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Childhood obesity project identifies successful strategies in 4 US communities

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April 14, 2018

Tina Kauh
Tina J. Kauh

Researchers from a collaborative team studying successful antiobesity strategies identified four U.S. communities implementing programs and policies that could have broader success nationwide, according to findings published in a special issue of Childhood Obesity.

“Although, recent data from the National Health and Nutrition Examination Survey (NHANES) suggest that the increase in childhood obesity has slowed over the last decade at the national level, childhood obesity rates are still much higher than they were a generation ago,” Tina J. Kauh, PhD, MS, senior program officer in the Research Evaluation Learning Unit at the Robert Wood Johnson Foundation in Princeton, New Jersey, told Endocrine Today. “Communities that have seen declines in childhood obesity rates have implemented a wide range of strategies to make healthy foods and beverages available in schools and communities and to integrate physical activity into daily life. While studies like the NIH-funded Healthy Communities Study were looking at the wide range of strategies that might be contributing to changes in obesity rates, the National Collaborative of Childhood Obesity Research (NCCOR) saw a gap in the field’s understanding of what fostered the implementation of these varied approaches.”

To address these research gaps, the NCCOR, a group that includes researchers from the CDC, NIH, the Robert Wood Johnson Foundation and the U.S. Department of Agriculture, initiated the Childhood Obesity Declines Project. The initiative complements the larger-scale Healthy Communities Study, which explores the drivers of obesity declines using methods that explore the association between community-level programs and policies with BMI, nutrition and physical activity in 5,000 children and their parents. The Childhood Obesity Declines Project used an adapted version of the Systematic Screening and Assessment method to collect retrospective data in four communities: Anchorage, Alaska; Granville County, North Carolina; New York; and Philadelphia. The four chosen jurisdictions reported declines in childhood obesity at the time the study was initiated and were selected based on a set of criteria developed by the research team.

Researchers with the project identified relevant strategies in school, community, child care and early childhood education and health care settings, as well as demographic characteristics for each jurisdiction. Key stakeholders in each community received surveys about which strategies were employed. Between April and May 2015, researchers conducted site visits consisting of up to 30 in-depth interviews with those who developed, implemented or evaluated successful programs within the jurisdictions.

The researchers identified multilevel approaches aimed at improving the nutrition and physical activity environments where children spend most of their time.


“It’s impossible to say from this project what led to the declines that these four communities saw in childhood obesity rates,” Kuah said. “There likely wasn’t a single silver bullet, but rather a constellation of strategies that were implemented across sectors and settings. This project did find that whatever the set of strategies each community implemented were, they often included cross-sector partnerships that involved coordination, decision maker buy-in and community engagement.”

Kuah added that the most recent NHANES data (2015-2016) have shown researchers that it is too soon to tell if the nation has made lasting progress.

“Over the past decade, policymakers and business leaders have made changes to make school meals healthier, help kids be active, and invest in prevention,” Kuah said. “That forward momentum must continue, because helping children maintain a healthy weight from an early age is essential to preventing a wide range of health problems and avoiding billions in health care costs. In addition, for too many children, the opportunity to grow up healthy is limited by where they live, how much money their family makes, or discrimination they face because of who they are. We need more research to identify policy, systems, and environmental changes that can impact the drivers of those persistent disparities.”

by Regina Schaffer

Disclosures: The authors report no relevant financial disclosures.