title: Healthy Living Cambridge Kids: a community-based participatory effort to promote healthy weight and fitness.
abstract: The objective of this study was to assess the impact of a community-based healthy weight intervention on child weight and fitness. Cambridge Public Schools (CPS) have monitored BMI and fitness annually since 2000. Annual increases of overweight and obesity from 2000 (37.0%) to 2004 (39.1%), triggered a multidisciplinary team of researchers, educators, health care, and public health professionals to mobilize environmental and policy interventions. Guided by the social-ecological model and community-based participatory research (CBPR) principles, the team developed and implemented Healthy Living Cambridge Kids (HLCK), a multicomponent intervention targeting community, school, family, and individuals. The intervention included city policies and community awareness campaigns; physical education (PE) enhancements, food service reforms, farm-to-school-to-home programs; and family outreach and "BMI and fitness reports". Baseline (2004) to follow-up (2007) evaluation design assessed change in children's weight and fitness status. A cohort of 1,858 K-5th grade children participated: 37.3% black, 14.0% Hispanic, 37.1% white, 10.2% Asian, 1.7% other race; 43.3% were lower income. BMI z-score (0.67-0.63 P < 0.001) and proportion obese (20.2-18.0% P < 0.05) decreased, and mean number of fitness tests (0-5) passed increased (3.7-3.9 P < 0.001). Whereas black and Hispanic children were more likely to be obese at baseline (27.0 and 28.5%, respectively) compared with white (12.6%) and Asian (14.3%) children, obesity among all race/ethnicity groups declined. Concurrent with a 3-year community intervention, modest improvements in obesity and fitness were observed among CPS children from baseline to follow-up. The CBPR approach facilitated sustaining policies and program elements postintervention in this diverse community.
authors.affiliation: Institute for Community Health, Cambridge Health Alliance, Cambridge, Massachusetts, USA. vchomitz@challiance.org
authors.forename: Virginia R
authors.initials: VR
authors.lastname: Chomitz
authors.forename: Robert J
authors.initials: RJ
authors.lastname: McGowan
authors.forename: Josefine M
authors.initials: JM
authors.lastname: Wendel
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Williams
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Cabral
authors.forename: Stacey E
authors.initials: SE
authors.lastname: King
authors.forename: Dawn B
authors.initials: DB
authors.lastname: Olcott
authors.forename: Maryann
authors.initials: M
authors.lastname: Cappello
authors.forename: Susan
authors.initials: S
authors.lastname: Breen
authors.forename: Karen A
authors.initials: KA
authors.lastname: Hacker
mesh_terms: D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003256:Community Participation; D055812:Community-Based Participatory Research; D005006:Ethnicity; D005260:Female; D006293:Health Promotion / Q000379:methods* / Q000458:organization & administration; D006801:Humans; D008297:Male; D008404:Massachusetts; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control; D050177:Overweight / Q000453:epidemiology / Q000517:prevention & control*; D010809:Physical Fitness / Q000502:physiology*; D015995:Prevalence; D015397:Program Evaluation; D012574:Schools