We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Outcomes of a Field Trial to Improve Children's Dietary Patterns and Physical Activity The Child and Adolescent Trial for Cardiovascular Health (CATCH)

Russell V. Luepker, MD; Cheryl L. Perry, PhD; Sonja M. McKinlay, PhD; Philip R. Nader, MD; Guy S. Parcel, PhD; Elaine J. Stone, PhD, MPH; Larry S. Webber, PhD; John P. Elder, PhD; Henry A. Feldman, PhD; Carolyn C. Johnson, PhD; Steve H. Kelder, PhD, MPH; Margaret Wu, PhD; Philip Nader, MD; John Elder, PhD; Thom McKenzie, PhD; Kathryn Bachman, MS, EdS; Shelia Broyles, PhD; Ellen Busch, RD; Steve Danna; Todd Galati, MA; Karen Haye; Christine Hayes, MA; Michael McGreevy; B. J. Williston, MEd; Michelle Zive, MS, RD.; Cheryl Perry, PhD; Leslie Lytle, RD, PhD; Russell Luepker, MD; Beth Davidann, MPH; Pat Brothen; Virginia Dahlstrom, MA; Maxine Dammen; Sally Ehlinger, PhD; Tawny Greene; Barbara Hann; Jean Heberle; Tom Hofflander, MEd; Colleen Kelder; Pat Kelliher; Therese Kunz; Bonnie Manning; Donna McDuffie; Todd Morrow; Margie Miller; Jennifer Mrosala; Gretchen Newman, MA; Mellanie Pusateri; Margaret Reinhardt, RD, MPH; Renee Sieving, MSN; Jennifer Smisson; Mary Smyth; Pat Snyder, MA, RD; Mike Staufacker, MA; Janelle Traut; Tracy Wick.; Guy Parcel, PhD; Steve Kelder, PhD, MPH; Deanna Montgomery, PhD, RD; Milton Nichaman, MD, ScD; Wendell Taylor, PhD, MPH; Kathleen (Wambsgans) Cook, MEd; Elvira Barrera, SpMFT, LPC; Larry Berry; Janet Carbonneau, MEd, RD; Karen Chemycz, MA; Peter Cribb, MEd; Sandra Evans, MPH; Rebecca Gordon; Jenifer Gwinn; Susan Luton, MA; Barbara Scaife, MS, RD; Sue Sharkey; Sharon Snider; Sema Spigner; Kay Wilson, MPH, RD; Sherry Woods, EdD; Edmundson, PhD; Jack Wilmore, PhD; Larry Webber, PhD; Carolyn Johnson, PhD; Theresa Nicklas, DrPH, MPH, LDN; Vincent Anthony; Nancy Baker, MS, RD; Kathryn Barnwell; Stacy Belou; Gerald Berenson, MD; Susan Bonura, MPA; Keith Bordelon; Sandra Cameron, RN; Ann Clesi, MEd; Lisa Crochet, MEd; Amy Cunningham, MS, RD; Didara Franklin; Anwarul Haque, MBBS; David Harsha, PhD; Javed Joy, MPH; Saundra M. Hunter, PhD; Daniel Kuras; Pam Lambie; Ann Layman, MA; Sharon Little-Christian, MEd; Sheryl Pedersen, MPH; Jacqueline Reeds-Epping, MEd; Rochelle Rice, MPH; Kelly Romero, MEd; Cynthia Pitcher-Smith; Patricia Strikmiller, MS; Marion White, MS, RD.; Sonja McKinlay, PhD; Stavroula Osganian, MD, MPH; Henry Feldman, PhD; Herman Mitchell, PhD; Susan Budman, MSW; Patty Connell; Michael Koehler; Paul Mitchell, MS; Christine Kannler; Glenn Rennie; Debbie Sellers, PhD; Moira Walsh; Minhua Yang, MS.; Johanna Dwyer, DSc, RD; Mary Kay Ebzery, MS, RD; Anne Garceau, MS, RD; Lynn Hewes, MS, RD; Caitlin Hosmer, MS, RD; Debra Raizman, MPH, RD.; Linda Bausserman, Ph; Elaine Stone, PhD, MPH; Marguerite Evans, MS, RD; Jeffrey Cutler, MD, MPH.; Ronald Lauer, MD; Thomas Coates, PhD; William Haskell, PhD; C. Anderson Johnson, PhD; Ronald Prineas, MD, PhD; Linda Van Horn, PhD, RD; Joel Verter, PhD
JAMA. 1996;275(10):768-776. doi:10.1001/jama.1996.03530340032026.
Text Size: A A A
Published online


Objective.  —To assess the outcomes of health behavior interventions, focusing on the elementary school environment, classroom curricula, and home programs, for the primary prevention of cardiovascular disease.

Design.  —A randomized, controlled field trial at four sites with 56 intervention and 40 control elementary schools. Outcomes were assessed using prerandomization measures (fall 1991) and follow-up measures (spring 1994).

Participants.  —A total of 5106 initially third-grade students from ethnically diverse backgrounds in public schools located in California, Louisiana, Minnesota, and Texas.

Intervention.  —Twenty-eight schools participated in a third-grade through fifth-grade intervention including school food service modifications, enhanced physical education (PE), and classroom health curricula. Twenty-eight additional schools received these components plus family education.

Main Outcome Measures.  —At the school level, the two primary end points were changes in the fat content of food service lunch offerings and the amount of moderate-to-vigorous physical activity in the PE programs. At the level of the individual student, serum cholesterol change was the primary end point and was used for power calculations for the study. Individual level secondary end points included psychosocial factors, recall measures of eating and physical activity patterns, and other physiologic measures.

Results.  —In intervention school lunches, the percentage of energy intake from fat fell significantly more (from 38.7% to 31.9%) than in control lunches (from 38.9% to 36.2%)(P<.001 ). The intensity of physical activity in PE classes during the Child and Adolescent Trial for Cardiovascular Health (CATCH) intervention increased significantly in the intervention schools compared with the control schools (P<.02). Self-reported daily energy intake from fat among students in the intervention schools was significantly reduced (from 32.7% to 30.3%) compared with that among students in the control schools (from 32.6% to 32.2%) (P<.001). Intervention students reported significantly more daily vigorous activity than controls (58.6 minutes vs 46.5 minutes; P<.003). Blood pressure, body size, and cholesterol measures did not differ significantly between treatment groups. No evidence of deleterious effects of this intervention on growth or development was observed.

Conclusion.  —The CATCH intervention was able to modify the fat content of school lunches, increase moderate-to-vigorous physical activity in PE, and improve eating and physical activity behaviors in children during 3 school years.(JAMA. 1996;275:768-776)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.