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Program Description

Overview The Medical College of Georgia (MCG) FitKid Project in Augusta/Richmond County, Georgia, was designed to fill low-socioeconomic-status youth’s after school hours with moderate-to-vigorous physical activity. The program emphasized enjoyment and improvement in games and sport activities.
Start Date fall 2003 (completed spring 2006)
Scope local
Type after school
Location urban, suburban, rural
Setting public school
Participants elementary school (Grades 3–5)
Number of Sites/Grantees 9 elementary schools
Number Served 182 youth in intervention schools attended at least 40% of year 1 program sessions
Components FitKid was offered in elementary schools for 2 hours a day, 5 days a week during the school year. All third graders attending program schools were invited to enroll for the period beginning in the 2003–2004 school year (Grade 3) and continuing through the 2005–2006 school year (Grade 5). Activities were implemented by instructors, who were mostly certified school teachers and professional staff from program schools. To promote regular participation, age-appropriate activities were selected to meet youth’s developmental needs, and each month had a different activity theme (fitness, basketball, soccer, etc.) to keep youth’s interest. In addition, youth were involved in decision making whenever possible. For example, youth helped select activities from among those that instructors identified as suitable for the facility and weather conditions.

Sessions began with 40 minutes of academic enrichment activities and homework help. Youth also received a healthy snack based on U.S. Department of Agriculture nutrition guidelines. An 80-minute period followed that provided about 20 minutes of warm-up and skills instruction, 40 minutes of continuous moderate-to-vigorous physical activity, and 10 minutes of calisthenics and cool down. To obtain 40 minutes of moderate-to-vigorous physical activity, the program used modified tag and ball games that kept youth moving continuously; the goal was to obtain an average heart rate of 140 beats per minute. Youth were transported home afterward on school buses.
Funding Level $3,300,946.00 (3-year grant)
Funding Sources National Institute of Diabetes and Digestive and Kidney Diseases
Other MCG FitKid Project’s development and implementation involves a partnership between the Richmond County Board of Education (RCBE), which governs public schools in the county, and research faculty/staff at MCG.


Evaluation

Overview The evaluation was designed to test the effectiveness of MCG FitKid on the reduction of obesity in children.
Evaluators Zenong Yin, Bernard Gutin, Marlo Cavnar, Janet Thornburg, Donna Moore, Paule Barbeau, and Patricia Humbles, Department of Pediatrics, Georgia Prevention Institute, Medical College of Georgia

Maribeth H. Johnson, Department of Biostatistics, Medical College of Georgia

John Hanes, Jr., Department of Education, Regent University

Justin B. Moore, Department of Health and Sport Sciences, University of Louisville
Evaluations Profiled An Environmental Approach to Obesity Prevention in Children: Medical College of Georgia FitKid Project Year 1 Results
Evaluations Planned The evaluation continued through the 3 years of the project; results for years 2 and 3 are forthcoming.
Report Availability Yin, Z., Gutin, B., Johnson, M., Hanes Jr., J., Moore, J. B., Cavnar, M., Thornburg, J., Moore, D., & Barbeau, P. (2005). An environmental approach to obesity prevention in children: Medical College of Georgia FitKid Project year 1 results. Obesity Research, 13, 2153–2161.

Yin, Z., Hanes, J., Jr., Moore, J. B., Humbles, P., Barbeau, P., & Gutin, B. (2005). An after school physical activity program for obesity prevention in children: The Medical College of Georgia FitKid Project. Evaluation & the Health Professions, 28(1), 67–89. Available at ehp.sagepub.com/cgi/reprint/28/1/67.

Yin, Z., Moore J. B., Johnson, M. H., Barbeau, P., Cavnar, M., Thornburg, J., & Gutin, B. (2005). The Medical College of Georgia FitKid Project: The relations between program attendance and changes in outcomes in year 1. International Journal of Obesity, 29, S40–45.


Contacts

Evaluation Zenong Yin
Loretta J. Lowak Clarke Distinguished Professor in Health and Kinesiology
Professor of Educational Leadership and Policy Studies
University of Texas at San Antonio
Department of Health and Kinesiology
6900 North Loop 1604
West San Antonio, TX 78249
Tel: 210-458-5650
Fax: 210-458-5873
Email: zenong.yin@utsa.edu
Program Zenong Yin
Loretta J. Lowak Clarke Distinguished Professor in Health and Kinesiology
Professor of Educational Leadership and Policy Studies
University of Texas at San Antonio
Department of Health and Kinesiology
6900 North Loop 1604
West San Antonio, TX 78249
Tel: 210-458-5650
Fax: 210-458-5873
Email: zenong.yin@utsa.edu
Profile Updated November 14, 2006

Evaluation: An Environmental Approach to Obesity Prevention in Children: Medical College of Georgia FitKid Project Year 1 Results


Evaluation Description

Evaluation Purpose To assess program impacts on percent body fat, cardiovascular disease risk factors (blood pressure and cholesterol), body composition (body mass index [BMI] and waist circumference), and cardiovascular fitness (heart rate). The study also examined program costs, risks (injuries), and nonhealth-related benefits (academic performance).
Evaluation Design Non-Experimental and Experimental: All 35 schools in the district were approached to for study participation; 18 were included in the study. Of the other 17, 11 did not respond to study requests, 5 were already involved in other physical activity studies, and 1 lacked the necessary facilities. Schools were stratified by location (urban, suburban, rural) and then randomized within strata to the program or control group (9 schools each). Without knowing their school’s program/control assignment, all second graders at these schools were invited to enroll in the study in spring 2003. Of these second graders, 135 returned parent consent/assent forms for study participation (12% response rate). Because only 30% of the planned sample size had enrolled by the end of the summer, in fall 2004 evaluators continued to recruit youth, who were aware of the school’s assignment, resulting in 482 more recruits; these youth did not significantly differ from the spring recruits on primary study outcome variables. The following were collected from all study youth: pretest/posttest physiological and survey data (height, weight, and waist circumference were also measured at midtest) and posttest scores on academic achievement assessments. Program implementation data (e.g., costs and injuries) were also collected from all sites.

At pretest, data were collected on 601 youth (312 program, 289 control). The sample was 48% boys and 52% girls and an average of 8.7 years old, with an average percent body fat of 26.3 and BMI of 19.1. The racial composition was 61% Black, 31% White, 2% Asian, 2% Hispanic, and 5% other. Significant race, gender, and/or age differences were found (p < .05) in most body composition measures: (a) compared to Whites and other races, Blacks had higher weight, fat-free mass, and bone mass density (BMD); (b) compared to Blacks and other races, Whites had lower blood pressure and higher total cholesterol/high density lipoprotein (HDL) cholesterol; (c) compared to Blacks, Whites had higher percent body fat and lower HDL cholesterol; (d) compared to boys, girls had higher fat mass, percent body fat, and cardiovascular fitness, and lower BMD; and (e) height, weight, BMI, waist circumference, and BMD were all found to increase with age. At posttest, 553 youth (275 program, 278 control) were retested for an overall retention rate of 92% (88% program, 96% control). Of these, 525 (260 program, 265 control) had pretest/posttest health screenings. Youth who were posttested and those who were not did not significantly differ on pretest outcomes or sociodemographic variables.

Analyses focus on comparisons between the 265 youth with pretest/posttest physiological data in control schools (control youth) and the 182 youth with pretest/posttest data in program schools who had an adequate exposure to the program, as indicated by attending at least 40% of year 1 program sessions (program youth). The only pretest outcome variable on which program and control youth differed was total cholesterol, which was significantly higher for program youth (p < .05). Compared to program youth, significantly more control youth attended after school remedial programs (22% vs. 10%, p < .005) and played sports (27% vs. 17%, p < .05). The groups did not differ in participation in other paid after school programs (e.g., the YMCA). There were no differences between youth attending more or less than 40% of sessions in their participation in these after school activities. Youth who attended over 40% of program sessions did not significant differ from those participating less frequently or from control youth on pretest study outcomes or sociodemographic variables.
Data Collection Methods Secondary Source/Data Review: Data were collected on program delivery costs and attendance by program staff, as well as youth sociodemographic variables (sex, race, free/reduced price lunch status).

Surveys/Questionnaires: Youth completed a survey about their involvement in other after school programs and their physical activity in response to the program.

Test/Assessments: The Criterion-Referenced Competency Tests (CRCTs) was administered by the County Board of Education at the end of the program year. CRCTs are academic achievement assessments in key subject areas (reading, math, English/language arts, science, and social studies).

The following physiological assessments were collected from all youth: (a) body composition (fat mass, fat-free soft tissue and bone mineral content) by dual-energy X-ray absorptiometry; (b) heart rate taken at the completion of the YMCA 3-minute bench-stepping test; (c) anthropometry (height, weight, waist circumference), (d) cholesterol checks through blood samples; and (e) resting blood pressure. BMI was calculated using height and weight; BMI percentile for gender and age was used to indicate overweight status: < 85th percentile = normal, 85th to < 95th = at risk for overweight, and < 95th = overweight. In addition, to monitor physical activity intensity in FitKid activities, 5% of program youth wore heart rate monitors during each FitKid session.
Data Collection Timeframe Data were collected from fall 2003 to spring 2004.


Findings:
Formative/Process Findings

Activity Implementation FitKid was provided on an average of 128 school days over an 8-month period.

The average heart rate was 149 beats per minute for the 80-minute physical activity period.

In year 1, there were 24 adverse program events such as injuries (20 mild, 3 moderate, and 1 serious). Overall, there were.0006 adverse events per FitKid hour, for an incident rate of .06 per youth.

Snacks had an average of 250 calories (total fat = 7 grams, saturated fat = 1.5 grams, cholesterol = 10 mg, sodium = 360 mg, dietary fiber = 1 gram, protein = 6 grams, and carbohydrate = 32 grams).
Costs/Revenues The gross year 1 program cost was $174,070, or $558 per student in program schools (based on the total number of students in the school, although some students had limited or no participation). The cost breakdown was 63% staff salary, 25% transportation, 7% materials (e.g., copying, equipment, books, food), and 4% instructor training.
Recruitment/Participation The average FitKid participant attended 49% of program sessions. Of those that attended over 40% of sessions, the average attendance was 69%, and many also reported participating in other after school recreational and sport activities (22%) and academic-related programs at school (5%) during the year.


Summative/Outcome Findings

Academic After adjusting for school- and child-level covariates, there were no significant differences between program and control youth on any of the CRCT scores.

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