CATCH: Child & Adolescent Trial for Cardiovascular Health

Principal Investigators
Russell V. Luepker, MD, Cheryl L. Perry, PhD, University of Minnesota; Sonja M. McKinlay, PhD, New England Research Institute; Philip R. Nader, MD, University of California, San Diego; Guy S. Parcel, PhD, University of Texas; Larry S. Webber, PhD, Tulane University; Elaine J. Stone, PhD, National Heart, Lung, and Blood Institute.

Funding
National Heart, Lung, and Blood Institute
National Institutes of Health

Hearty Heart & Friends

Objective
A trial that accessed the outcomes of health behavior interventions, focusing on the elementary school environment, classroom curricula, and home programs, for the primary prevention of cardiovascular disease.

Design
The randomized, controlled field trial included four sites and involved 56 intervention and 40 control elementary schools. Outcomes were assessed using pre-randomization measures (fall, 1991) and follow-up measures (spring, 1994). Participants: A total of 5106 initially third grade students from ethnically diverse backgrounds in public schools in California, Louisiana, Minnesota, and Texas. Intervention: 28 schools participated in a third grade through fifth grade intervention including school food service modifications, enhanced physical education (PE), and classroom health curricula. 28 additional schools received these components plus family education.

Results
At the school level, the two primary end points were changes in the fat content of food service lunch offerings and the amount of moderate-to-vigorous physical activity in the PE programs. At the level of the individual student, serum cholesterol change was the primary end point and was used for power calculations for the study. Individual level secondary end points included physiological factors, recall measure of eating and physical activity patterns, and other physiologic measures.

In intervention school lunches, the percentage of energy intake from fat fell significantly more (38.7% to 31.9%) than in control lunches (from 38.9% to 36.2%) (P<.001). The intensity of physical activity in PE classes during the CATCH intervention increased significantly in the intervention schools compared with the control schools (P<.02). Self-reported daily energy intake from fat among students in the intervention schools was significantly reduced (from 32.7% to 30.3%) compared with that among student in the control schools (from 32.6% to 32.2%) (P<.001). Intervention student reported significantly more daily vigorous activity than controls (58.6 minutes vs. 45.5 minutes; P<.003).

Conclusion
The CATCH intervention was able to modify the fat content of schools lunches, increase moderate to vigorous physical activity in PE, and improve eating and physical activity in children during 3 school years.

Materials
CATCH curricula manuals and student materials, physical education program, family component materials, and school food service program guide are available from http://www.flaghouse.com

Publications
Luepker RV, Perry CL, McKinlay SM, et al. Outcomes of a field trial to improve children's dietary patterns and physical activity. Journal of the American Medical Association. 1996; 275(10):768-76.