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Rural Health Information Hub

Effective Interventions for Schools

Includes programs demonstrated in published high-quality, peer-reviewed studies and evaluation reports to produce significant, positive health or behavioral outcomes, and policy, environment, or economic impacts.

  • Program name: Coordinated Approach to Child Health (
    Change type: Individual; Policy, Systems, and Environmental (PSE)
    Description: Program covers children from preschool through 8th grade and has been implemented in thousands of schools and after-school organizations. It uses multiple approaches, including school, after-school, early childhood, and training. Employing a holistic approach that includes classroom, physical education, and food service components, the program promotes physical activity, healthy food choices, and tobacco prevention in children. The original clinical trial took place in four regions, with 25+ years of research and field testing following.
    Demonstrated Success
    • Tested in rural setting
    • Audiences tested: Multiple across age and SES groups
    • Improved diet
    • Improved physical activity
    • Significant positive academic improvements
    • Cost-effectiveness
    • Prevention of childhood obesity among disadvantaged youth
    • Sustainability/Lasting effects
  • Program name: Pathways
    Change type: Individual; PSE
    Description: Program was created by a partnership between five universities and seven American Indian communities with a focus on primary prevention of obesity in American Indian children (3rd, 4th, and 5th graders). Components include culturally appropriate curriculum promoting healthy eating and physical activity, family involvement, food service, and physical activity.
    Demonstrated Success
    • Tested in rural setting
    • Audience tested: Conducted with 1,704 3rd-5th graders from 41 schools in seven American Indian nations
    • Increases in knowledge and cultural identity in intervention when compared to control schools
    • Retention of knowledge over three years
    • Lowered the percent of energy from fat in school lunches
  • Program name: Project LEAN (Leaders Encouraging Activity and Nutrition)
    Change type: Individual; PSE
    Description: Focuses on youth empowerment, policy and environmental change strategies, and community-based solutions. Multiple components with tools such as school wellness, parent engagement, youth engagement, and lesson plans aimed at increasing healthy eating and physical activity to reduce the prevalence of obesity and chronic diseases (e.g., heart disease, cancer, diabetes).
    Demonstrated Success
    • Tested in rural setting
    • Audiences tested: School board members and high school students in California
    • Increase in nutrition-related issues on school board agendas
    • More favorable nutrition-related policies
    • Increased knowledge and awareness of nutrition programs
  • Program name: Planet Health
    Change type: Individual
    Description: Provides an interdisciplinary curriculum to improve activity and dietary behaviors in middle school students with intervention materials integrated into language, arts, math, science, social studies, and physical education classes. Uses grade-level and subject-appropriate skills and competencies to improve nutrition, reduce television time, and increase physical activity.
    Demonstrated Success
    • Two-year randomized controlled trial
    • Audience tested: 1,295 ethnically diverse 6th and 7th graders from public schools in four Massachusetts communities
    • Obesity decreased among girls
    • Television viewing decreased for boys and girls
    • Girls ate less overall, consumed more fruits and vegetables
  • Program name: Winning with Wellness
    Change type: Individual
    Description: A school-based obesity prevention project promoting healthy eating and physical activity at a rural Appalachian elementary school in Northeast Tennessee. The initiative included eight program areas: nutrition services, health education, physical education, school health services, counseling and psychological services, healthy school environment, school site health promotion for staff, and family and community involvement. Based on the CDC’s Coordinated School Health (CSH) model and a community-based participatory research (CBPR) approach.
    Demonstrated Success
    • Tested in rural setting
    • Audiences tested: 114 third and fourth grade students participated in the study along with 98% of the school’s teachers
    • Findings from this preliminary project revealed improvements in nutrition offerings and increased physical activity during the school day.
    • Pedometer data confirmed that students were more active at school after program implementation than before the program, with an increase of approximately 886 steps per day.
    • Because of preliminary success with elementary students, the program was adapted for use with middle school students.