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School-based intervention for underserved children results in modest obesity rate reductions
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An intervention aimed at reducing the prevalence of obesity and encouraging healthy behaviors in school-aged children in underserved communities resulted in modest reductions in the rate of obesity and improvements in consumption of sugar-sweetened beverages and water, according to findings from a demonstration project published in Obesity.
Rebecca L. Franckle, ScD, MPH, a postdoctoral fellow in the department of nutrition at Harvard T.H. Chan School of Public Health, and colleagues evaluated the effect of an intervention on obesity in childhood in two low-income communities (community 1, n = 40,318; community 2, n = 95,072) from Massachusetts from 2012 to 2014. The Massachusetts Childhood Obesity Research Demonstration Project (MA-CORD) aimed to reduce obesity and encourage healthy behaviors, including replacing nutrient-poor foods with fruits and vegetables, decreasing consumption of sugar-sweetened beverages, increasing physical activity, decreasing screen time and increasing sleep duration in school-aged children. The two low-income communities were compared with matched control communities (n = 84,372). Participants of MA-CORD self-reported on healthy behaviors at baseline and after the intervention period. Participants were in first, fourth and seventh grades.
Both communities that participated in MA-CORD were predominately white (68% for both) with a large Hispanic population (community 1, 22%; community 2, 17%) and substantially lower per capita incomes compared with the state overall. The setting in community 1 consisted of three elementary schools, two middle schools and one combined elementary/middle school, and the setting in community 2 consisted of 19 elementary schools and three middle schools.
Compared with the control communities, no significant decreases in the rates of participants with obesity from baseline to intervention end were observed (community 1, –0.77% change per year; community 2, –0.17% change per year). However, the obesity rate among seventh-grade participants decreased slightly in community 1 (–2.24% change per year) and significantly in community 2 (–2.68% change per year) compared with the control communities.
Both MA-CORD communities demonstrated statistically significant decreases in consumption of sugar-sweetened beverages (community 1, RR = 1.29; 95% CI, 1.14-1.46; community 2, RR = 1.21; 95% CI, 1.11-1.32) and increases in consumption of water (community 1, RR = 1.07; 95% CI, 1.03-1.11; community 2, RR = 1.04; 95% CI, 1-1.07). Screen time significantly declined in community 2 (RR = 1.24; 95% CI, 1.09-1.41), but not in community 1. No differences were observed in either community in relation to fruit, vegetable and 100% juice consumption, sleep or physical activity.
“We found that the MA-CORD project was associated with a modest reduction in obesity prevalence among seventh-graders in one community compared to controls, and we also observed improvements in behavioral targets,” Franckle told Endocrine Today. “While our results were modest, they were achieved over a relatively short period of time, which is important given the substantial challenges of implementing a large-scale community initiative to address obesity. These results demonstrate the potential impact of a whole-community intervention on obesity and behavioral targets for students in these communities.” – by Amber Cox
For more information:
Rebecca L. Franckle, ScD, can be reached at franckle@hsph.harvard.edu.
Disclosures: The researchers report no relevant financial disclosures.
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