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

Summary 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....

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Bibliographic Details
Published in:Pediatric obesity 2018-10, Vol.13 (S1), p.46-55
Main Authors: Woodward‐Lopez, G., Gosliner, W., Au, L. E., Kao, J., Webb, K. L., Sagatov, R. D., Strauss, W. J., Landgraf, A. J., Nagaraja, J., Wilson, D. K., Nicastro, H. L., Nebeling, L. C., Schultz, J. A., Ritchie, L. D.
Format: Article
Language:English
Subjects:
Adolescent
Child
Child, Preschool
childhood
Children & youth
Childrens health
Community
Diet
Diet - statistics & numerical data
Feeding Behavior
Female
Humans
Male
Nutrition
Obesity
Pediatric Obesity - prevention & control
Pediatrics
policy
Prevention
Preventive Health Services - statistics & numerical data
Public Health - statistics & numerical data
Residence Characteristics - statistics & numerical data
Social Class
United States
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Summary:Summary 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. What is already known about this subject: There are disparities in obesity, dietary intake and physical activity levels by race/ethnicity, socioeconomic status and region in the US. Similar multi-component and multisector approaches to prevention of obesity are implemented across the country in communities with diverse characteristics. Little is known about the relative effectiveness of obesity prevention efforts in communities with different characteristics. What this study adds: We found that region, urbanicity, community-level income, and community level race/ethnicity modify the association between childhood obesity prevention efforts and dietary intake. We identified which aspects of obesity prevention
ISSN:2047-6302
2047-6310
DOI:10.1111/ijpo.12434