Gittelsohn Joel, Anderson Steeves Elizabeth, Mui Yeeli, Kharmats Anna Y, Hopkins Laura C, Dennis Donna
Johns Hopkins Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St, Baltimore, MD 21205-2179, USA.
BMC Public Health. 2014 Sep 11;14:942. doi: 10.1186/1471-2458-14-942.
Childhood obesity rates in the U.S. have reached epidemic proportions, and an urgent need remains to identify evidence-based strategies for prevention and treatment. Multi-level, multi-component interventions are needed due to the multi-factorial nature of obesity, and its proven links to both the social and built environment. However, there are huge gaps in the literature related to doing these kinds of interventions among low-income, urban, minority groups.
The B'More Healthy Communities for Kids (BHCK) intervention is a multi-level, multi-component intervention, targeting low-income African American youth ages 10-14 and their families in Baltimore, Maryland. This intervention prevents childhood obesity by working at multiple levels of the food and social environments to increase access to, demand for, and consumption of healthier foods. BHCK works to create systems-level change by partnering with city policy-makers, multiple levels of the food environment (wholesalers, corner stores, carryout restaurants), and the social environment (peers and families). In addition, extensive evaluation will be conducted at each level of the intervention to assess intervention effectiveness via both process and impact measures.
This project is novel in multiple ways, including: the inclusion of stakeholders at multiple levels (policy, institutional, and at multiple levels of the food system); that it uses novel computational modeling methodologies to engage policy makers and guide informed decisions of intervention effectiveness; it emphasizes both the built environment (intervening with food sources) and the social environment (intervening with families and peers). The design of the intervention and the evaluation plan of the BHCK project are documented here.
NCT02181010 (July 2, 2014).
美国儿童肥胖率已达到流行程度，迫切需要确定基于证据的预防和治疗策略。由于肥胖具有多因素性质，且已证实与社会和建筑环境有关联，因此需要采取多层次、多组成部分的干预措施。然而，在低收入、城市、少数群体中开展这类干预措施的相关文献存在巨大空白。
“巴尔的摩儿童更健康社区”（BHCK）干预措施是一项多层次、多组成部分的干预措施，针对马里兰州巴尔的摩市10至14岁的低收入非裔美国青少年及其家庭。该干预措施通过在食品和社会环境的多个层面开展工作，以增加获得、需求和消费更健康食品的机会，从而预防儿童肥胖。BHCK通过与城市政策制定者、食品环境的多个层面（批发商、街角商店、外卖餐厅）以及社会环境（同龄人及家庭）合作，努力实现系统层面的变革。此外，将在干预的每个层面进行广泛评估，通过过程和影响指标来评估干预效果。
该项目在多个方面具有创新性，包括：纳入多个层面的利益相关者（政策、机构以及食品系统的多个层面）；使用新颖的计算建模方法来促使政策制定者参与并指导关于干预效果的明智决策；强调建筑环境（干预食品来源）和社会环境（干预家庭和同龄人）。本文记录了BHCK项目的干预设计和评估计划。
NCT02181010（2014年7月2日）。
