1 Division of Violence Prevention, Centers for Disease Control and Prevention , Atlanta, GA.
2 Division of Health, Research, Informatics, and Technology, ICF, Atlanta, GA.
Child Obes. 2018 Mar;14(S1):S12-S21. doi: 10.1089/chi.2018.0020.
Although childhood obesity rates have been high in the last few decades, recent national reports indicate a stabilization of rates among some subpopulations of children. This study examines the implementation of initiatives, policies, and programs (referred to as strategies) in four communities that experienced declines in childhood obesity between 2003 and 2012.
The Childhood Obesity Decline project verified obesity declines and identified strategies that may have influenced and supported the decline in obesity. The project used an adaptation of the Systematic Screening and Assessment method to identify key informants in each site. Four settings were highlighted related to childhood: (1) communities, (2) schools, (3) early care and education, and (4) healthcare. The findings indicate that programs and policies were implemented across local settings (primarily in schools and early childhood settings) and at the state level, during a timeframe of supportive federal policies and initiatives.
Multilevel approaches were aimed to improve the nutrition and physical activity environments where children spend most of their time. We hypothesized that other, more distal strategies amplified and reinforced the impact of the efforts that more directly targeted children. The simultaneous public health messaging and multilayered initiatives, supported by cross-sector partnerships and active, high-level champions, were identified as likely important contributors to success in attaining declines in rates of childhood obesity.
尽管在过去几十年中，儿童肥胖率一直居高不下，但最近的全国性报告表明，一些儿童亚群的肥胖率已经趋于稳定。本研究调查了在 2003 年至 2012 年间经历儿童肥胖率下降的四个社区实施举措、政策和计划（简称策略）的情况。
《儿童肥胖下降项目》核实了肥胖率的下降，并确定了可能影响和支持肥胖率下降的策略。该项目采用了系统筛选和评估方法的改编版，以确定每个地点的主要信息来源。突出强调了四个与儿童有关的环境：（1）社区，（2）学校，（3）早期关怀和教育，以及（4）医疗保健。调查结果表明，在联邦政策和举措的支持下，在一段时间内，各种计划和政策在地方各级（主要是在学校和幼儿环境中）和州一级得到了实施。
多层次的方法旨在改善儿童大部分时间所花费的营养和体育活动环境。我们假设，其他更遥远的策略放大并加强了更直接针对儿童的努力的影响。同时，公共卫生宣传和多层次的举措，得到跨部门伙伴关系和积极、高层支持者的支持，被认为是成功实现儿童肥胖率下降的重要贡献因素。
