A Coordinated School Health Approach to Obesity Prevention among Appalachian Youth: Middle School Student Outcomes from the Winning With Wellness Project

The Winning With Wellness (WWW) project was a school-based obesity prevention program that was developed to promote healthy eating and physical activity in youth residing in rural Appalachia. The project was based on the Coordinated School Health model (Centers for Disease Control and Prevention (CDC), 2013a) and used a community-based participatory research approach with an emphasis on feasibility and sustainability. The purpose of this study was to examine self-reported health outcomes for middle school students across the course of the intervention. Sixth grade middle school students (N = 149; 52% girls) from four schools in Northeast Tennessee completed a survey assessing demographic factors and health behaviors as well as the Pediatric Quality of Life Inventory (PedsQL, Varni, Seid, & Kurtin, 2001) at baseline and followup, approximately 9-months after project implementation. Across the course of the intervention there were no statistically significant changes from baseline to follow-up in fruit and vegetable consumption, physical activity, or screen time. Further, there were no statistically significant changes in health-related quality of life (HRQoL). The lack of change in health behaviors is similar to a recent study also emphasizing sustainability (Neumark-Sztainer, Story, Hannan, & Rex, 2003). Unlike in the current study, Palacio-Vieira and colleagues (2008) found HRQoL to significantly decline with age in a population-based sample of Spanish youth. It will be important to examine whether or not obesity interventions may ameliorate this effect as well as to test the feasibility and school/structural support for sustained intervention implementation at a level that promotes lifestyle change.