The Program Being Evaluated
In response to dramatic increases in the number of Arkansas children and adolescents who are overweight or at risk for overweight, the Arkansas legislature passed Arkansas Act 1220 of 2003 to Combat Obesity. This new law included the most ambitious school reforms in the nation at that time. The law limited vending and a la carte items and established a state committee that made recommendations that were adopted as regulation in 2007. These regulations established better standards for food offerings and physical activity.
One section of the act requires all school districts to measure body mass index (BMI) for every public school student annually and report results to parents.
The Robert Wood Johnson Foundation (RWJF) supported two activities to understand the effectiveness of school-based initiatives in reducing childhood obesity: Act 1220 Evaluation and the Arkansas BMI Database Project.
About the Evaluation
The Arkansas 1220 Evaluation examines the law’s effect on children, families and schools. Each year, from the inception of the law through 2011, the evaluation surveys parents and youth about children’s eating and physical activity. It also surveys principals and superintendents about the school environment. The lead evaluator for this program is James Raczynski, Ph.D., of the University of Arkansas for Medical Sciences College of Public Health.
Major Evaluative Topics and Questions
The goals of the Act 1220 evaluation are to:
- Characterize the processes for enacting and implementing all provisions of Act 1220.
- Assess changes in school environments relating to nutrition and physical activity.
- Assess changes in student and family behavior regarding nutrition and physical activity that may be associated with school environment changes.
Knowledge and Impact
Over the four-year evaluation period:
- School districts increasingly adopted new nutrition and physical activity policies. For example:
- The percentage of districts with a policy prohibiting vending and a la carte foods and beverages of limited nutritional value in cafeterias increased from 37 percent to 63 percent.
- From year one to year four, an increase of 32 percent to 41 percent of school districts prohibited the use of physical activity as a punishment for bad behavior.
- An increasing percentage of school districts required that physical activities such as walking be included in the physical education program—in elementary school the increase was from 39 to 56 percent; in middle schools from 52 to 63 percent and in high schools from 56 percent to 66 percent.
- The percentage of all schools—elementary, middle and high—with vending machines on campus decreased from 85 percent to 80 percent. In districts with separate elementary schools, no vending machines in elementary schools were available to children.
- In the first-year evaluation report, researchers determined that 100 percent of the elementary schools assessed had removed student access to vending machines—which is what the law required.
- Principals report that the percentage of healthier food and beverages sold in the machines increased from 18 percent to 26 percent.
- Parents did not view BMI assessments as controversial. Over the four-year evaluation period, 85 percent of principals had fewer than five parental contacts on the issue during the school year.
- Parents are frequently unable to characterize their child's weight status accurately, when the child is overweight or obese. Among parents whose children were overweight, 51 percent incorrectly perceived the child to be of normal weight. Most parents (93%) of children with BMI percentiles in the normal to underweight categories correctly characterized their children's weight status.
- After the first year of BMI reporting, parents of children who are overweight or at risk for overweight significantly improved their ability to accurately identify their child’s weight risk status.
- Screenings increased parents’ awareness of health problems associated with childhood obesity. Some 81 percent of parents interviewed mentioned diabetes as a health problem for overweight children in year four, compared with 66 percent in year one.
- Student reports of teasing because of their weight did not increase.
- Student reports of inappropriate dieting behaviors (such as fasting and taking diet pills) remained stable over the four-year period and were similar to behaviors reported by students across the country.
- Information for Action: School Policies to Prevent Childhood Obesity February 10, 2015