Illinois Reports to CDC - CATCH Works!

Social Support Interventions in Community Settings

Applied Program Example: The Impact of CATCH P.E. on Moderate to Vigorous Physical Activity during Physical Education Classes in Selected Illinois Schools.

The Illinois CATCH (Coordinated Approach to Child Health) program initiative was implemented in January 2004 by the Illinois Department of Public Health (IDPH) to promote healthy eating and physical activity among elementary schoolchildren. Nineteen pilot schools were selected to participate based on current cardiovascular health, obesity, diabetes and environmental program efforts within the community; previous involvement in similar types of efforts through IDPH's Health and Wellness Initiative grant program; an expressed interest in the CATCH Program; and geographical distribution in the state. The physical education classes of these schools were observed prior to CATCH training and again six to 12 months after implementation of CATCH to measure the effectiveness of the CATCH Physical Education (P.E.) component at their school.

What does the intervention involve?

CATCH is a coordinated school health program designed to promote healthy lifestyle choices by children and their families as a way to prevent cardiovascular disease and type 2 diabetes. The program features classroom activities, school-wide efforts to improve nutrition and physical activity, and take-home material to encourage parents to participate along with their children.

CATCH grew out of a National Heart, Lung and Blood Institute-funded research study that initially followed 5,000 students in 96 ethnically and racially diverse elementary schools in California , Louisiana , Minnesota and Texas . Numerous follow-up studies have demonstrated that children and families participating in the program have shown positive health outcomes in the areas of physical activity, nutrition and body mass index (BMI).

In the spring of 2004, participating schools sent “CATCH teams” to a one-day training session sponsored by IDPH. Teams consisted of a classroom teacher (3 rd to 5 th grade), a food service manager and a physical education teacher. Other school personnel (e.g., principal, school nurse or school counselor), a parent representative and a community stakeholder also were encouraged to attend as part of each team. The hands-on, interactive training provided an overview of the health status of children today, the need for a coordinated school health program, and a review of the CATCH program components (classroom, physical education, cafeteria and community/family) and how they can be coordinated.

To promote family and community participation, schools hosted an event similar to a health fair to familiarize parents and others with CATCH activities and philosophy. Participants played CATCH P.E. games and sampled healthy foods. Such events introduced parents and community members to the program's theme of “Go, Slow and Whoa” foods. Go foods are lowest in fat content and are considered “everyday foods.” Slow foods, higher in fat, are “sometimes foods.” Whoa foods – fried potatoes and whole milk, for example – are foods that are the highest in fat of the three groups and are “once-in-a-while foods.”

Each school completed the U.S. Centers for Disease Control and Prevention's “School Health Index for Physical Activity, Healthy Eating and Tobacco-free Lifestyles” during the 2004-2005 academic year. This self-assessment and planning tool identified strengths and weaknesses in the school's health promotion policies and programs, and assisted in developing an action plan for improving student health. IDPH staff advised the school's CATCH team in completing the index. Assessment surveys also were conducted online by classroom teachers, physical education teachers and foodservice managers to gain a better understanding of how CATCH is being implemented. Also, an online progress reporting system has been developed to document the accomplishments, promotional activities of the program and the activities of the CATCH school committees.

A major component of CATCH is CATCH P.E. It is designed to promote children's enjoyment and participation of MVPA (moderate to vigorous physical activity) during P.E. classes, recess, extracurricular activities, and recreation time with family and friends. CATCH P.E. content enhances movement skills, sports skills, physical fitness, social development and subsequently promotes lifelong physical activity. P.E. is an important component of school health.

One tool used to evaluate the CATCH P.E. program is SOFIT (System for Observing Fitness Instruction Time). This is a validated instrument designed for observing P.E. classes. Trained observers use the system to determine the level of activity and the context of the lesson. One CATCH goal is to have each student involved in moderate to vigorous physical activity for at least 50 percent of the class time.

Participation and results:

Nineteen CATCH schools participated in the observation of their physical education classes prior to CATCH training and again six to 12 months after implementation of CATCH. Classes were randomly selected on both observation visits. Baseline data, collected from SOFIT, was then presented to the physical education teachers. This data showed strengths and weakness of the classes and provided a tool for teachers to reflect on their teaching.

The results of the observations appear in the following table:

The post SOFIT observations showed improvement in MVPA percentages as the result of providing CATCH P.E. to students. The MVPA percent is the sum of time students expend energy equivalent to walking or being very active in relation to the total time available in the P.E. class. The average MVPA increased from a baseline of 45.9 percent to 60.7 percent of class time. The percent of very active physical activity time more than doubled, thus students were engaging in more physical activity. The amount of time students spent in fitness activities was also increased. Thus students were able to experience the concepts of the FITT (Frequency, Intensity, Type and Time) principle. Also the time that teachers were spending in management went down providing more opportunity for physical activity to occur. Physical educators provided their students with more opportunities for vigorous physical activity through active versus passive class management techniques, non-elimination type games and increased awareness to maximizing time being active.

Physical educators can implement this program first by recognizing that the CATCH curriculum and P.E. activities for grades kindergarten through 5 can easily be aligned to their states' learning standards. In Illinois , CATCH has been aligned to the physical development and health standards .

Second, physical educators need to become familiar with the curriculum and the P.E. activity kits. CATCH implementation training is highly suggested to utilize effective implementation strategies and instructional best practices. The P.E. activity kits are a “celebration of learning”. The children will enjoy the process of being active and healthy learners for a lifetime. The activities provide numerous opportunities to practice and to be challenged to use acquired skills in a variety of instructional environments.

CATCH K-2 Activity Box: More than 300 activities introduce children to a variety of essential movement concepts and fundamental skill themes. Lessons are fun and help children acquire the fundamental competencies that are the foundation for more complex skill mastery.

CATCH 3-5 Activity Box: More than 500 activities expand the range of skill themes and physical fitness activities challenging children to learn in more complex movement environments. Lesson structure maximizes skill practice and opportunities to learn so that increasingly children become competent in many movement forms and achieve mastery in a few.

CATCH 6-8 Activity Box: More than 400 activities build on the foundation of the elementary years and exposes middle school students to various lifetime sport, fitness and recreational activities. Youngsters are able to explore new adventures, as well as, refine traditional sports skills through more complex simulated game challenges.

Third, the physical educator should incorporate the CATCH curriculum as part of the P.E. curriculum. Physical educators who have implemented CATCH P.E. in their schools have found the planning and activities are similar to their existing programs (see Table 1). Generally, the implementation of CATCH P.E. was a positive experience, but there were some challenges similar to all physical educators working to implement a program within a school (see Table 2).

Table 1

Table 2

Cost to implement

Participating schools in Illinois received $5,000 grants from IDPH to train key personnel, to implement the program curriculum, to purchase necessary equipment and to promote CATCH activities and program philosophy.

The cost to implement a non-IDPH funded CATCH Program is nominal. A complete set of the CATCH Resource Materials are available for $635 from the national distributor. Training in CATCH also is available through a variety of training formats offered by the CATCH Texas training team and IDPH. The cost of training depends on location and the particular training format.

Lessons learned and future plans

Physical educators found CATCH P.E. to be a curriculum that can be easily implemented and supplemental to their existing program. It provides meaningful movement opportunities, maximizes time on task, promotes physical activity, and engages students in fun and motivating activities. By following the CATCH P.E. objectives (enjoyment, opportunity to participate and practice, MVPA at least 50 percent of class time and encouragement to participate in physical activity outside of P.E. class), students are provided with quality P.E. lessons and learn to be comfortable being physically active. Students armed with these tools and opportunities through CATCH P.E. will be more active and will enjoy being active as adults.

For successful implementation, physical educators need to work with other teachers, school administrators, cafeteria staff and community members to integrate the CATCH curriculum throughout the school. Additionally, implementation and booster trainings and on-going support and communication from the CATCH training team are very vital to the maintenance and success of the program.

In the future, the Illinois CATCH Initiative will continue as a pilot program. In 2006, 23 new schools have adopted CATCH through various funding sources. IDPH staff will continue to provide guidance and assistance in soliciting potential funding sources. More schools will be added as funding becomes available.

Resources

• Illinois Department of Public Health, Division of Chronic Disease Prevention and Control, 535 W. Jefferson, Springfield , IL 62761 Phone: 217-782-3300 Fax: 217-782-1235 TTY: 800-547-0466 Web site: http://www.idph.state.il.us/

• National CATCH Program Web site: http://www.CATCHInfo.org

• CATCH Texas Web site: www.CATCHTexas.org

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