Development and design of a tri-state coordinated school health program to reduce childhood obesity: The heroes initiative

Background: The HEROES (Healthy, Energetic, Ready, Outstanding, Enthusiastic Schools) Initiative is a childhood obesity prevention program, based on the U.S. Centers for Disease Control and Prevention's Coordinated School Health Model (CSHM), implemented in schools in Indiana, Illinois, and Kentucky. Purpose: To describe the development, implementation, and results of the HEROES Initiative, including its conceptual model and evaluation framework. Significance: The HEROES Initiative is a multi-level longitudinal intervention with a rigorous evaluation framework that has been found to facilitate behavior change and weight loss among children. Studies have called for disseminating formative information about program development of effective programs, which this presentation aims to do. Methodology: Through the application of an academic-community partnership, the HEROES Initiative is evaluated through a two-tiered approach that assesses the implementation of the CSHM framework and the extent to which students change their nutrition and physical activity behaviors and show changes in biometric indicators such as body mass index. Findings/Results: Z-score calculations showed that the proportion of students who were overweight after 18 months of the intervention was lower than the percentage at the beginning of the intervention (p=.006). In addition, students showed positive improvements in multiple nutrition and physical activity behaviors (p<.05 for all behaviors). Conclusions/Recommendations: Through the provision of an empowering infrastructure and ongoing technical assistance, students and staff in HEROES schools have taken ownership of innovative and data-driven programming that is beginning to improve children's health and well-being.