Abstract| Volume 45, ISSUE 4, SUPPLEMENT , S13-S14, July 2013

Food, Health & Choices: Using the DESIGN Stepwise Procedure to Develop a Childhood Obesity Prevention Program


      To address the high rates of childhood obesity, well designed, behaviorally focused, theory-based programs are needed. This project used the DESIGN Stepwise Procedure of Contento to develop an innovative program, Food, Health & Choices.

      Target audience

      Upper elementary students.

      Theory, Prior Research, Rationale

      DESIGN is based on the integration of behavioral theory with educational design principles.


      Followed the DESIGN process: 1) Decide issue (obesity prevention) and behaviors (choose more fruits and vegetables and physical activity; and choose less sweetened beverages, processed packaged snacks, fast food and recreational screentime); 2) Explore determinants/mediators (identified appropriate mediators for group based on literature and audience assessment); 3) Select theory and philosophy (combination of social cognitive theory and self-determination theory with a philosophy that takes a system-blame approach); 4) Indicate objectives (general objectives for each theory-based mediator and specific objectives for lesson activities); 5) Generate plans (23 lesson plans); 6) Nail down evaluation (developed protocol for measuring height, weight, and percent body fat, and instruments to measure changes in the targeted behaviors and theory-based mediators).


      The DESIGN procedure resulted in a curriculum that, according to process evaluation data, had positive reviews by teachers and actively engaged students. Formative student pre to post data (n=146) showed positive outcomes on anthropometric, behavioral, and theory-based psychosocial mediators.

      Conclusions and Implications

      The value of systematic program development is often underestimated. Using a systematic process, such as the user-friendly DESIGN Stepwise Procedure, can lead to curricula that are tailored to the intended audience, theory-based, and more likely to be effective at changing behaviors.


      USDA 2010-85215-20661.