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A Cascade Model for School Wellness Programming: A Feasibility Case Study

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Objective: In this paper, we report on the Wellness Cascade process for engaging stakeholders in population-level school-based obesity preventive/treatment programming. Methods: We implemented the 5-step process to improve body mass index (BMI) >85th percentile (elevated BMI) or participation in less than 7 hours a week of moderately vigorous physical activity (inadequate MVPA) by defining numerators and denominators, identifying potential data sources, considering data source issues, and compiling and analyzing data. Results: We collected and compiled data on 239 youth (ages 11-14 years) during the 2016-2017 and 2017-2018 school years. Participant attainment of Wellness Cascade step milestones included Step 1 (Assessment) where 56% and 84% of those assessed had elevated BMI and inadequate MVPA, respectively; Step 2 (Enrollment) where 39% and 40% of participants with elevated BMI and inadequate MVPA, respectively, enrolled in preventive/treatment programming; Step 3 (Engagement) where 38% and 39%, respectively, engaged in programming; Step 4 (Completion) where 33% and 34%, respectively, completed programming; and Step 5 (Outcomes) where 16% with elevated BMI improved their BMI and 19% with inadequate MVPA increased hours spent in MVPA and attained expected outcomes. Conclusion: Stakeholder Wellness Cascade adoption can facilitate monitoring via attainment of step milestones which identify gaps in obesity prevention and treatment.
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Keywords: BODY MASS INDEX (BMI); HEALTH PROGRAM PLANNING; OBESITY; PHYSICAL ACTIVITY; SCHOOL HEALTH; WELLNESS CASCADE

Document Type: Research Article

Publication date: January 1, 2020

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  • Health Behavior and Policy Review is a rigorously peer-reviewed scholarly bi-monthly publication that seeks manuscripts on health behavior or policy topics that represent original research, including papers that examine the development, advocacy, implementation, or evaluation of policies around specific health issues. The Review especially welcomes papers that tie together health behavior and policy recommendations. Articles are available through subscription or can be ordered individually from the Health Behavior and Policy Review site.
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