Design and statistical analysis for the pathways study

We report the design, rationale, and statistical procedures used in Pathways, a randomized, school-based intervention for the primary prevention of obesity in American Indian children. The intervention, which is now being implemented in 7 American Indian communities around the country, includes a health-promotion curriculum, a physical education program, a school meal program, and a family involvement component. Forty-one schools serving American Indian children were randomly assigned to be either intervention or control groups. The intervention will begin in the third grade and continue through the end of the fifth grade. Efficacy of intervention will be assessed by differences in mean percentage body fat, calculated by a prediction equation, between intervention and control schools at the end of the fifth grade. Power computations indicate that the study has power to detect a mean difference of 2.8% in body fat. Data analysis will use intention-to-treat concepts and the mixed linear model. The study will be completed in 2000.