Children with High BMI, Female Sex, and No-Sports Participation Show Differential Health Benefits from a 20-week School-Based, Mentored, Behavioral Change Model Program - Team KiPOW!

Background/Purpose: According to the California Department of Education, in Orange County (OC), California, almost 37% of 5th graders are overweight or obese, and low-income and minority youth are most impacted. Obesity causes long-term health issues and has intergenerational implications [Wang et al., 2019]. Team Kid Power! OC (KiPOW! OC) is an academic-community partnership initiated in 2015 to support school health policies and coach 5th graders in Title I elementary schools through on-site mentorship for behavioral change during lunch and recess. In 2017, KiPOW! OC began an annual 20-week program at Thorman Elementary (75% of students enrolled in the Free or Reduced Lunch program, and 95% Latinx). Methods: Quasi-experimental pretest posttest design, without a control site, implemented over two academic years. Annually, volunteer health coaches spend 700-minutes with 5th graders (Weekly: 25-min lessons, 20-min meal coaching, and 25-min active play sessions). Pre- and post-test assessments included BMI percentile (BMI%), blood pressure (BP), mile-run, and health behaviors (HABITS questionnaire). Unadjusted analyses: Two-sample paired t-test. Adjusted analyses: Bonferroni correction. Results: n=142; All: Ages 9-11 years, 37.3% with overweight or obese BMI, 56% female, 73% no-sports participation; BMI%, mean(SD): pre 64.25(30.28), post 60.86(30.69), p=0.0009, sBP change -5 mm Hg, p<0.0001, change in mile run time -0.65 minutes, p<0.0001. Subgroup analyses: Obese BMI (BMI >95th percentile): BMI% change -1.88%, p=0.0011; Females: BMI% change -5.5%, p=0.0003, sBP change -5 mm Hg, p=0.0002; No sports participation: BMI% change -4.1%, p=0.0009, sBP change -5 mm Hg, p<0.0001. No significant findings were identified in health behaviors consistently across subgroups. All significant results held significance after Bonferroni correction for multiple comparisons, except sBP among children with obese BMI. Conclusion: Overall, KiPOW! OC demonstrated a significant impact on participants’ BMI%, sBP, and mile run. In subgroup analyses, findings held significance among children with obese BMI, female sex, and no-sports participation for BMI% and mile run. A significant difference was also noted in sBP for children with female sex, and no-sports participation. Although identifying subgroup differences was not the initial goal of KiPOW! OC, findings highlight that KiPOW! OC may have greater impact among low-income children with these characteristics. This is of particular interest when considering that children from low-income communities have higher risk of obesity and face barriers to sports participation [Towne et al., 2018]. Future studies of KiPOW! OC will further explore the subgroup findings identified, analyze study impact with the use of a comparison site, and grow partnerships with Title I OC schools.