Exploring declines in childhood obesity in four communities

Childhood Obesity published six papers highlighting findings from the National Collaborative on Childhood Obesity Research’s (NCCOR) Childhood Obesity Declines project. The supplement details the strategies and policies implemented in four diverse communities—Anchorage, AK; Granville County, NC; New York City, NY; and Philadelphia, PA—that experienced declines in childhood obesity prevalence from 2003 to 2011. The six articles in this supplement are described below and are available at

  • “An Effort of the National Collaborative on Childhood Obesity Research to Explore Progress in Four Communities” introduces the rationale, aims, and overall study design of COBD, which systematically studied and documented the what, how, when, and where of community-based obesity strategies in four distinct communities across the nation.
  • “A Different Methodology” explains the rationale for adapting the Systematic Screening and Assessment (SSA) method for COBD to confirm obesity declines and better understand what and how policies and programs or interventions may contribute as drivers.
  • “An Exploratory Study of Strategies Identified in Communities Reporting Declines” highlights the multi-level approaches in each of the jurisdictions intended to improve the nutrition and physical activity environments where children spend most of their time and supporting community context. The in-depth retrospective analysis suggests simultaneous public health messaging and multi-layered initiatives—including cross-sector partnerships and active, high-level champions—were likely important contributors to success in attaining declines in the prevalence of childhood obesity.
  • “A Review of Enacted Policies” identifies co-occurring state and local level policies that were reviewed and coded by setting (i.e., early care and education also known as child care, school, and community), jurisdictional level (i.e., state or local), and policy type (i.e., legislation or regulation) and then analyzed for similarities among the types of policies enacted in the four communities.
  • “Highlights of Community Strategies and Policies” examines the programs and policies implemented in the communities through the lens of a social-ecological model. This lens can clarify how multiple levels of influence operate, what assets and people are needed as change makers, and how this synergy may drive behavior and health outcomes.
  • “Implications for Research and Evaluation Approaches” discusses the research and evaluation design implications of an adapted SSA method for community-based prevention efforts. The article discusses the rationale for SSA compared to other design and evaluation schemas (e.g., randomized controlled trials and cohort studies) and highlights evidence generated by this method and how that evidence can be integrated into other evaluation strategies. Guidance for future studies of community-based childhood obesity prevention is suggested.

After nearly a decade of work to reduce the prevalence of childhood obesity in the United States, NCCOR remains a leader in the field by promoting novel research and evaluation strategies. Learn more about other NCCOR initiatives at

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