Journal
PREVENTIVE MEDICINE
Volume 57, Issue 4, Pages 322-327Publisher
ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.ypmed.2013.06.001
Keywords
Child health; Obesity; Fitness; Nutrition; BMI; Community; Intervention; Environmental change; Overweight
Funding
- Centers for Disease Control and Prevention (CDC), Atlanta [R06/CCR121519-01]
- Blue Cross Blue Shield of Massachusetts, United Way of Mass Bay, The US Potato Board, Stonyfield Farm, and Dole Foods
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Objective: The objective of this study was to test the hypothesis that community-based environmental change intervention prevents undesirable weight gain in children. Method: The method used in this study was a two-year, non-randomized, controlled trial (2003-2005) using community-based,participatory methodology in three diverse cities in Massachusetts: one intervention and two socio-demographically-matched control communities (pooled for analysis). Children (n = 1028), with a mean age = 7.61 + 1.04 years participated. Interventions were made to improve energy balance by increasing physical activity options and availability of healthful foods (Year 1). To firmly secure sustainability, the study team supported policies and shifted intervention work to community members (Year 2). Results: Change in body mass index z-score (BMIz) was assessed by multiple regression, accounting for clustering within communities and adjusting for baseline covariates. Sex-specific overweight/obesity prevalence, incidence and remission were assessed. Over the two-year period, BMIz of children in the intervention community decreased by 0.06 [p = 0.005,95% confidence interval: 0.08 to 0.041 compared to controls. Prevalence of overweight/obesity decreased in males (OR = 0.61, p = 0.01) and females (OR = 0.78, p = 0.01) and remission increased in males (OR 3.18, p = 0.03) and females (OR 1.93,p = 0.03) in intervention compared to controls. Conclusion: Results demonstrate promise for preventing childhood obesity using a sustainable multi-level community-based model and reinforce the need for wide-reaching environmental and policy interventions. (C) 2013 Published by Elsevier Inc.
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