Biomedical subjects

K J Bachman

Publications and source records attributed to K J Bachman.

5 recordsLinked to original sources

PubMed1997

The Child and Adolescent Trial for Cardiovascular Health (CATCH): intervention, implementation, and feasibility for elementary schools in the United States.

The Child and Adolescent Trial for Cardiovascular Health (CATCH) was the largest school-based field trial ever sponsored by the National Institutes of Health. The trial demonstrated positive changes in the school food service and physical education program, as well as in students' cardiovascular health behaviors. Because the CATCH intervention programs were implemented in 56 schools (in four states) that were typical of schools throughout the United States, their reception by schools and degree of implementation provide evidence about their feasibility for schools nationally. Extensive process evaluation data were collected from students, teachers, school food service personnel, and physical education specialists throughout the three school years of the CATCH intervention. Four of the CATCH programs--school food service, physical education, classroom curricula, and home programs--were assessed over the three school years. The process data provide information on participation, dose, fidelity, and compatibility of the CATCH programs in the intervention schools for these programs. High levels of participation, dose, fidelity, and compatibility were observed for the four programs during the 3 school years. CATCH emerges as a model of a feasible multilevel health promotion program to improve eating and exercise behaviors for elementary schools in the United States.

Adolescent↗

PubMed1996

Using process data to explain outcomes. An illustration from the Child and Adolescent Trial for Cardiovascular Health (CATCH).

The purpose of this article is to illustrate the use of process evaluation for understanding study outcomes. Data from the Child and Adolescent Trial for Cardiovascular Health (CATCH), a large school-based field trial, are used. Teacher characteristics, measures of classroom curriculum implementation, and competing influences are linked to changes in dietary knowledge, intentions, and self-efficacy of students in the intervention schools. Multiple regression analyses indicate that teacher characteristics did not predict program implementation. Teacher characteristics and program fidelity, or the number of modifications made to the classroom curriculum during implementation, had direct and independent effects on student outcomes.

Adolescent↗

PubMed1994

CATCH: classroom process evaluation in a multicenter trial.

The purpose of this paper is to describe the process evaluation model for the classroom curricula of the Child and Adolescent Trial for Cardiovascular Health (CATCH) Project. The process evaluation plan specifically targets how much each curriculum was implemented, to what degree it was implemented as designed, and the barriers to implementation. Additionally, the rationale for each of the process evaluation measures and the instrument development process are presented. Data resulting from these measures will be essential in order to answer questions regarding the internal validity of the main outcomes of the project. Specific examples and sample results are provided from the CATCH third-grade classroom curriculum, which was implemented the first year of CATCH. A discussion also is presented of how the findings from a sample of these measures were used to gain additional insight on the salient features of the curriculum, and how those features may be related to student outcomes.

Adolescent↗

PubMedDate not supplied

Changes in the nutrient content of school lunches: results from the CATCH Eat Smart Food service Intervention.

BACKGROUND: The Child and Adolescent Trial for Cardiovascular Health (CATCH) tested the effectiveness of a multilevel intervention aimed at promoting a healthful school environment and positive eating and physical activity behaviors in children. The CATCH Eat Smart Program targeted the school food service staff and aimed to lower the total fat, saturated fat, and sodium content of school meals. METHODS: The Eat Smart intervention was conducted in 56 intervention schools over a 2(1/2)-year period.+Five consecutive days of school menu, recipe, and vendor product information were collected from intervention and control schools at three intervals, Fall 1991, Spring 1993, and Spring 1994, to assess the nutrient content of school menus as offered. RESULTS: There was a significantly greater mean reduction in the percentage of calories from total fat (adjusted mean difference -4.1%; P < 0.0001) and saturated fat (adjusted mean difference -1.3%; P = 0.003) in intervention compared with control schools from baseline to follow-up. Although the sodium content of school lunches increased in both conditions, the mean increase was significantly lower in intervention schools (adjusted mean difference -89 mg; P = 0.034). There were no statistically significant differences for total amounts of cholesterol, carbohydrate, protein, dietary fiber, total sugars, calcium, iron, vitamin A value, and vitamin C. Average total calories decreased significantly; however, the mean total calories (683 kcal) for intervention schools remained above one-third of the Recommended Dietary Allowances for this age group. CONCLUSIONS: The CATCH Eat Smart intervention successfully lowered the total fat and saturated fat content of school lunches as offered, while maintaining recommended amounts of calories and essential nutrients.

Adolescent↗

PubMedDate not supplied

Improving school breakfasts: effects of the CATCH Eat Smart Program on the nutrient content of school breakfasts.

BACKGROUND: This paper describes the impact of the Eat Smart School Nutrition Program, the food service component of the Child and Adolescent Trial for Cardiovascular Health (CATCH), on the percentage of calories from total fat and saturated fat and the sodium content of school breakfasts. METHODS: Fifty-nine of the 96 CATCH schools offered breakfast. We collected 5 consecutive days of school breakfast menu, recipe, and vendor product information at three periods to assess the nutrient content of the school menus as offered. RESULTS: At baseline (Fall 1991), intervention school breakfasts provided 28% of calories from total fat and control schools 30%. Decreases occurred over time in both groups, but no significant differences were attributable to the intervention (adjusted mean difference = -0.4; P = 0.77). Saturated fat exceeded the Eat Smart goal at baseline in all schools and by follow-up (Spring 1994), the reduction in mean percentage of calories from saturated fat was greater in intervention than in control schools (adjusted mean difference = -1.6%; P = 0.052). Sodium goals were not achieved. Mean calorie levels were maintained at or above Eat Smart goals throughout the study in both groups. Differences over time in other dietary variables (percentage of calories from protein and carbohydrate and mean levels of protein, carbohydrate, calcium, iron, vitamin A value, vitamin C, total sugars, and dietary fiber) were not statistically significant between groups. No significant reductions in student participation in the School Breakfast Program (SBP) occurred. CONCLUSIONS: The Eat Smart food service intervention improved school breakfast composition, but not significantly more so than in control schools. Fat and saturated fat in school breakfasts were lowered while maintaining calories, other essential nutrient levels, and student participation in the SBP. Secular trends and also the possibility that control schools were affected by the Eat Smart intervention may account for these findings.

Adolescent↗