{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T07:08:21Z","timestamp":1751872101979,"version":"3.40.5"},"reference-count":52,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T00:00:00Z","timestamp":1672099200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000003","name":"Boeing","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000003","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000886","name":"Duke Endowment","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000886","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of School Health"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Associations between school participation in an academic medical center\u2010supported school\u2010based wellness initiative and programmatic components implemented with change in average student body mass index (BMI) over time were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>This was an observational study of 103\u2009K\u201012 South Carolina schools over school years 2014\u20102018, classified as participating (n\u00a0=\u00a087 schools, 27,855 students) or non\u2010participating (n\u00a0=\u00a016 schools; 3608 students). Associations between students' BMI z\u2010score (BMIz) and school participation were evaluated by linear multilevel mixed\u2010effects modeling using data from FitnessGram and the School Wellness Checklist\u00a9 (SWC), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>One\u2010third of the students had a BMI percentile \u226585. Average student BMIz decreased in participating schools (p\u00a0=\u00a0.026) and increased in non\u2010participating schools (p\u00a0=\u00a0.004) over time. For schools that participated two or more years, there was an inverse relationship between SWC score and student BMIz (p\u00a0=\u00a0.002) that did not differ by school type, rural\/urban location, Title 1 status, or student sex. Physical activity and stress management interventions for students, as well as employee wellness and establishing a wellness committee at the school level were significantly associated with decreased average student BMIz (all p\u2009&lt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>Implementation of similar comprehensive school\u2010based wellness programs focused on improving physical activity, stress management, and employee engagement may help prevent and reduce pediatric obesity in diverse communities.<\/jats:p><\/jats:sec>","DOI":"10.1111\/josh.13292","type":"journal-article","created":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T06:22:07Z","timestamp":1672208527000},"page":"547-556","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Participation in a School\u2010Based Wellness Initiative Associated With Improved K\u201012 Student Body Mass Index Trends"],"prefix":"10.1111","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1130-6243","authenticated-orcid":false,"given":"Kathleen C.","family":"Head","sequence":"first","affiliation":[{"name":"Boeing Center for Children's Wellness, Departments of Pediatrics and Internal Medicine, Medical University of South Carolina, 125 Doughty St., MSC 561  Charleston SC 29425\u20105610"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristen","family":"Morella","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Medical University of South Carolina  135 Rutledge Ave MSC 835 Charleston SC 29425\u20105610"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3769-4793","authenticated-orcid":false,"given":"Michael P.","family":"Lugo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Medical University of South Carolina, 10 McClennan Banks Drive MSC 915  Charleston SC 29425\u20105610"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9131-6489","authenticated-orcid":false,"given":"Janice D.","family":"Key","sequence":"additional","affiliation":[{"name":"Boeing Center for Children's Wellness, Department of Pediatrics, Medical University of South Carolina, 125 Doughty St., MSC 561  Charleston SC 29425\u20105610"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,12,27]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"FryarC CarrollM AffulJ.prevalence of overweight obesity and severe obesity among children and adolescents aged 2\u201319\u2009years United States 1963\u20131965 through 2017\u20132018. 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