Multi-Component School-Based Obesity Prevention is modeled in Arkansas, Chicago, IL,  San Antonio, TX, Philadelphia, PA, and Los Angeles, CA.

I need to say THANK YOU! The SPARK PE Workshop was incredible! My whole 3rd grade team is now implementing it. It's become a highlight of our off-the-record planning time and how we're serving the needs of our students. The coolest thing is we, the teachers, realize how important it is that we prioritize PE for our kids. We've noticed how are kids are more attentive and excited about coming to school now. Today, after a short session of "Mingle" activity, my students were so happy they were grinning ear to ear and giggling. They said, "I feel like I can fly." "I feel like my mind is free." "I feel so happy!" And much more. At the end of the day they were excited to do some more exercises at home. They are learning that moving is fun and worth the effort. We have so much fun and our learning time is much more focused after our SPARK PE time.

-Betsy Cantrall - Teacher
Oceanside Unified School District - Oceanside, CA

Obesity in America has become a major problem and the most shocking development has been the rise in obesity among children. This PBS report on one child's battle with obesity is a window into a national issue of childhood obesity. One way to combat this issue is through school-based obesity prevention programs.

Multi-component school-based obesity prevention programs are structured to improve the health of children, using the school as the primary provider. These programs aim to increase physical activity and nutrition, but also have other positive education outcomes. They can involve increased time spent in physical education and redesigned curriculum to promote more effective instruction and a more active classroom. The program goes beyond the traditional gym class sports and incorporates activities such as rock climbing, yoga, zumba and archery to engage all children and make exercise fun. Although they are primarily structured in the school system, it can also have additional parts that occur in the child's home or their local community to further stress the importance of health for children.

The program can be implemented for children of all ages in the school system. Most of the studies we found examined elementary and middle school aged children. These programs have been implemented in varying forms in all 50 states. Examples include PATH, SPARK, CATCH, and Eat Well and Keep Moving.

We chose to base our model on an implementation of the program in the Northside Independent School District in San Antonio, TX, specifically for elementary school children. The Northside program consists of the following parts: 

- Adopted the SPARK curriculum, which also includes purchasing equipment for classes such as rock walls.

- Child nutrition lessons through the physical education classes.

- Learning Tree, an after school program using staff trained in the CATCH program. 

- It also includes a family involvement program called Fit Family Fun.

Active engagement of all students during physical education class is important. Activities where students stand around watching a few of their peers are not as effective. This emphasizes the importance of adopting a wide variety of activities and games to keep all students involved. After-school programs can be important too, and mechanisms in the students' homes and community have been demonstrated to have stronger results.

We chose to base our model on an implementation of the program in the Northside Independent School District in San Antonio, TX, that is specifically for elementary school children. The Northside program consists of the following parts:

- Adopted the SPARK curriculum, which also includes purchasing equipment for classes such as rock walls.

- Child nutrition lessons through the physical education classes.

- Learning Tree, an after school program using staff trained in the CATCH program.

- It also includes a family involvement program called Fit Family Fun.

To estimate the impact of a program or policy, we use systematic literature reviews to determine causal pathways and effect sizes. Well-researched interventions that have robust, high-quality evaluations allow us to model the impact of an intervention with greater certainty. However, sometimes interventions have limited evidence and not all of the outcomes that are likely to be associated with the intervention have been studied. In those cases, we can only model what is available in the evidence base. We urge future research to take the following gaps into consideration.

Duration of Follow-up - While we do recognize long-term follow-up studies are expensive to conduct, we do believe our modeling would have benefited greatly from examining changes in obesity five or ten years from the termination of the program.

More emphasis on obesity measure as opposed to changes in BMI - We were unable to use many studies that simply evaluated changes in BMI as opposed to changes in the percentage of obese children. We felt that the distributional changes in obesity were more informative in establishing cost-savings which is why we opted to use that measure in our modeling.