• Christina D Economos, Raymond R Hyatt, Aviva Must, Jeanne P Goldberg, Julia Kuder, Elena N Naumova, Jessica J Collins, and Miriam E Nelson.
• Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA. Electronic address: christina.economos@tufts.edu.
• Prev Med. 2013 Oct 1; 57 (4): 322327322-7.

ObjectiveThe objective of this study was to test the hypothesis that community-based environmental change intervention prevents undesirable weight gain in children.MethodThe method used in this study was a two-year, non-randomized, controlled trial (2003-2005) using community-based participatory methodology in three diverse cities in Massachusetts: one intervention and two socio-demographically-matched control communities (pooled for analysis). Children (n=1028), with a mean age=7.61+1.04years participated. Interventions were made to improve energy balance by increasing physical activity options and availability of healthful foods (Year 1). To firmly secure sustainability, the study team supported policies and shifted intervention work to community members (Year 2).ResultsChange in body mass index z-score (BMIz) was assessed by multiple regression, accounting for clustering within communities and adjusting for baseline covariates. Sex-specific overweight/obesity prevalence, incidence and remission were assessed. Over the two-year period, BMIz of children in the intervention community decreased by -0.06 [p=0.005, 95% confidence interval: -0.08 to -0.04] compared to controls. Prevalence of overweight/obesity decreased in males (OR=0.61, p=0.01) and females (OR=0.78, p=0.01) and remission increased in males (OR 3.18, p=0.03) and females (OR 1.93, p=0.03) in intervention compared to controls.ConclusionResults demonstrate promise for preventing childhood obesity using a sustainable multi-level community-based model and reinforce the need for wide-reaching environmental and policy interventions.Copyright © 2013. Published by Elsevier Inc.

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