1. + Allison A. Parsons 1, Christine E Blake 1, Scotty M. Buff 2 1 Arnold School of Public Health, University of South Carolina, Columbia, SC, 2 Medical University of South Carolina, Charleston, South Carolina Acknowledgements: This evaluation was supported with a grant from Sherman Financial Group Kerry McIver, PhD, for guidance and assistance with accelerometer data collection and analysis Comprehensive changes in school environment, health education, and teacher modeling led to healthier obesity-related diet and physical activity behaviors in preschool children

2. + Introduction MSA is a rigorous, college-preparatory school serving low-income children MSA’s holistic approach includes: extended school day and year intensive academic program mandatory family involvement healthy diet and PA environments

3. + Introduction Comprehensive Childhood Obesity program Taught by MUSC health professional and biomedical science students Three modules throughout school year Nutrition Physical Activity Healthy Lifestyle Incorporates Parents and Teachers

4. + Purpose Assess the impact of the Meeting Street Academy (MSA)/Junior Doctors of Health © (JDOH) collaboration on preschool children’s nutrition knowledge, diet and physical activity (PA) behaviors, and BMI.

5. + Study Design Data were collected at three time points: Baseline (BL) in August 2012 Midyear (MY) in January 2013 Follow-up (FU) in May 2013 Table 1 Measures completed by wave MeasureWave 1Wave 2Wave 3 Child demographics ✔✔✔ Teacher report of physical activity environment ✔ ✔ School physical activity and nutrition environment ✔ ✔ Child nutrition knowledge and preferences ✔✔✔ Child physical activity ✔✔✔ Child dietary intake ✔✔✔ Child BMI* ✔ ✔ * The second measure of BMI was taken in August 2013

6. + Data Analyses We used paired t-tests to determine changes in Child nutrition knowledge and preference All participants combined Child PA: accelerometers Boys and girls separately 3’s and 4’s combined Instructional and afterschool hours Minutes spent in sedentary, light/moderate, and vigorous PA Child dietary intake Each nutrient – all participants combined except kilocalories Child BMI percentile Boys and girls separately

7. + Results: Child Participants Table 2 Child demographics, 3 and 4 year olds, BL, MY, FU ClassroomSexRace 3s4sMFBW BL a 16 (48.5%)17 (51.5%)15 (45.5%)18 (54.5%)29 (87.8%)4 (12.1%) MY b and FU b 17 (53.1%)15 (46.9%)14 (43.8%)18 (56.3%)28 (87.1%)4 (12.5%) In all waves the children were approximately evenly split between the 3 and 4 year old classrooms, there were more females than males, and the majority of children were Black. a: n = 33 b: n = 32

8. + Results: School environment and teacher modeling Scoring range: 25 - 86 BL: 79.25 FU: 84 Increase in: Number of times and duration of outdoor play provided Number of times and duration of teacher-led PA in regular, daily lessons Scoring range: 36 - 144 BL: 108 FU: 119 Increase in: Staff eating the same food as the children Decrease in: Menu options with added fats Unhealthy celebratory foods SHAPES and NAPSACC (PA) Scores NAPSACC (NUTRITION) scores

9. + Results: Child diet behavior

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14. + Results: Child physical activity behavior

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16. + Results: Child BMI BMI data was measured at two time points: September 9, 2012 (baseline) and August 8, 2013 (follow-up).

17. + Limitations No control group so unable to determine causality Small sample size (n=32) could have limited our ability to detect changes, particularly in nutrition knowledge and preferences scores School environment scores were high at baseline leaving very little room for score improvement

18. + Discussion Increased teacher modeling and improvements to the school environment may have led to positive dietary and PA changes Significant increases in dietary fiber and iron and a decrease in added sugars Increases in morning physical activity Future efforts Continued improvements to the school menu Modifications in afterschool programming MSA/JDOH should continue to focus their efforts on providing nutrition and physical activity education Encourage and supports parents and teachers to promote and model health lifestyle behaviors

19. + Questions?