.
Health, Cardiovascular Health, Elementary School, Physical Fitness,
School-Based, Nutrition, 4th Grade, 5th Grade, White or
Caucasian, Black or African American, Children, Middle Childhood (6-11).
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