As far as school health and wellness programs go, Tim Hardison had pretty much seen them all, and none that he had seen had ever been successful. A physiology wellness researcher turned middle school science teacher, Hardison was uniquely qualified to develop a program of his own when he was put in charge of school improvement at a campus in what he terms “one of the sickest, poorest areas in the United States, east of Interstate 95 in North Carolina.”
Hardison observed that the programs that had come before and, unfortunately failed, had usually been developed by people who were not actively engaged in schools, people who were from public health or university backgrounds. With that knowledge in mind, he set about drawing from his extensive background in education, including his familiarity with school improvement issues, and the No Child Left Behind Act, to incorporate key elements to ensure his program’s success. “Practically everybody agrees that schools are the place where this needs to occur,” he explains, “but nobody has really been successful.”
Nobody, that is, until Hardison introduced “MATCH, Motivating Adolescents with Technology to CHOOSE Health,” an Internet-based management system that cleverly utilizes technology to engage middle school students and encourage them to make healthier choices. Students enrolled in the program enter baseline data, heights and weights, and participate in an online behavioral survey that periodically monitors sleeping, eating and physical activities, including technology usage. The students receive a virtual trophy case that they can stock with other awards from the program for making good choices and significant progress.
Given that the primary responsibility of schools is education, Hardison decided that an effective program would need to incorporate academics into the health and wellness objectives. His extensive background in exercise, cardiac rehab and research enabled him to take a body systems approach to teaching the students how to take care of their heart and circulatory system. “Absorbing everything that we’ve been taught in our ongoing professional development courses about how kids learn best when taught in an interdisciplinary manner in a rigorous relevant way, inspired me to backwards design a program that would be successful,” he says. “To me, our success is not surprising because everything that we’ve done has been based on sound psychological models that have been proven to work in the area of health.”
When students see that most chronic diseases — such as heart disease, kidney disease, diabetes — are related to lifestyle behaviors that are under their control, when they begin to see the end result of these chronic diseases within their own families, they begin to want to make healthy choices, according to Hardison.
“What we try to do is impress on kids that this is their opportunity to learn, because so much of this is under their control,” he adds. “Knowledge is power, and when these kids are empowered by the information we provide, they realize that it’s up to them to make good choices. We show them what the healthy choices are, and we make sure they also understand the consequences of negative choices. It’s a body systems approach, but it’s not just taught in health or science. There’s math lessons, language arts lessons, social studies, science, computer skills... It’s basically taught across the curriculum in an ideal setting.”
Now in its 12th school year, MATCH has achieved an unprecedented level of success. “We’re the only middle school program that’s received the designation of ‘Research Tested’ by the outside rating agency, the Center for Training and Research Translation (Center TRT) at Chapel Hill,” says Hardison. “They [the rating agency] basically went through all our materials, then published papers with their findings, and they evaluate if programs are either emerging, practice tested, or research tested. We actually have received their highest level of scrutiny: researched tested.”
Earlier this year, Hardison’s team presented the program at a national obesity conference in San Francisco, where they discovered that their results were almost twice as effective as those of other programs presented there, many of which are considered among the best in the country, including one comprised of a group of 31 hospital-based childhood obesity and weight management programs with considerable collective resources.
“The obese kids in these 31 best hospital-based programs recorded a Z-score reduction of .05. An hour earlier in a different conference room, we reported that our kids score in a school-based program was .09, almost double the effectiveness from a hospital-based program, without all the bells and whistles of the expensive doctors and everything that goes along with that,” explains Hardison. “They get to work one-on-one with the kids, and we work with entire schools and classes at a time, and we’re almost twice as successful!”
These kinds of results have a lot of potential stakeholders right now very interested in MATCH, according to Hardison, not the least of whom is North Carolina State Superintendent of Public Instruction Mark Johnson. “MATCH is a shining example of how we need to be teaching students today,” says Johnson. “Personalized learning using technology can develop academic skills and lay a foundation of health for the future. MATCH represents the commitment of North Carolina Public Schools to develop students to become agents of change in our schools, homes, and communities.”
Eventually, Hardison came to the realization that the best way to get people to look closely at MATCH was to turn its outcomes into cost savings. “We had an economist from RTI International look at (recent) Medicaid charges in North Carolina by weight category,” says Hardison, “and there’s a substantial difference between what Medicaid pays for a healthy-weight kid versus an overweight or obese kid. And you know when you begin to categorically move kids from overweight to healthy weight or from obese to overweight, when you actually can move them and keep them there, you can begin to project savings. Nobody’s ever been able to do that, because nobody’s ever been able to show categorical change over time, and our long-term studies showed that.”
With the potential financial savings in mind, not to mention the vast improvement in the physical condition of students and its predictable positive effect on their overall learning outcomes, Hardison’s dream of a mass rollout of MATCH across the country seems not only possible, but likely, and soon.
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