Qualitative Exit Survey. Part 5
The greater decrease in BMI as compared with the current study might be attributed to the intervention design, which utilized a structured exercise-training component, and the older age of the participants. The L.E.S.T.E.R. (Let’s Eat Smart Then Exercise Right) program, which uses a modified stoplight diet, behavior modification, physical activity and targets family lifestyle had positive weight loss for 26 children ages six to 11 after an eight-week intervention (Kibbe & Offner, 2003). Consistent with the current study, L.E.S.T.E.R. participants had improvements in eating & exercise patterns, knowledge and attitude and significant decreases in anthropometric measures. Heard (2004) reported that 87% (n=425) of the L.E.S.T.E.R. children achieved a significant decrease of about 1.0 BMI unit (p = .03). 77% (n = 107) of the LEAP children achieved a significant decrease of 1.0 BMI unit (p <.01) versus the 0.74 BMI unit mean decrease for all children in the study, which included children that had an increase in BMI.
The results of the current study indicate a significant mean decrease in percent body fat for the child participants from week one to week eight. Bio-impedance analysis to measure percent body fat is less commonly used as an outcome measure for body composition changes in children undergoing small changes in weight. The use of the Tanita body composition analyzer has been reported to be an accurate method for measuring body fat in adult women during weight loss (Powell, Nieman, Melby, Cureton, Schmidt, & Howley, et al, 2001). A validation study reported no significant differences in % body fat measures with leg-to-leg BIA and UWW between obese and non-obese women and was accurate in measuring small body composition changes during weight loss in the obese (Utter, Nieman, Ward, & Butterworth, 1999). However, leg-to-leg BIA as an assessment of body fat change for children is not as well defined and results can vary by age, gender, especially for girls, and among different ethnicities (Daniels, Khoury, & Morrison, 1997; Taylor, Jones, Williams, & Goulding, 2002).
Results from the Likert scale eating and activity survey and the exit survey demonstrated that both the child and parent participants achieved desired changes toward healthy behaviors. The child participants reported an increase in daily physical activity levels in response to the pre and post survey statement — “I exercise 60 minutes or more each day”. In support, the parent survey scores indicated stronger agreement to the statements — “I structure an active family lifestyle” and “I exercise 30 minutes a day with my child”. Both the children and parents indicated stronger agreement with the statement “I eat 5 or more fruits and vegetables each day” at the end of the program. These results are consistent with results from a six-week program, FIT KIDS, for overweight children aged six to 12 and their parents, which is similar to the LEAP program in design and goals. According to information currently distributed by FIT KIDS, pre-post questionnaires showed that “86% of the children report eating more fruits and vegetables, 71% drink more water and 64% report exercising more as a family” (Passehl, 2005).