Date of Award
Doctor of Philosophy
Katherine T. Thomas
The Nutrition and Physical Activity Program to Prevent Obesity and Other Chronic Diseases at the Centers for Disease Control and Prevention employs a five-level Social-Ecological Model (SEM) to address and understand the issues of overweight and obesity (Hamre et al., 2006). The model suggests that there are multiple levels of influence, and that effective prevention and reduction programs should address each of these levels. This research evaluated the effectiveness of programs and institutions with an emphasis on reducing childhood overweight and obesity. The first study evaluated the effectiveness of the Trim Kids program (Sothern, von Almen & Schumacher, 2001), a program with applications at the individual, interpersonal and organizational levels. The hypothesis that Trim Kids would help children achieve a healthier weight through a reduction in mass, BMI, BMI-for-age percentile or waist circumference was only partially supported. Participants did see a statistically significant reduction in BMI, but the effect size was low and a concurrent statistically significant increase in stature appeared to account for the reduction. In the second study, a macro-level initiative was evaluated, namely the health education curricula of ten states, using the Health Education Curriculum Analysis Tool (HECAT). The hypothesis that states with lower obesity rates would have higher HECAT Scores when compared to states with higher obesity rates was not supported. HECAT scores demonstrated that the tool is not unfairly biased against states whose standards are not based on the National Health Education Standards and allows for meaningful application of concepts and skills to reflect the priorities of a given area. The lack of support for either hypothesis demonstrates that there is much more research to be done in the area of program and curricular development aimed at reducing childhood overweight and obesity. Both Trim Kids and many states' curricula provided good nutrition and physical activity concept coverage, demonstrating that knowledge alone is not sufficient for behavior change.
Susan Lee Brown
Brown, Susan Lee, "Using a social-ecological model to examine obesity interventions" (2011). Graduate Theses and Dissertations. 10440.