Effect of the Healthy Schools Program on prevalence of overweight and obesity in California schools, 2006-2012

The Alliance for a Healthier Generation's Healthy Schools Program (HSP) is a national evidence-based obesity-prevention initiative aimed at providing the schools in greatest need with onsite training and technical assistance (TTA) and consultation with national experts (HSP national advisors) to create sustainable healthy change in schools' nutrition and physical activity environments. The objective of this study was to evaluate the impact of HSP on the prevalence of overweight and obesity in California schools, from HSP's inception in 2006 through 2012. We used statewide body mass index (BMI) data collected annually from 5th-, 7th-, and 9th-grade students to determine whether enrolling in the HSP's onsite intervention reduced the prevalence of overweight and obesity in intervention schools (n = 281) versus propensity-score matched control schools (n = 709) and whether increasing exposure to the program (TTA and contact with HSP national advisors) was associated with reductions in the prevalence of overweight and obesity. Analyses showed no difference between HSP schools and control schools in overweight or obesity prevalence. However, program exposure varied widely among participating schools, and each additional contact with TTA or HSP national advisors was associated with a 0.3% decline in overweight and obesity prevalence (P < .05). HSP appears to be an important means of supporting schools in reducing obesity. Although participation in HSP alone was not sufficient to improve weight status in California schools, there was a clear dose-response relationship to the program. HSP serves as an effective model for addressing childhood obesity among engaged schools.