A Multi-Level Intervention to Address Childhood Obesity in Rural Hispanic Communities.

Area of Science:

• Public Health
• Pediatrics
• Community-Based Research

Background:

• Pediatric obesity disproportionately impacts underserved populations, including those in rural areas.
• Social and physical environments significantly influence childhood obesity.
• Few community-engaged interventions specifically target rural childhood obesity.

Purpose of the Study:

• To test the effectiveness of a multi-level, community-based obesity prevention intervention.
• To evaluate the intervention's impact on Body Mass Index (BMI) z-scores in Hispanic children in rural communities.
• To explore the relationship between engagement with intervention components and BMI changes.

Main Methods:

• A community-based trial involving 653 Hispanic children aged 8-12 years.
• A 13-month multi-level intervention including educational materials, nutrition and physical activity (PA) classes, media literacy, PA breaks, and a community program (Ciclovía).
• Primary outcome: differences in BMI z-score measured at baseline, 6, and 18 months.

Main Results:

• No significant between-group differences in BMI z-scores were observed at 6 or 18 months follow-up.
• Mean BMI z-score differences between intervention and comparison groups were -0.02 at 6 months (p=0.31) and 0.03 at 18 months (p=0.32).
• BMI z-scores decreased progressively with increased exposure to intervention components (p-trend < 0.01).

Conclusions:

• The multi-level community-based intervention did not demonstrate an overall effect on BMI z-scores.
• Greater engagement with intervention components was associated with greater reductions in BMI z-scores.
• Findings highlight the potential and difficulties of implementing community-based obesity prevention in rural settings.