Understanding Community Obesity Initiatives and Informing Tailored Community Interventions to Reduce Childhood Obesity

在1980年的S和2000年的S之间，美国儿童肥胖率急剧上升 在所有人口子组中保持较高水平。在非洲裔美国人和西班牙裔美国人中，这一比例尤其高 孩子们。为了应对这些趋势并遵循主要卫生当局的建议，许多 美国社区实施了旨在改善儿童饮食的方案和政策，增加了 他们的身体活动水平，并减少儿童肥胖症。然而，这些努力的影响是 有限，无论是研究还是专业实践都还没有确定社区计划的属性 以及在改善儿童饮食、增加他们的体力活动方面一贯成功的政策，以及 降低他们超重或肥胖的可能性。建议的总体目标是 研究的目的是产生发现，为公共卫生政策和实践提供信息，旨在减少 儿童肥胖症的流行。具体目标将是确定社区计划的属性和 与儿童饮食、体力活动和体重状况相关的政策 按种族/族裔和社会经济地位分层的社区、学校和家庭。这些目标将是 通过在现有数据集中进行二次分析来解决，该数据集中包括对 对5000多名儿童进行了多样化的抽样，并对9500多项社区计划和政策进行了评估，以 减少130个美国社区的儿童肥胖症。此外，在这些社区内，关于 学校营养和体育活动政策、实践和资源适用于274名小学和 149所中学。基于家庭的数据收集协议提供了人体测量数据以及详细的 关于儿童饮食和体育活动行为的信息。两种分析方法，分类法和 将使用回归树(CART)和梯度增强机(GBM)来检验 社区计划和政策的属性与儿童饮食、体力活动和 体重状况。这些分析程序将在社区、学校和 按种族/族裔和社会经济地位状况分层的家庭。拟议研究的结果将 使研究人员和从业者能够根据社区的特点量身定做干预措施 人口统计子组。这项研究将具有重要意义，因为它将为预防 儿童肥胖症在社区和人口亚群中受 肥胖的负面后果。这项研究将是创新的，因为它将应用最先进的分析 方法使用唯一大且全面的数据集。

Childhood obesity rates in the United States increased dramatically between the 1980’s and the 2000’s and remain high in all demographic sub-groups. The rates are particularly high in African American and Hispanic children. In response to these trends and following the recommendations of leading health authorities, many U.S. communities have implemented programs and policies aimed at improving children’s diets, increasing their physical activity levels, and reducing childhood obesity. However, the impact of these efforts has been limited, and neither research nor professional practice has yet identified the attributes of community programs and policies that are consistently successful in improving children’s diet, increasing their physical activity, and decreasing the probability that they will develop overweight or obesity. The overarching goal of the proposed research is to produce findings that inform public health policies and practices aimed at reducing disparities in the prevalence of childhood obesity. Specific aims will be to identify attributes of community programs and policies that are associated with children’s diet, physical activity and weight status within groups of communities, schools, and families stratified by race/ethnicity and socioeconomic status. These aims will be addressed by conducting secondary analyses in an existing dataset that includes in-depth observations of a diverse sample of over 5000 children and assessment of over 9500 community programs and policies to reduce childhood obesity in 130 U.S. communities. Further, within those communities, extensive data on school nutrition and physical activity policies, practices and resources are available for 274 elementary and 149 middle schools. A home-based data collection protocol provided anthropometric data as well as detailed information on children’s diet and physical activity behaviors. Two analytic methods, Classification and Regression Trees (CART) and Gradient Boosting Machines (GBM), will be employed in examining relationships between attributes of community programs and policies and children’s diet, physical activity and weight status. These analytic procedures will be conducted within sub-groups of communities, schools and families stratified by race/ethnicity and socioeconomic status profiles. The findings of the proposed study will enable researchers and practitioners to tailor community-based interventions to the characteristics of demographic sub-groups. This research will be significant because it will inform strategies for preventing childhood obesity in communities and population sub-groups that are disproportionately affected by the negative consequences of obesity. The study will be innovative because it will apply state-of-the-art analytical methods using a dataset that is uniquely large and comprehensive.