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Prev Chronic Dis. 2017 Jul 6;14:E53. doi: 10.5888/pcd14.160577.

A Community Resource Map to Support Clinical-Community Linkages in a Randomized Controlled Trial of Childhood Obesity, Eastern Massachusetts, 2014-2016.

Author information

1
Division of Gastroenterology and Nutrition, Massachusetts General Hospital for Children, 175 Cambridge St, 5th FL, Boston, MA 02114. Email: lfiechtner@partners.org.
2
Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts.
3
Columbia University, the College of Physicians and Surgeons, New York, New York.
4
Section of General Pediatrics, Yale University School of Medicine, New Haven, Connecticut.
5
Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.
6
Harvard Vanguard Medical Associates, Boston, Massachusetts.
7
Center for Geographic Analysis, Harvard University, Cambridge, Massachusetts.
8
Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts.

Abstract

BACKGROUND:

Novel approaches to health care delivery that leverage community resources could improve outcomes for children at high risk for obesity.

COMMUNITY CONTEXT:

We describe the process by which we created an online interactive community resources map for use in the Connect for Health randomized controlled trial. The trial was conducted in the 6 pediatric practices that cared for the highest percentage of children with overweight or obesity within a large multi-specialty group practice in eastern Massachusetts.

METHODS:

By using semistructured interviews with parents and community partners and geographic information systems (GIS), we created and validated a community resource map for use in a randomized controlled trial for childhood obesity. We conducted semistructured interviews with 11 parents and received stakeholder feedback from 5 community partners, 2 pediatricians, and 3 obesity-built environment experts to identify community resources that could support behavior change. We used GIS databases to identify the location of resources. After the resources were validated, we created an online, interactive searchable map. We evaluated parent resource empowerment at baseline and follow-up, examined if the participant families went to new locations for physical activity and food shopping, and evaluated how satisfied the families were with the information they received.

OUTCOME:

Parents, community partners, and experts identified several resources to be included in the map, including farmers markets, supermarkets, parks, and fitness centers. Parents expressed the need for affordable activities. Parent resource empowerment increased by 0.25 units (95% confidence interval, 0.21-0.30) over the 1-year intervention period; 76.2% of participants were physically active at new places, 57.1% of participant families shopped at new locations; and 71.8% reported they were very satisfied with the information they received.

INTERPRETATION:

Parents and community partners identified several community resources that could help support behavior change. Parent resource empowerment and use of community resources increased over the intervention period, suggesting that community resource mapping should inform future interventions.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT02124460.

PMID:
28682745
PMCID:
PMC5510302
DOI:
10.5888/pcd14.160577
[Indexed for MEDLINE]
Free PMC Article

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