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Top 10 Lessons Learned from Project Healthy Schools


Childhood obesity is increasing in the United States; obese children are more likely to become obese adults with obesity-associated health issues. Effective programs designed to reduce the prevalence of childhood overweight and obesity are needed. We sought to review one such program, Project Healthy Schools (PHS), for key findings. Project Healthy Schools is a health curriculum that includes educational lessons, school environment changes, and health measurement. Data have shown improvement in numerous metrics after the program, including positive changes in physiologic measures and healthier lifestyle behaviors. The school’s socioeconomic status has been shown to correlate with baseline and follow-up measures, and gender differences exist. Additionally, school environmental changes support improved health behaviors. The collaborative effort and support of various stakeholders have led to the success of this health education program, resulting in numerous physiologic and behavioral benefits in middle school students throughout Michigan, and providing a replicable, real-world approach to combating childhood obesity.

The prevalence of childhood obesity (body mass index [BMI] ≥95th percentile) in the United States has drastically increased over the past 30 years.1 Childhood obesity has immediate and long-term effects on a child’s health. Obese children are more likely than non-obese children to have risk factors for cardiovascular disease,23 the leading cause of death in the United States for men and women.4 Obese children are more likely to become obese adults; obese adults are also more likely to have cardiovascular disease risk factors and other health complications.25 There are numerous long-term health issues associated with obesity (eg, diabetes, hypertension, sleep apnea, osteoarthritis, cancer).26 Project Healthy Schools (PHS) was established to address childhood obesity and its associated cardiovascular risk factors.

Project Healthy Schools is a middle school–based program, created from a partnership between the University of Michigan Health System, middle schools in Michigan, community organizations, and donors to educate and encourage children to lead healthier lifestyles. Project Healthy Schools began as a pilot program in 1 Ann Arbor middle school during the 2004-2005 school year. Since 2004, PHS has been implemented in more than 80 schools across Michigan; more than 50,000 students have participated in the program. The program utilizes school-based environmental changes and health education focused on sixth grade students.

The educational component consists of 10 sessions (Table 1) taught by a PHS health educator: a trained PHS staff member or teacher from the school. The interactive sessions focus on targeted health topics and last from 20 to 45 minutes, resulting in a minimum total of 3 hours and 20 minutes of health education. The sessions are designed to be hands-on and fun for students, while emphasizing the 5 goals of PHS: 1) eat more fruits and vegetables; 2) choose less sugary food and beverages; 3) eat less fast and fatty foods; 4) be active every day; and 5) spend less time in front of a screen. Environmental changes consist of a variety of tactics to encourage healthier behaviors in the students, including making healthier food and beverage choices available in the school (Table 2). The frequency and type of environmental changes vary by school and are determined by school administrators. The sessions and environmental changes continually evolve, on the basis of feedback from students and staff.


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-Ryan Rogers, Rachel Krallman, BS, Elizabeth A. Jackson, MD, MPH, Jean DuRussel-Weston, RN, MPH, LaVaughn Palma-Davis, MA, Rosa de Visser, MS, Taylor Eagle, BS, MS, Kim A. Eagle, MD, Eva Kline-Rogers, MS, RN

This article originally appeared in the August 2017 issue of The American Journal of Medicine.

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