CATCH Research and Development
CATCH Background
The CATCH Program is based on the CDC coordinated school health model (as it relates to physical activity, diet, and tobacco prevention) in which eight components work interactively to educate young people about and provide support for a healthful lifestyle. The eight components are: health education, physical education, health services, child nutrition services, counseling and psychological services, healthy school environment, health promotion for staff, and family/community involvement.
CATCH employs a holistic approach to child health promotion by targeting multiple aspects of the school environment and involves classroom teachers, Child Nutrition Services, physical education (PE) teachers, students and their families, and the broader school community in a wide range of health-promoting activities for all children.
CATCH was implemented as a clinical trial from 1991 to 1994 and evaluated in four regional sites by researchers at Tulane University–New Orleans, the University of California–San Diego, the University of Minnesota–Minneapolis, and the University of Texas–Houston. The participants were elementary school children, grades 3 through 5, and included a large number of multi-cultural students representing the greater United States school population. At the completion of the main trial, CATCH succeeded in producing positive and lasting changes in children’s behaviors; decreasing fat consumption and increasing physical activity among children and adolescents (Leupker et al, 1996); and, the changes were maintained for three years post-intervention (Nader et al, 1999).
The Research Continues
There is an impressive evidence-base that the CATCH Program improves diet, physical activity, and prevents the onset of child obesity amongst disadvantaged children including Hispanic Americans on the Texas border. A recent replication study of CATCH in El Paso reported significant effects of the program on preventing the onset of overweight and obesity among Hispanic children (Hoelscher et al, 2009). In Travis County Texas, implementation of CATCH led to significant reductions in overweight and obesity among Hispanic, African American, and Anglo children (Hoelscher, 2010). The PASS and CATCH study demonstrated that incorporating 10 minutes per day of movement activities within a classroom setting (e.g., during science class) led to significant positive academic improvements (Murray et al, 2010). A cost-effectiveness study of CATCH (Brown et al, 2007) reports the program cost-effectiveness ratio was $889.68 (revealing the intervention costs per quality-adjusted life years) and net benefit was $68,125 (comparison of the present value of averted future costs with the cost of the CATCH intervention). A recent independent review article in Health Affairs reports, “ Based on the published literature, the most cost-effective way to prevent obesity in youth is the Coordinated Approach to Child Health (CATCH), a comprehensive intervention to promote healthy eating and physical activity in elementary schools, which costs $900 per QALY saved (Health experts consider any intervention below $50,000 as cost effective).” (Cawley, 2010).
The goal of CATCH is to positively impact children’s health behaviors, improve the school health environment, and influence and change school health policies and practices of schools, in order to reduce and eliminate health risk factors and risk-related behaviors of students. These changes, if spread across the entire population of children and maintained, should have a substantial impact on subsequent disease rates in the United States.
As the public health focus shifted from cardiovascular health to obesity and diabetes, CATCH materials have been revised to reflect the new dietary guidelines and physical activity recommendations. The CATCH acronym stands for the Coordinated Approach To Child Health to reflect this broader health perspective. CATCH has been broadly translated for implementation in schools in the United States, Canada, Mexico, Europe, and South America (Owens, Glantz, Sallis, Kelder; Hoelscher et al, 2004; Hoelscher, Kelder 2001; Franks et al, 2007).