title: Direct observation of physical activity and dietary behaviors in a structured environment: Effects of a family-based health promotion program Relationship between self-monitoring of diet and exercise change and subsequent risk factor changes in children and adults. San Diego family health project: reaching families through the schools.
abstract: The effects of cardiovascular risk reduction are typically assessed by self-reported behavior change and physiological outcomes . There is a need to enhance evaluation protocol s by including direct observation measures of targeted health behaviors . To improve the evaluation of a family-based diet and physical activity change program , families were observed during a planned visit to the San Diego Zoo . This st and ardized environment afforded many options for dietary intake and physical activity . Thirty families who had participated in a 1-year intervention program and 30 control families were observed . Caucasian and Mexican-American families were equally represented . Observations in this st and ard environment discriminated between intervention and control families , and the findings indicated that intervention effects generalized to this novel setting . Intervention families consumed fewer calories , ate less sodium , and walked further than did control families . Ethnic differences were noted Self-monitoring is often used in health behaviour change programs ; but it is not known to what extent self-monitoring data are valid and useful in predicting changes in cardiovascular disease ( CVD ) risk .  Subjects included 72 Anglo adults , 68 Anglo children , 80 Mexican-American adults and 94 Mexican-American children . Subjects were families with fifth and sixth grade children who participated in an 18-session family-based diet and exercise change program design ed to reduce CVD risk . During the intervention , each participant self-monitored diet and aerobic physical activity .  Families were measured at baseline , 3 , 12 , and 24 months . For adults , self-monitored changes in diet correlated with changes in body mass index , systolic blood pressure , total cholesterol and LDL 1 and 2 years later . Correlations between self-monitored diet and diet-related risk factor changes were not observed among children . Correlations between self-monitored exercise and subsequent risk factor changes were not observed among adults . For children , self monitored changes in aerobic physical activity correlated significantly with changes in VO2Max and HDL/LDL ratio 1 and 2 years later . Thus , this study provides some support for the predictive validity of  diet self-monitoring  in adults and exercise self-monitoring in children This project tests the effectiveness of a family-based health behavior change intervention in two ethnic groups . The aim is to help family members initiate and maintain dietary and physical activity behaviors believed to be linked to risk factors for cardiovascular disease . This paper describes the project and the baseline results . Twelve San Diego elementary schools were r and omly assigned to intervention or control conditions .  Hispanic and Anglo families with a fifth or sixth grade child were recruited to participate in a two-year study . The intervention emphasizes enjoyable experiences design ed to transmit knowledge and skills required for long-term changes in diet and physical activity habits . Groups of families met at schools for 12 weekly sessions and six maintenance sessions distributed throughout the following nine months . Outcome behavioral and physiologic measures will be collected at baseline , three months , 12 months , and 24 months . Differences between Anglo and Mexican-American subjects justify targeted activities specific to these groups
target: There is good evidence that school-based physical activity interventions have a positive impact on four of the nine outcome measures .
  Specifically positive effects were observed for duration of physical activity , television viewing , VO2 max , and blood cholesterol .
  Generally school-based interventions had no effect on leisure time physical activity rates , systolic and diastolic blood pressure , body mass index , and pulse rate .
  At a minimum , a combination of printed educational material s and changes to the school curriculum that promote physical activity result in positive effects .
background: BACKGROUND The World Health Organization estimates that 1.9 million deaths worldwide are attributable to physical inactivity .
  Chronic diseases associated with physical inactivity include cancer , diabetes and coronary heart disease .
  OBJECTIVES The purpose of this systematic review is to summarize the evidence of the effectiveness of school-based interventions in promoting physical activity and fitness in children and adolescents .