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Pediatr Obes. 2018 Oct;13 Suppl 1:46-55. doi: 10.1111/ijpo.12434. Epub 2018 Jul 10.

Community characteristics modify the relationship between obesity prevention efforts and dietary intake in children: the Healthy Communities Study.

Author information

1
Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Berkeley, California, USA.
2
Battelle Health and Analytics, Baltimore, Maryland, USA.
3
Health Analytics Hub, LLC, Lewis Center, Ohio, USA.
4
Battelle Health and Analytics, Columbus, Ohio, USA.
5
Department of Psychology, University of South Carolina, Columbia, South Carolina, USA.
6
National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA.
7
National Cancer Institute, Bethesda, Maryland, USA.
8
Center for Community Health and Development, University of Kansas, Lawrence, Kansas, USA.

Abstract

BACKGROUND:

The influence of community characteristics on the effectiveness of childhood obesity prevention efforts is not well understood.

OBJECTIVE:

Examine the interaction of community characteristics with the relationship between community programmes and policies (CPPs) and dietary intake.

METHODS:

An observational study of 5138 children in grades K-8 in 130 US communities was conducted in 2013-2015. Key informant interviews identified and characterized CPPs. CPP scores were generated for the number of target behaviours (CPP-Behav) and the number of behaviour change strategies (CPP-Strat) addressed by all CPPs and CPPs with nutrition goals over the prior 6 years in each community. Dietary intake was assessed by dietary screener and included intake of sugar from sugar-sweetened beverages; energy-dense foods; fruits and vegetables; whole grains; and fibre. Multivariate statistical models assessed the interactions between US region, urbanicity, community-level income, and community-level race/ethnicity and CPP scores in relation to dietary intake.

RESULTS:

CPP-Strat was positively associated with healthier dietary intakes in the Northeast and West, and in high Hispanic communities; the reverse was true in the South, and in high African-American and low-income communities. The CPP-Behav was positively associated with healthier dietary intakes in the South and rural areas, and the reverse was true in the West.

CONCLUSION:

The relationships between CPP index scores and dietary intake were most strongly influenced by region and urbanicity and to a lesser extent by community-level race/ethnicity and income. Findings suggest that different considerations may be needed for childhood obesity prevention efforts in communities with different characteristics.

KEYWORDS:

childhood; nutrition; obesity; policy

PMID:
29992765
PMCID:
PMC6382075
DOI:
10.1111/ijpo.12434
[Indexed for MEDLINE]
Free PMC Article

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