Multilevel Interventions Targeting Obesity: Research Recommendations for Vulnerable Populations (original) (raw)
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Journal of Health Care for The Poor and Underserved, 2010
Introduction. Successfully addressing childhood onset obesity requires multilevel (individual, community, and governmental), multi-agency collaboration. Methods.
Population-Level Intervention Strategies and Examples for Obesity Prevention in Children *
Annual Review of Nutrition, 2012
With obesity affecting approximately 12.5 million American youth, population-level interventions are indicated to help support healthy behaviors. The purpose of this review is to provide a summary of population-level intervention strategies and specific intervention examples that illustrate ways to help prevent and control obesity in children through improving nutrition and physical activity behaviors. Information is summarized within the settings where children live, learn, and play (early care and education, school, community, health care, home). Intervention strategies are activities or changes intended to promote healthful behaviors in children. They were identified from (a) systematic reviews; (b) evidence-and expert consensus-based recommendations, guidelines, or standards from nongovernmental or federal agencies; and finally (c) peer-reviewed synthesis reviews. Intervention examples illustrate how at least one of the strategies was used in a particular setting. To identify interventions examples, we considered (a) peerreviewed literature as well as (b) additional sources with research-tested and practice-based initiatives. Researchers and practitioners may use this review as they set priorities and promote integration across settings and to find research-and practice-tested intervention examples that can be replicated in their communities for childhood obesity prevention. 391 Annu. Rev. Nutr. 2012.32:391-415. Downloaded from www.annualreviews.org by Center for Disease Control -IRMO/ Information Center/ CDC on 07/18/12. For personal use only.
Stemming Racial and Ethnic Disparities in the Rising Tide of Obesity
American Journal of Health Education, 2003
At the national level, obesity and obesity-related illnesses are increasing dramatically. As with many other public health problems, some racial and ethnic populations are disproportionately affected. This article presents current information on the prevalence and consequences of obesity for racial and ethnic groups in the United States and evaluates race/culture-specific causes of obesity for these populations. After analysis of various interventions that attempt to address this problem, a full-spectrum, three-pronged model for eliminating racial and ethnic disparities in obesity is presented and discussed. It is argued that a comprehensive population model, with a balance between downstream, midstream, and upstream interventions is necessary. Examples of culturally appropriate interventions that address the behavioral, social, and environmental determinants of obesity at each of these levels are presented. Using the tools of sound theory, appropriate methods, and cultural sensitivity, health educators are in a unique position to provide leadership to this effort.
Nutritional Interventions for Addressing the Health Disparities of Obesity in a Clinical Setting
Journal of Nutritional Health & Food Engineering, 2016
Society of Bariatric Physicians (ASBP) also defines obesity as a chronic, relapsing, multifactorial, neurobehavioral disease, where in an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biochemical and psychosocial health consequences. In the past three decades, obesity drastically increased in prevalence in the United Sates and other parts of the Western World. According to the Centers of Disease Control and Prevention (CDC) health disparities and inequalities report of 2011, the prevalence of obesity varies by age, sex, race-ethnic groups, socioeconomic status and geographical region; Obesity increases with age. According to CDC's 2011-2012 report, the prevalence of obesity was higher among middle aged adults, 40-64years of age, (39.5%); Obesity prevalence was highest among females than males; also the prevalence of obesity was higher among non-Hispanic black (47.8%), Hispanic (42.5%), and non-Hispanic white (32.6%) adults than among non-Hispanic Asian adults (10.8%) (Figure 1).
Obesity Reviews, 2010
To date, most interventions aimed at preventing obesity have underemphasized the application of systematic intervention development, implementation and evaluation. The present review provides a thorough insight in factors promoting implementation and/or effectiveness in interventions aimed at preventing overweight/obesity among adults. A total of 46 studies evaluating interventions aimed at preventing obesity were reviewed, followed by both qualitative and quantitative analyses. The Intervention Mapping protocol and the Environmental Research framework for weight Gain prevention (EnRG) were applied to analyse and classify the included studies. The interventions were categorized by setting (workplace, community, health care) and target group (ethnic minorities, pregnant women, [pre]menopausal women, smokers, people with intellectual disabilities). Generally, interventions were found to have potential in changing energy balance-related behaviours and anthropometric outcomes. Effect sizes for changes in body mass index ranged between -0.09 and 0.45. When the programme goal specifically aimed at weight management, the intervention was found to be more successful than interventions with programme goals that were aimed at preventing cardiovascular disease or improving general health status. Although a considerable part of studies included motivational interventions, only some actually assessed the effects on potential cognitive mediators. A general lack of reporting underlying theoretical models for behaviour change was observed as well as the inclusion of linkage groups and strategies to promote empowerment.
Health Education Research, 2020
OPREVENT2 was a multilevel, multicomponent (MLMC) adult obesity prevention that sought to improve access and demand for healthier food and physical activity opportunities in six Native American communities in the Southwest and Midwest. OPREVENT2 worked with worksites, food stores, schools (grades 2–6), through social media and mailings, and with a local community action committee (CAC), in each of the three intervention communities, and was implemented in six phases. We conducted a process evaluation to assess implementation of each intervention component in terms of reach, dose delivered and fidelity. Implementation of each component was classified as high, medium or low according to set standards, and reported back at the end of each phase, allowing for improvements. The school and worksite components were implemented with high reach, dose delivered and fidelity, with improvement over time. The school program had only moderate reach and dose delivered, as did the social media comp...
Contemporary Clinical Trials, 2014
Low-income youth are at increased risk for excess weight gain. Although evidence-based prevention programs exist, successful adaptation to provide wide dissemination presents a challenge. Hip-Hop to Health (HH) is a school-based obesity prevention intervention that targets primarily preschool children of low-income families. In a large randomized controlled trial, HH was found to be efficacious for prevention of excessive weight gain. The Expanded Food and Nutrition Education Program (EFNEP) and the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) are USDA-funded nutrition education programs offered to low-income families, and may provide an ideal platform for the wide dissemination of evidence-based obesity prevention programs. A research-practice partnership was established in order to conduct formative research to guide the adaptation and implementation of HH through EFNEP and SNAP-Ed. We present the design and method of a comparative effectiveness trial that will determine the efficacy of HH when delivered by peer educators through these programs compared to the standard EFNEP and SNAP-Ed nutrition education (NE) curriculum. Results from this trial will inform larger scale dissemination. The dissemination of HH through government programs has the potential to increase the reach of efficacious obesity prevention programs that target low-income children and families.
Overview of the obesity intervention taxonomy and pooled analysis working group
Translational Behavioral Medicine, 2016
The National Heart, Lung, and Blood Institute and the National Institutes of Health Office of Disease Prevention convened a meeting on August 29-30, 2013 entitled BObesity Intervention Taxonomy and Pooled Analysis.T he overarching goals of the meeting were to understand how to decompose interventions targeting behavior change, and in particular, those that focus on obesity and to combine data from groups of related intervention studies to supplement what can be learned from the individual studies. This paper summarizes the workshop recommendations and provides an overview of the two other papers that originated from the workshop and that address decomposition of behavioral change interventions and pooling of data across diverse studies within a consortium.