A Mixed-Method Evaluation of a Rural Elementary School Implementing the Coordinated Approach to Child Health (CATCH) Program.

Despite children living in rural US areas having 26% greater odds of being affected by obesity compared to those living in urban areas, the implementation of evidence-based programs in rural schools is rare. We collected quantitative data (weight and height) from 272 racially and ethnically diverse students at baseline, and qualitative data from students (4 focus groups), parents, and school staff (16 semi-structured interviews and 29 surveys) to evaluate program outcomes and perceptions. At the 2-year follow-up, paired data from 157 students, represented by racial/ethnic groups of 59% non-Hispanic White, 31% non-Hispanic Black, and 10% Hispanic, showed an overall mean change (SD) in BMI z-score of -0.04 (0.59), a decrease of -0.08 (0.69) in boys, and a significant -0.18 (0.33) decrease among Hispanic students. Boys had a mean decrease in obesity prevalence of 3 percentage points (from 17% to 14%), and Hispanic students had the largest mean decrease in BMI percentile. Qualitative data showed positive perceptions of the CATCH program and its implementation. This community-engaged research, with collaboration from an academic institution, a health department, a local wellness coalition, and a rural elementary school, demonstrated successful CATCH program implementation and showed promising outcomes in mean BMI changes.

Creating a Culture of Breastfeeding Support and Continuity of Care in Central Illinois.

Central Illinois breastfeeding rates fall short of the recommendation to breastfeed exclusively through 6 months, and Black, low-income, and rural families disproportionately experience low rates. A continuity of care framework, which emphasizes interdisciplinary coordination from the prenatal period through weaning, can support breastfeeding. This case study describes an innovative practice model informed by the Collective Impact Model (CIM) designed to promote breastfeeding continuity of care and community support in Central Illinois. Development and maintenance of the Central Illinois Breastfeeding Professional Network (CIBPN), a network of diverse public health practitioners, leveraged CIM principles. The CIBPN began with influential Breastfeeding Champions, identified through the Illinois State Physical Activity and Nutrition program. Champions convened Central Illinois breastfeeding allies and led the CIBPN to coalesce around a common agenda and engage in mutually reinforcing activities. Linked breastfeeding data for families giving birth at a Central Illinois hospital and receiving postnatal care at a health center were analyzed as a snapshot of CIBPN initiatives. The CIBPN engaged at least 135 practitioners and more than 27 organizations. At least 33 people received advanced breastfeeding training, and many professional development opportunities were offered. Numerous breastfeeding support improvements were made at and between CIBPN sites. Breastfeeding rates at the birthing hospital and health center were stable, including during the COVID-19 pandemic. This article contributes to the practice-based evidence for breastfeeding support by strengthening continuity of care through a successful application of the CIM by public health practitioners.