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Research Results

OVERVIEW

The CAST partnership conducted a five-year investigation of student, school, community, and family characteristics to examine the environmental factors influencing child obesity outcomes.  The partnership also piloted and evaluated multiple school and community-based health programs. Researchers and partners developed multiple reports and a variety of community resources to share a record of lessons learned from the study.

Results from the partnership are organized into 5 categories:

1. Student Health

2. School and Family Environments

3. Bethel Built Environment

4. Bethel Food Environment

5. Insights from the CAST Process




1. STUDENT HEALTH (Back to top)

Pages below contain data from activities in Bethel schools and the Bethel community. Data on annual body mass index (BMI) measures of K-5 students and initial results of a small pilot Farm To School project.

Bethel School Health Report 2007

Bethel Initial Report.jpgThis report describes preliminary studies in Bethel schools prior to the CAST project, which established baseline information on student BMI, nutrition, and physical activity. One pilot study described in the report estimated that the prevalence of child overweight/obesity in Bethel were similar to BMI levels in other county schools and was greater in schools serving lower SES student populations. A second study included in the report describes survey results with teachers regarding satisfaction with school health instruction and practices in the district. The survey pointed to a lack of physical activity and physical activity promotion within schools, under-consumption of fresh fruit and vegetables among children, and a limited ability of children to identify healthy food options.

Read the complete Bethel School Health Report

Body Mass Index (BMI) Measures

Bethel BMI Report.jpgA primary goal of CAST was to document changes in the frequency and prevalence of overweight and obesity among children in the district across the life of the project. This report provides a brief description of Bethel School District students who participated in CAST during the first two years of the project. Results showed increased prevalence of overweight/obesity in older children, among children from Hispanic families, and a greater prevalence over time among two of the seven elementary schools.

Find out more in the Bethel BMI Report (Years 1 and 2)

Open the 5 Year Overview of Overweight/Obesity


2. SCHOOL AND FAMILY ENVIRONMENTS (Back to top)

Pages below contain data from activities in Bethel schools and the Bethel community. Data on annual body mass index (BMI) measures of K-5 students and initial results of a small pilot Farm To School project.

Family SurveyFamily Survey Report.jpg

The CAST Family Survey was developed by project partners during the first year of the study and distributed to a random selection of school district families in years 2 to 5 of CAST. The survey asked for parent report on family food choices and eating habits, food shopping practices, adult and child physical activity patterns, perceptions of neighborhood safety, transportation, and accessibility to recreation. The survey also included demographic items and a short food security questionnaire.

The Family Survey First Year Report discusses results from the first neighborhood survey, which were consistent with responses reported by parents the next year. In the final two-year distribution of the survey, questions were added to assess parent perceptions of school nutrition and physical activity practices. Parent report on these questionnaire items are reported in the presentation called CAST Family Survey Results: Year 4 and Year 5 Survey Responses.

Read the Family Survey First Year Report

Read the CAST Family Survey Results: Year 4 and Year 5 Survey Responses

Healthy Moves Report

Health Moves Report.jpgThe Healthy Moves Trainer-in-Residence program was developed to respond to the physical activity needs of youth through fun and active instruction in elementary school physical education (PE) classes. The program engaged volunteer professional trainers from the local community to present lessons in PE classrooms for a six-week period, two sessions per week. Findings pointed to a need to boost physical activity opportunities among elementary school children, and the potential of the Healthy Moves program to support schools and communities in fostering greater activity opportunities for youth in schools.

Read the Healthy Moves Report

School Wellness Report

School Wellness Report.jpgTo better understand how district practices promote healthy student behavior, a group of Bethel parents, members of the CAST Parent Advisory Council, conducted observational assessments of the district's seven schools. The purpose of the observational study was to gather information on school health practices related to a) the general school environment for health promotion, b) food service practices at breakfast and lunch, and c) the quality of playground activity environments for student recess. Parents noted a number of barriers to healthy nutrition and physical activity while noting strengths and accomplishments among schools that could be replicated in others. The Bethel School Wellness Observation Report reviews the findings of this study.

Read the Bethel School Wellness Observation Report


3. BETHEL BUILT ENVIRONMENT (Back to top)

SRTS Survey Results

Clear Lake SRTS Survey.jpgThe CAST project conducted a Safe Routes to School survey among all schools in the first year of the study (November and October of 2008). The Safe Routes to School survey consisted of an in-class student tally and a parent transportation survey. Results from this survey informed a successful grant application for a Safe Routes to School Program in the Bethel School District. Funding supported a two-year Bethel Safe Routes To School project aimed at Education, Encouragement, and Enforcement programming to boost elementary student walking and biking transport from home to school.

See the Safe Routes to School Reports for each of the Bethel elementary schools

Clear Lake | Danebo | Fairfield | Irving | Malabon | Meadow View | Prairie Mountain

Complete Streets Report

CompleteStreetsReport_tn.jpg This report describes the procedures and results of a street and intersection audit designed to assess child safety in walking and biking between home and school. This project used a mobile GIS-based tool designed for quick, geo-referenced analysis of local street attributes. Parents reported a great deal of variation between neighborhoods in the amount of infrastructure available for student active commuting to or from school. Three types of neighborhood walking environments were found: an overall complete street network environment for active transport by children; a mixed complete and incomplete street network for children, and; an overall incomplete street network for children. This data were used as the basis for decision-making and follow-up steps and introduced new understanding among parents and school administrators on the issues of child pedestrian safety.

Read the Complete Streets Report

Walkability of Bethel Neighborhoods

ClearLakeAmmenities_tn.jpg Parents of elementary school children assessed the safety and accessibility of the built environments surrounding their schools. The assessment involved an audit, using handheld PDA devices, of the streets and intersections in the Bethel School District on factors related to safe walking and biking conditions for children. We presented a detailed look at walking infrastructure surrounding each of the seven Bethel schools. You can find the map for each school below.

Clear Lake | Danebo | Fairfield | Irving | Malabon | Meadow View | Prairie Mountain

Safe Routes to School Route Maps--Spring 2011

Routes_Map_tn.jpg Parents, community partners, and researchers used the street audit information to develop maps of safe walking routes within a quarter mile of each elementary school in the district. Routes were recommended based on distance, perceived safety, and where students live. Sometimes recommended routes are still less than ideal for young walkers; in these instances, our recommended routes highlight streets and crossings where extra attention and resources should be invested. These maps were made available to each elementary school and were distributed to families during annual Walk to School Day events. Look at the recommended routes for each Bethel school below.

Clear Lake | Danebo | Fairfield | Irving | Malabon | Meadow View | Prairie Mountain


4. BETHEL FOOD ENVIRONMENT (Back to top)

Bethel School District Report: Food Environment Mapping

FoodEnvironmentMapping_tn.jpg The CAST Food Assessment Workgroup initiated a food environment assessment in order to understand the food environment in the Bethel School District and evaluate the availability of resources where residents could access healthful, affordable food. Two hundred thirty-seven food outlets were identified in the Bethel area, although just three were full-service grocery stores. The data indicated that there was a wide variety of food resources in the Bethel School District, yet fast food and sit-down restaurants constituted the largest proportion of food outlets.

Read the Bethel Food Environment Mapping Report

Bethel Consumer Food Report

 BethelConsumerFoodReport_tn.jpg In order to understand the consumer nutrition environment in the Bethel School District and evaluate the availability of resources where residents can access healthful, affordable food, CAST researchers and the Food Assessment Workgroup conducted an evaluation of the two largest grocery stores in the school district. This study examined the availability and pricing differences of healthy foods and mapped the store floor plan and layout for their influences on shopping patterns. The study was used to determine if stores promoted healthy eating choices and provided information about nutritional content of food to consumers. The scores for stores in the Bethel community were adequate but not especially supportive of a healthy diet. One store did demonstrate more progressive efforts to promote healthier food options; however, healthier options were more costly, which is a factor consistently found to be a barrier to healthy food purchases.

Read the Bethel Consumer Food Report

Farm to School Report

This report provides an overview of the Farm To School activities in the Bethel School District and provides the results of the FTS evaluation survey that were collected in conjunction with the program. The main goals of the Farm to School activities in Bethel School District were to educate children about where their food comes from, how to grow their own food, and encourage the consumption of fresh fruits and vegetables. The increase in understanding of garden concepts was the strongest aspect of the FTS program in the school district. The Oregon Department of Education announced in 2013 that Bethel was one of eleven school districts awarded competitive Farm to School and School Garden grants.

Read the Farm to School Report

Danebo Neighborhood Market Report

DaneboNeighborhoodMarketReport_tn.jpg During the summer of 2009 and 2010, the Bethel-Danebo Neighborhood Market (BDNM) was initiated. The goal of the market was to connect the Bethel community with affordable area farm-fresh and backyard-gardener food. Information about the market was collected at the market site about the a) range of items sold at the market, b) the experience of the customers, and c) the experience of the vendors. Benefits of the market included the low cost of participation to vendors, the connection made between small growers and backyard gardeners with community residents, and the boost to the community in accessing low cost, healthy produce. Staff noted a number of important lessons for establishing other such markets.

Read the Bethel Danebo Neighborhood Market Report


5. INSIGHTS FROM THE CAST PROCESS (Back to top)

A Community-Based Participatory Approach for Preventing Childhood Obesity: the Community and Schools Together Project

Published Fall 2015 in Progress in Community Health Partnerships: Research, Education, and Action (vol 9.3)

This peer-reviewed research article discusses the community-based participatory research (CBPR) approach pioneered by the CAST project that centered on he rise of childhood obesity in the US. The CBPR research tradition is founded on the conviction that change occurs through community partnerships and that researchers are part of that community. Schools are naturally situated to combat childhood obesity and the CAST project successfully bridged diverse communities concerned with child health. Partners include the Bethel School District, local government, non-profit organizations, and public health researchers. Lessons learned from CAST illustrate how such school and community health coalitions form, opportunities and challanges they might face, and the role of research mediating that process.

Read the article in the Journal of Progress in Community Health Partnerships, Fall 2015, vol 9.3

Community Health Information Database System (CHIDS)

The development of the Community Health Information Database System (CHIDS) was a principal  aim of the CAST project. CHIDS acted as an hub for storing information regarding local community demographics, school health profiles, social and built environments, and food systems. This technical manual describes CHIDS in detail, including system organization, content, and data sources.

Read the Community Health Information Database System (CHIDS) Technical Manual

Family Health Program

The CAST Family Health Program (FHP) was designed during the project as a multi-cultural, bilingual family education program to provide behavioral, skill-based training to reverse community risk for child obesity.  FHP used local community resources to support parents as teachers in helping children develop life-long healthful food and physical activity choices. FHP consisted of 10 weekly, 2-hour group sessions teaching parents how to monitor family daily physical activity; evaluate personal biometric health screenings; understand obesity and related disease risks (e.g., cardiovascular disease, Type II diabetes); and develop skills in reading menu labels, planning healthier family meals and snacks, cooking for lower cholesterol and sodium intake, and avoiding energy-dense restaurant items and sugary drinks. Grade 2-5 children attended parallel group training aimed at increasing their knowledge of heart health and obesity risks, reading menu labels, learning physical activity games for home and school, and gardening and whole-food cooking. Reported study outcomes include pre-post and 3-month follow up measures on parent weight, HDL/LDL, total cholesterol, glucose, triglycerides, and blood pressure and self-reported attitudes and behaviors in family feeding practices and physical activity. Child outcomes included BMI and parent-reported behaviors in eating fruits and vegetables and levels of physical activity and sedentary behaviors.

The CAST Family Health Program Manual describes the program, its theoretical model, and session content for parents and children, and also summarizes participation in the two rounds of feasibility study for the program and the measures used to evaluate FHP.

Read the Family Health Program Manual

BMI Data Gathering Procedures

Child BMI data was a key variable in the CAST project. Height and weight measures of K-5 students in the partner school district were collected annually in conjunction with the school district's annual wellness screening.  In the three documents below, we have summarized the procedures used in the project for 1) collecting height/weight measures with children, 2) training school nurses and staff on obesity risks and 3) BMI data processing using Centers for Disease Control's EPI Info.

Read the BMI Protocols Technical Manual

Read the BMI Training Model for Nurses

Read the EPI Info Data Management Procedures

Family Survey Procedures

The CAST Family Survey was developed to measure family environments in the school community that related to child activity and diet in the home. The survey was developed by

CAST partners and implemented with a representative sample of households in the second and third year of the project. A modified version of the survey was developed and assessed with families in the fourth and fifth year of the project that included items on parenting practices and adult perceptions of school nutrition/physical activity practices.

The Family Survey Manual describes the development of the survey, the design and construction of the survey sample, survey mailing procedures, and procedures used in revising the content of the survey's second version.

Read the Family Survey Manual




If you have any questions regarding CAST data contact the project at cast.info@ori.org.

If you use these materials in grant proposals, reports, or papers PLEASE credit the CAST project using these citation format guidelines.