United States: Encouraging Active Living and Healthy Eating
Active Living by Design and Healthy Eating by Design are two projects that
aim to increase active living, physical activity, healthy eating and improved
nutrition among residents of the Logan Square Neighbourhood of Chicago.
Based on a primary care model, they are run by a collaboration that was
initiated by the University of Illinois at Chicago College of Nursing, with the
Illinois Health Education Consortium and the Logan Square Neighbourhood
Association. Staff work with the community to identify health needs that
they then endeavour to meet through a variety of feasible and aff ordable
programmes. The programmes are community-based or school-based and
serve children, their families, the school staff and the larger community. The
community members are primarily low-income Hispanic immigrant families.
Over 95% of the children at the focal school meet federal income guidelines
for free school meals. Most families speak Spanish at home; English is their
second language. The activities are run by personnel employed by the various
partners and coordinated by a community organizer for health who is
employed by the Logan Square Neighbourhood Association. All the other
staff have a high school diploma, at least, and include community AmeriCorps
Chicago Health Corps members and a volunteer.
Funding has been obtained from a wide and diverse range of donors and contributors – primarily the Robert Wood Johnson Foundation that gave US $34,250 for 2006–2007 – and are supplemented by grants totalling US $105,668
from 16 other organizations. Substantial in-kind donations exceeding US $68,000 have been received from a further 14 organizations.
Doctoral-prepared nurses and a health economist evaluate the activities and
outcomes, using a combination of quantitative and qualitative methods that
include: community-wide surveys of physical activity behaviour and perceived
barriers to activity; in-class monitoring of fruit and vegetable consumption;
before-and-after assessments of children’s knowledge of the health
benefits of physical activity and good nutrition; school-wide assessments of
body-mass index (BMI) relative to age, and more. Students and teachers are
interviewed to gather their opinions. Attendance, disciplinary, and student
performance data from the school’s database are also studied to assess the
programme’s eff ects on student behaviour and learning. During the year that
a healthy fruit or vegetable snack was provided daily to all first-grade children,
their attendance and performance on standardized state tests improved,
visits to the school nurse’s offi ce decreased, and visits to the school disciplinary
office dropped dramatically.
The team administered “before and after” assessments of children’s knowledge
of the health benefi ts of physical activity and good nutrition, using
the pre-and post-knowledge surveys provided by the “Take 10! curriculum”
(http ://www.take10.net). Descriptive statistics and chi-square tests with a
significance level of p <0.05 were used to analyse the data. Statistically significant changes in knowledge of physical activity were found for 10 of the
11 learning objectives for all grades (p<0.001). Changes in nutrition knowledge
varied considerably across classrooms and grades; the evaluation tools
provided with the curriculum did not perform well psychometrically with
Explore the entire Compendium of Primary Care Case Studies (2009) published by the World Health Organization.