title: A community intervention reduces BMI z-score in children: Shape Up Somerville first year results.
abstract: OBJECTIVE
  The objective was to test the hypothesis that a community-based environmental change intervention could prevent weight gain in young children (7.6 +/- 1.0 years).
  
  
  METHODS
  A non-randomized controlled trial was conducted in three culturally diverse urban cities in Massachusetts. Somerville was the intervention community; two socio-demographically-matched cities were control communities. Children (n = 1178) in grades 1 to 3 attending public elementary schools participated in an intervention designed to bring the energy equation into balance by increasing physical activity options and availability of healthful foods within the before-, during-, after-school, home, and community environments. Many groups and individuals within the community (including children, parents, teachers, school food service providers, city departments, policy makers, healthcare providers, before- and after-school programs, restaurants, and the media) were engaged in the intervention. The main outcome measure was change in BMI z-score.
  
  
  RESULTS
  At baseline, 44% (n = 385), 36% (n = 561), and 43% (n = 232) of children were above the 85th percentile for BMI z-score in the intervention and the two control communities, respectively. In the intervention community, BMI z-score decreased by -0.1005 (p = 0.001, 95% confidence interval, -0.1151 to -0.0859) compared with children in the control communities after controlling for baseline covariates.
  
  
  CONCLUSIONS
  A community-based environmental change intervention decreased BMI z-score in children at high risk for obesity. These results are significant given the obesigenic environmental backdrop against which the intervention occurred. This model demonstrates promise for communities throughout the country confronted with escalating childhood obesity rates.
authors.affiliation: New Balance Chair in Childhood Nutrition, Friedman School of Nutrition Science and Policy, 150 Harrison Avenue, Tufts University, Boston, MA 02111, USA. christina.economos@tufts.edu
authors.forename: Christina D
authors.initials: CD
authors.lastname: Economos
authors.forename: Raymond R
authors.initials: RR
authors.lastname: Hyatt
authors.forename: Jeanne P
authors.initials: JP
authors.lastname: Goldberg
authors.forename: Aviva
authors.initials: A
authors.lastname: Must
authors.forename: Elena N
authors.initials: EN
authors.lastname: Naumova
authors.forename: Jessica J
authors.initials: JJ
authors.lastname: Collins
authors.forename: Miriam E
authors.initials: ME
authors.lastname: Nelson
mesh_terms: D015992:Body Mass Index; D001900:Boston; D002648:Child; D002662:Child Health Services; D018864:Cultural Diversity; D004734:Energy Metabolism; D015444:Exercise; D005190:Family; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000517:prevention & control*; D010809:Physical Fitness; D013177:Sports; D016138:Walking