Healthier school environment leads to decreases in childhood obesity: The Kearney Nebraska story

Kate A. Heelan, R. Todd Bartee, Allison Nihiser, Bettylou Sherry

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Background: Schools play a role in addressing childhood obesity by implementing healthy eating and physical activity strategies. The primary aim of this case study was to describe prevalence of overweight and obesity among elementary school students in a rural Mid-western community between 2006 and 2012. The secondary aim was to use a novel approach called "population dose" to retrospectively evaluate the impact dose of each strategy implemented and its estimated potential population level impact on changes in overweight and obesity. Methods: Weight and height were directly measured annually beginning in January 2006 to assess weight status, using BMI (kg/m2), for all kindergarten to fifth-grade students (N2400 per year). Multiple evidence-based strategies were implemented in nine schools to increase physical activity and healthy eating behaviors. BMI reporting and revised school meal programs were implemented districtwide. Comprehensive school physical activity programs, school food environment, and supportive/promotional strategies were implemented at individual schools. Results: The absolute change in prevalence of obesity (BMI ≥95th percentile) decreased from 16.4% to 13.9%, indicating a 15.2% relative change in prevalence of obesity in 6 years. There was an inverse relationship between the number of strategies implemented and prevalence of overweight and obesity over time. Conclusions: District and school-level approaches have the potential to impact childhood obesity. Schools can successfully implement strategies to address overweight and obesity, but the extent of implementation between schools may vary. Population dose analysis can be used to estimate impact of clusters of strategies to address overweight/obesity.

Original languageEnglish (US)
Pages (from-to)600-607
Number of pages8
JournalChildhood Obesity
Issue number5
StatePublished - Oct 1 2015
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics


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