Impact of school-based vegetable garden and physical activity coordinated health interventions on weight status and weight-related behaviors of ethnically diverse, low-income students: Study design and baseline data of the Texas, Grow! Eat! Go! (TGEG) cluster-randomized controlled trial

Abstract Background Coordinated, multi-component school-based interventions can improve health behaviors in children, as well as parents, and impact the weight status of students. By leveraging a unique collaboration between Texas AgriLife Extension (a federal, state and county funded educational outreach organization) and the University of Texas School of Public Health, the Texas Grow! Eat! Go! Study (TGEG) modeled the effectiveness of utilizing existing programs and volunteer infrastructure to disseminate an enhanced Coordinated School Health program. The five-year TGEG study was developed to assess the independent and combined impact of gardening, nutrition and physical activity intervention(s) on the prevalence of healthy eating, physical activity and weight status among low-income elementary students. The purpose of this paper is to report on study design, baseline characteristics, intervention approaches, data collection and baseline data. Methods The study design for the TGEG study consisted of a factorial group randomized controlled trial (RCT) in which 28 schools were randomly assigned to one of 4 treatment groups: (1) Coordinated Approach to Child Health (CATCH) only (Comparison), (2) CATCH plus school garden intervention [Learn, Grow, Eat & Go! (LGEG)], (3) CATCH plus physical activity intervention [Walk Across Texas (WAT)], and (4) CATCH plus LGEG plus WAT (Combined). The outcome variables include student’s weight status, vegetable and sugar sweetened beverage consumption, physical activity, and sedentary behavior. Parents were assessed for home environmental variables including availability of certain foods, social support of student health behaviors, parent engagement and behavior modeling. Results Descriptive data are presented for students (n = 1369) and parents (n = 1206) at baseline. The sample consisted primarily of Hispanic and African American (53 % and 18 %, respectively) and low-income (i.e., 78 % eligible for Free and Reduced Price School Meals program and 43 % food insecure) students. On average, students did not meet national guidelines for vegetable consumption or physical activity. At baseline, no statistical differences for demographic or key outcome variables among the 4 treatment groups were observed. Conclusions The TGEG study targets a population of students and parents at high risk of obesity and related chronic conditions, utilizing a novel and collaborative approach to program formulation and delivery, and a rigorous, randomized study design

Weight-Related Barriers for Overweight Students in an Elementary Physical Education Classroom: An Exploratory Case Study with One Physical Education Teacher

IntroductionAs physical performance may be more difficult for overweight children than for their non-overweight peers, understanding how weight impacts student performance in the physical education (P.E.) classroom could inform school-based obesity prevention programming.Materials and methodsThis qualitative case study examined one elementary physical educator’s perspectives of overweight students’ weight-related experiences in her classroom. Narratives were elicited during an in-depth interview and analyzed using structural and thematic analyses. We utilized the social cognitive theory to inform our exploration of the narratives.FindingsThe thematic analysis illuminated a behavioral pattern of student refusal to participate in the P.E. classroom while the structural analysis emphasized the teacher’s constructive, individualized responses to participation refusals. Combined, the two analytic techniques provided a more holistic snapshot of the experiences of overweight students in this elementary school. In addition, a preliminary model explaining the behavioral pattern among overweight students in this particular P.E. classroom was created.DiscussionStudents who were overweight were more likely to initially refuse to attempt physical tasks in the classroom because they feared peer ridicule, and the teacher played a critical role in whether these students chose to participate in subsequent classes. As agents of change, P.E. educators should be included in formative stages of comprehensive, systemic changes to combat childhood obesity