title: Shape Up Somerville two-year results: a community-based environmental change intervention sustains weight reduction in children.
abstract: OBJECTIVE
  The objective of this study was to test the hypothesis that community-based environmental change intervention prevents undesirable weight gain in children.
  
  
  METHODS
  The method used in this study was a two-year, non-randomized, controlled trial (2003-2005) using community-based participatory methodology in three diverse cities in Massachusetts: one intervention and two socio-demographically-matched control communities (pooled for analysis). Children (n=1028), with a mean age=7.61+1.04years participated. Interventions were made to improve energy balance by increasing physical activity options and availability of healthful foods (Year 1). To firmly secure sustainability, the study team supported policies and shifted intervention work to community members (Year 2).
  
  
  RESULTS
  Change in body mass index z-score (BMIz) was assessed by multiple regression, accounting for clustering within communities and adjusting for baseline covariates. Sex-specific overweight/obesity prevalence, incidence and remission were assessed. Over the two-year period, BMIz of children in the intervention community decreased by -0.06 [p=0.005, 95% confidence interval: -0.08 to -0.04] compared to controls. Prevalence of overweight/obesity decreased in males (OR=0.61, p=0.01) and females (OR=0.78, p=0.01) and remission increased in males (OR 3.18, p=0.03) and females (OR 1.93, p=0.03) in intervention compared to controls.
  
  
  CONCLUSIONS
  Results demonstrate promise for preventing childhood obesity using a sustainable multi-level community-based model and reinforce the need for wide-reaching environmental and policy interventions.
authors.affiliation: Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA. Electronic address: 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: Aviva
authors.initials: A
authors.lastname: Must
authors.forename: Jeanne P
authors.initials: JP
authors.lastname: Goldberg
authors.forename: Julia
authors.initials: J
authors.lastname: Kuder
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; D002648:Child; D055812:Community-Based Participatory Research / Q000379:methods; D004779:Environment Design; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control*; D050177:Overweight / Q000453:epidemiology / Q000517:prevention & control; D015995:Prevalence; D061217:Weight Reduction Programs / Q000379:methods*
keywords: BMI; Child health; Community; Environmental change; Fitness; Intervention; Nutrition; Obesity; Overweight