Population-level intervention strategies and examples for obesity prevention in children.

Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
Annual Review of Nutrition (Impact Factor: 10.46). 04/2012; 32:391-415. DOI: 10.1146/annurev-nutr-071811-150646
Source: PubMed

ABSTRACT With obesity affecting approximately 12.5 million American youth, population-level interventions are indicated to help support healthy behaviors. The purpose of this review is to provide a summary of population-level intervention strategies and specific intervention examples that illustrate ways to help prevent and control obesity in children through improving nutrition and physical activity behaviors. Information is summarized within the settings where children live, learn, and play (early care and education, school, community, health care, home). Intervention strategies are activities or changes intended to promote healthful behaviors in children. They were identified from (a) systematic reviews; (b) evidence- and expert consensus-based recommendations, guidelines, or standards from nongovernmental or federal agencies; and finally (c) peer-reviewed synthesis reviews. Intervention examples illustrate how at least one of the strategies was used in a particular setting. To identify interventions examples, we considered (a) peer-reviewed literature as well as (b) additional sources with research-tested and practice-based initiatives. Researchers and practitioners may use this review as they set priorities and promote integration across settings and to find research- and practice-tested intervention examples that can be replicated in their communities for childhood obesity prevention.


Available from: Ashleigh L May, Feb 27, 2015
  • JAMA Pediatrics 10/2012; DOI:10.1001/2013.jamapediatrics.358 · 4.25 Impact Factor
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    ABSTRACT: Childhood obesity is a major concern for public health. There are multiple factors (e.g., genetic, social, and environmental) that contribute to unhealthy weight gain. Drawing from findings on "obesogenic environments" and core principles of preventive strategies to reduce health inequalities, this paper gives an overview of recent childhood prevention programs that target aspects of the physical environment ("environmental changes"). Out of the ten reviews we screened (including more than 300 studies), we identified very few that addressed aspects of the environment. We focus here on 14 programs that follow different approaches to environmental changes (e.g., access to/quality of playgrounds, changes in school cafeterias). Altering the environment offers opportunities for healthier behaviors and seems to be an effective strategy to prevent childhood obesity. However, the evaluation of those (mostly) multidimensional interventions does not allow drawing firm conclusions about the single effect of environmental changes. We conclude that obesity prevention programs should combine person-based and environmental approaches.
    05/2015; 28(5-6):485-95. DOI:10.1515/jpem-2015-0127
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    ABSTRACT: Abstract Background: Almost 40% of children are overweight or obese by age 8 years in the US-Affiliated Pacific, inclusive of the five jurisdictions of Alaska, Hawaii, American Samoa, Guam, and the Commonwealth of the Northern Mariana Islands. This article describes how the Children's Healthy Living (CHL) Program used the ANGELO (Analysis Grid for Environments/Elements Linked to Obesity) model to design a regional intervention to increase fruit and vegetable intake, water consumption, physical activity, and sleep duration and decrease recreational screen time and sugar-sweetened beverage consumption in young children ages 2-8 years. Methods: Using the ANGELO model, CHL (1) engaged community to identify preferred intervention strategies, (2) reviewed scientific literature, (3) merged findings from community and literature, and (4) formulated the regional intervention. Results: More than 900 community members across the Pacific helped identify intervention strategies on importance and feasibility. Nine common intervention strategies emerged. Participants supported the idea of a regional intervention while noting that cultural and resource differences would require flexibility in its implementation in the five jurisdictions. Community findings were merged with the effective obesity-reducing strategies identified in the literature, resulting in a regional intervention with four cross-cutting functions: (1) initiate or strengthen school wellness policies; (2) partner and advocate for environmental change; (3) promote CHL messages; and (4) train trainers to promote CHL behavioral objectives for children ages 2-8 years. These broad functions guided intervention activities and allowed communities to tailor activities to maximize intervention fit. Conclusions: Using the ANGELO model assured that the regional intervention was evidence based while recognizing jurisdiction context, which should increase effectiveness and sustainability.