Position of the American Dietetic Association: individual-, family-, school-, and community-based interventions for pediatric overweight American Dietetic Association (ADA) J Am Diet Assoc 2006 106 6 925 945
Available from: Sara Folta
- "Instead, modest, low cost, and replicable changes can be made in each of the settings within the community. The broader focus also has the potential to reach a larger proportion of the population . Sustainability is more likely through environmental and policy changes, and the potential for community ownership that translates into institutional and cultural changes. "
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ABSTRACT: The purpose of this study is to describe the behavioral changes in children resulting from Shape Up Somerville (SUS), a community-based, participatory obesity prevention intervention that used a multi-level, systems-based approach. It was set in Somerville, an urban, culturally diverse community in Massachusetts, USA.
This was a non-randomized, controlled 2-year community-based intervention trial with children enrolled in grades 1 to 3 (ages 6-8 years). Overall, the SUS intervention was designed to create environmental and policy change to impact all aspects of a child's day. Pre-post outcomes were compared between Somerville and two control communities that were chosen based on socio-demographic similarities. Behavioral outcomes were fruit and vegetable and sugar-sweetened beverage consumption; number of organized sports and physical activities per year; walking to and from school; screen and television time; television in bedroom; and dinner in room with television on. These measures were assessed by parent/caregiver report using a 68-item Family Survey Form. Data were analyzed using multiple linear regression, accounting for covariates and clustering by community.
Intervention group children, compared to the control group, significantly reduced sugar-sweetened beverage consumption (-2.0 ounces per day; 95% CI -3.8 to -0.2), increased participation in organized sports and physical activities (0.20 sports or activities per year; 95% CI 0.06 to 0.33), and reduced their screen time (-0.24 hours per day; 95% CI -0.42 to -0.06).
Results of this study, particularly intake of sugar-sweetened beverages and screen time, are similar to others that used a multi-level approach to realize change in behavior. These results support the efficacy of a multi-level and systems-based approach for promoting the behavioral changes necessary for childhood obesity prevention. This study is registered at ClinicalTrials.gov as NCT00153322.
Available from: PubMed Central
- "Age-related increases in substance use and excess weight-gain that occur among youth are cause for concern as they are associated with numerous negative health outcomes [1-9]. Substance use and obesity (and the correlates of obesity) tend to be established during adolescence [2,10-12], and most Canadian youth exhibit one or more of these risk factors for future morbidity [10-15]. For instance, according to data from grade 9 to 12 students in the 2008 Youth Smoking Survey (YSS), 8.9% were current smokers (increasing from 6.8% to 15.6% between grade 9 and 12), 18.8% were current marijuana users (increasing from 17.7% to 29.1% between grade 9 and 12), and 27.0% were current binge drinkers (increasing from 21.0% to 50.8% between grade 9 and 12) . "
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Substance use and weight gain among youth increase the risk for future disease. As such, the purpose of this study is to examine how many Canadian youth are currently failing to meet substance use and weight gain related public health guidelines.
Data from the 2010–11 Youth Smoking Survey were used to examine grade 9 to 12 students meeting seven different guidelines by sex and by grade.
Among Canadian youth, 8.8% were current smokers, 18.8% were current marijuana users, 25.5% were current binge drinkers, 22.5% were considered overweight or obese, 31.2% did not meet physical activity guidelines, 89.4% exceeded sedentary behaviour guidelines, and 93.6% reported inadequate fruit and vegetable intake. The mean number of risk factors per student was 2.9 (±1.2); only 0.5% of youth reported having none of the risk factors.
Students rarely met all seven public health guideline examined, and the vast majority of actually reported having two or more modifiable risk factors for disease.
Available from: Rachel E Laxer
- "Age-related increases in obesity and unhealthy eating that occur among youth are cause for concern as they are associated with increased risk of cardiovascular disease, cancer and diabetes [1-4]. Since overweight, obesity, and poor eating behaviours are prevalent among youth populations [5-7], it is important to promote healthier body weights and eating habits among youth populations. "
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The COMPASS study is designed to follow a cohort of ~30,000 grade 9 to 12 students attending ~60 secondary schools for four years to understand how changes in school characteristics (policies, programs, built environment) are associated with changes in youth health behaviours. Since the student-level questionnaire for COMPASS (Cq) is designed to facilitate multiple large-scale school-based data collections using passive consent procedures, the Cq is only comprised of self-reported measures. The present study assesses the 1-week (1wk) test-retest reliability and the concurrent validity of the Cq measures for weight status and dietary intake.
Validation study data were collected from 178 grade 9 students in Ontario (Canada). At time 1 (T1), participants completed the Cq and daily recoding of their dietary intake using the web-based eaTracker tool. After one week, (T2), students completed the Cq again, participants submitted their daily eaTracker logs and staff measured their height and weight. Test-retest reliability of the self-reported (SR) weight status and dietary intake measures at T1 and T2, and the concurrent validity of the objectively measured and SR weight status and dietary intake measures at T2 were examined using intraclass correlation coefficients (ICC).
Test-retest reliability for SR height (ICC 0.96), weight (ICC 0.99), and BMI (ICC 0.95) are considered substantial. The concurrent validity for SR height (ICC 0.88), weight (ICC 0.95), and BMI (ICC 0.84) are also considered substantial. The test-retest reliability for SR dietary intake for fruits and vegetables (ICC 0.68) and milk and alternatives (ICC 0.69) are considered moderate, whereas meat and alternatives (ICC 0.41), and grain products (ICC 0.56) are considered fair. The concurrent validity for SR dietary intake identified that fruits and vegetables (ICC 0.53), milk and alternatives (ICC 0.60), and grain products (ICC 0.41) are considered fair, whereas meat and alternatives (ICC 0.34) was considered slight.
While the test-retest reliability of the measures used in this study were all high, the concurrent validity of the measures was considered acceptable. The results support the use of the self-reported COMPASS weight status and dietary intake measures for use in research where objective measures are not possible.
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