Identifying best practices in communities to promote childhood obesity prevention and control
The National Collaborative on Childhood Obesity Research (NCCOR) aims to identify and assess the relationships between community programs and policies, and childhood obesity, diet, and physical activity to inform public health practice. It places emphasis on interventions involving multilevel and/or multi-component approaches, and those that will strengthen the capacity (e.g., knowledge, skills, tools) to implement evaluations and more interventions. Evidence is necessary at the individual, community, and population levels.
To promote and accelerate this kind of research, maximize outcomes from research, and create and support the mechanisms and infrastructure needed for translation and dissemination, NCCOR supported the NIH Broad Agency Agreement (BAA): “The Healthy Communities Study, How Communities Shape Children’s Health” in its development and application review phases. The five-year observational study contract was awarded to Battelle Memorial Institute in Columbus, Ohio, in August 2010.
Battelle examined community programs and policies in a total of 130 demographically diverse communities across the nation. Researchers recruited 5,138 children and their families. Some communities were selected because of promising policies and programs each already have in place. The remaining communities were randomly chosen through a national probability sample. Communities with high proportions of Latino and African American residents were oversampled.
The community efforts assessed were those designed to address local childhood obesity rates in areas where childhood obesity rates are highest. Investigators examined how such efforts are related to health behaviors and body weight. Retrospective and prospective data was collected. The retrospective data included BMI (extracted from medical charts) and details of community programs/policies dating back 10 years. Prospective data included in-person and telephone assessment of BMI, diet, and physical activity.
The Healthy Communities Study is sponsored by the National Institutes of Health, including primary funding by the National Heart, Lung and Blood Institute (NHLBI), with additional support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and the Office of Behavioral and Social Sciences Research (OBSSR) at the National Institutes of Health (NIH). Additional collaborators include the Robert Wood Johnson Foundation (RWJF) and the Centers for Disease Control and Prevention (CDC). Research Partners for the study include the University of South Carolina, the University of California, Berkeley, the University of Kansas, and Examination Management Services, Inc.
During 2011, NHLBI and its study partners completed the initial work necessary to conduct the study, including developing and refining the study protocol and obtaining Office of Management and Budget (OMB) clearance to conduct the study, establishing an external Observational Study Monitoring Board to monitor the conduct of the study and ensure the safety of participants, and establish study subcommittees.
Study planners anticipated that the Healthy Communities Study would answer important research questions about how diet, physical activity, and body mass index (BMI) are related to aspects of community programs and policies, such as their intensity and their duration, funding, and target population. They also hoped to gain insights into optimal combinations of policies and programs and into program and policy factors that modify or mediate BMI, diet, and physical activity. Answers gained from this project will be a step forward in helping NCCOR achieve its first goal: Identify, design, and evaluate practical and sustainable interventions, especially in high-risk populations and communities.
In October 2015, study authors released a series of articles in the American Journal of Preventive Medicine to describe the study rationale and purpose and the protocol and methods. Articles in the series include:
- Pate RR. Overview of the Protocol Manuscripts for the Healthy Communities Study. Am J Prev Med. 2015 Oct; 49(4): 614.
- Arteaga SS, Loria CM, Crawford PB, et al. The Healthy Communities Study: Its rationale, aims, and approach. Am J Prev Med. 2015 Oct; 49(4): 615-623.
- Strauss WJ, Sroka CJ, Frongillo EA, et al. Statistical design features of the Healthy Communities Study. Am J Prev Med. 2015 Oct; 49(4): 624-630.
- John LV, Gregoriou M, Pate RR, et al. Operational implementation of the Healthy Communities Study: How communities shape children’s health. Am J Prev Med. 2015 Oct; 49(4): 631-635.
- Fawcett SB, Collie-Akers VL, Schultz JA, Kelley M. Measuring community programs and policies in the Healthy Communities Study. Am J Prev Med. 2015 Oct; 49(4): 636-641.
- Sroka CJ, McIver KL, Sagatov RDF, Arteaga SS, Frongillo EA. Weight status measures collected in the Healthy Communities Study: Protocols and analyses. Am J Prev Med. 2015 Oct; 49(4): 642-646.
- Ritchie LD, Wakimoto P, Woodward-Lopez G. The Healthy Communities Study nutrition assessments: Child diet and the school nutrition environment. Am J Prev Med. 2015 Oct; 49(4): 647-652.
- Pate RR, McIver KL, Colabianchi N. Physical activity measures in the Healthy Communities Study. Am J Prev Med. 2015 Oct; 49(4): 653-659.
The first study results were published in the American Journal of Preventive Medicine:
- Frongillo EA, Fawcett SB, Ritchie LD, et al. Community Policies and Programs to Prevent Obesity and Child Adiposity. Am J Prev Med. Forthcoming 2017.
In October 2018, study authors released a special supplement in Pediatric Obesity detailing the findings from the study: