Woodward-Lopez G, Gosliner W, Au L E, Kao J, Webb K L, Sagatov R D, Strauss W J, Landgraf A J, Nagaraja J, Wilson D K, Nicastro H L, Nebeling L C, Schultz J A, Ritchie L D
Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Berkeley, California, USA.
Battelle Health and Analytics, Baltimore, Maryland, USA.
Pediatr Obes. 2018 Oct;13 Suppl 1(Suppl 1):46-55. doi: 10.1111/ijpo.12434. Epub 2018 Jul 10.
The influence of community characteristics on the effectiveness of childhood obesity prevention efforts is not well understood.
Examine the interaction of community characteristics with the relationship between community programmes and policies (CPPs) and dietary intake.
An observational study of 5138 children in grades K-8 in 130 US communities was conducted in 2013-2015. Key informant interviews identified and characterized CPPs. CPP scores were generated for the number of target behaviours (CPP-Behav) and the number of behaviour change strategies (CPP-Strat) addressed by all CPPs and CPPs with nutrition goals over the prior 6 years in each community. Dietary intake was assessed by dietary screener and included intake of sugar from sugar-sweetened beverages; energy-dense foods; fruits and vegetables; whole grains; and fibre. Multivariate statistical models assessed the interactions between US region, urbanicity, community-level income, and community-level race/ethnicity and CPP scores in relation to dietary intake.
CPP-Strat was positively associated with healthier dietary intakes in the Northeast and West, and in high Hispanic communities; the reverse was true in the South, and in high African-American and low-income communities. The CPP-Behav was positively associated with healthier dietary intakes in the South and rural areas, and the reverse was true in the West.
The relationships between CPP index scores and dietary intake were most strongly influenced by region and urbanicity and to a lesser extent by community-level race/ethnicity and income. Findings suggest that different considerations may be needed for childhood obesity prevention efforts in communities with different characteristics.
社区特征对儿童肥胖预防工作效果的影响尚未得到充分理解。
研究社区特征与社区项目和政策（CPPs）与饮食摄入之间关系的相互作用。
2013 - 2015年对美国130个社区的5138名K - 8年级儿童进行了一项观察性研究。通过关键信息人访谈确定并描述CPPs。计算每个社区过去6年中所有CPPs以及有营养目标的CPPs所针对的目标行为数量（CPP - Behav）和行为改变策略数量（CPP - Strat）的得分。通过饮食筛查评估饮食摄入情况，包括来自含糖饮料的糖摄入量、能量密集型食物、水果和蔬菜、全谷物以及纤维的摄入量。多变量统计模型评估了美国地区、城市化程度、社区层面收入和社区层面种族/族裔与CPP得分在饮食摄入方面的相互作用。
CPP - Strat与东北部和西部以及高西班牙裔社区更健康的饮食摄入呈正相关；在南部以及高非裔美国人和低收入社区则相反。CPP - Behav与南部和农村地区更健康的饮食摄入呈正相关，在西部则相反。
CPP指数得分与饮食摄入之间的关系受地区和城市化程度影响最大，受社区层面种族/族裔和收入的影响较小。研究结果表明，针对不同特征的社区开展儿童肥胖预防工作可能需要不同的考虑因素。
