Using the RE-AIM Framework to Evaluate the Statewide Dissemination of a School-Based Physical Activity and Nutrition Curriculum: “Exercise Your Options”

PURPOSE: Examine the reach, efficacy, adoption, implementation, and maintenance of a physical activity and nutrition curriculum for middle-school students. DESIGN: Nonexperimental pilot evaluation of a statewide dissemination trial. SETTING: California middle schools during the 2006 to 2007 school year. SUBJECTS: Sixteen classes (N = 668 students and 16 teachers) sampled from the statewide pool who used the program. INTERVENTION: An eight-lesson nutrition and physical activity curriculum, "Exercise Your Options" (EYO), including a teacher guide, video clips, a student activity booklet, and ancillary materials was made available to teachers. MEASURES: Program records, classroom observations, teacher surveys, and student presurveys and postsurveys (assessing physical activity, sedentary behaviors, and dietary intake). ANALYSIS: Descriptive statistics and multilevel random-coefficient modeling. RESULTS: The EYO program reached 234,442 middle-school students in California. During the program, total physical activity increased (p < .001), whereas watching TV/DVDs and playing electronic games/computer use decreased (p < .05). Intake of dairy products increased (p < .05), whereas consumption of sugars/sweets decreased (p < .001). Forty-two percent of eligible middle-school classrooms ordered the program materials. Eighty-six percent of sampled teachers implemented all of the lessons. Over the past 5 years, 51% of all middle-school students in California were exposed to the program. CONCLUSIONS: The EYO program showed its potential for moderate to high public health impact among California middle-school students.