title: Enhancing physical and social environments to reduce obesity among public housing residents: rationale, trial design, and baseline data for the Healthy Families study.
abstract: Intervention programs that change environments have the potential for greater population impact on obesity compared to individual-level programs. We began a cluster randomized, multi-component multi-level intervention to improve weight, diet, and physical activity among low-socioeconomic status public housing residents. Here we describe the rationale, intervention design, and baseline survey data. After approaching 12 developments, ten were randomized to intervention (n=5) or assessment-only control (n=5). All residents in intervention developments are welcome to attend any intervention component: health screenings, mobile food bus, walking groups, cooking demonstrations, and a social media campaign; all of which are facilitated by community health workers who are residents trained in health outreach. To evaluate weight and behavioral outcomes, a subgroup of female residents and their daughters age 8-15 were recruited into an evaluation cohort. In total, 211 households completed the survey (RR=46.44%). Respondents were Latino (63%), Black (24%), and had ≤ high school education (64%). Respondents reported ≤2 servings of fruits & vegetables/day (62%), visiting fast food restaurants 1+ times/week (32%), and drinking soft drinks daily or more (27%). The only difference between randomized groups was race/ethnicity, with more Black residents in the intervention vs. control group (28% vs. 19%, p=0.0146). Among low-socioeconomic status urban public housing residents, we successfully recruited and randomized families into a multi-level intervention targeting obesity. If successful, this intervention model could be adopted in other public housing developments or entities that also employ community health workers, such as food assistance programs or hospitals.
authors.affiliation: Boston University, School of Medicine, 801 Massachusetts Ave, Crosstown Center, 2nd Floor, MISU, Boston, MA 02118, USA. Electronic address: lmquinti@bu.edu.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Quintiliani
authors.affiliation: Boston University, College of Health & Rehabilitation Sciences, Sargent College, 635 Commonwealth Ave, 4th Floor, Boston, MA 02215, USA. Electronic address: debiasse@bu.edu.
authors.forename: Michele A
authors.initials: MA
authors.lastname: DeBiasse
authors.affiliation: Boston University, School of Public Health, Partners in Health and Housing Prevention Research Center, Albany St, Talbot Building 120W, Boston, MA 02118, USA. Electronic address: jmbranco@bu.edu.
authors.forename: Jamie M
authors.initials: JM
authors.lastname: Branco
authors.affiliation: Boston University, School of Public Health, Partners in Health and Housing Prevention Research Center, Albany St, Talbot Building 120W, Boston, MA 02118, USA. Electronic address: sgees@bu.edu.
authors.forename: Sarah Gees
authors.initials: SG
authors.lastname: Bhosrekar
authors.affiliation: Boston University, School of Public Health, Partners in Health and Housing Prevention Research Center, Albany St, Talbot Building 120W, Boston, MA 02118, USA. Electronic address: jrorie@bu.edu.
authors.forename: Jo-Anna L
authors.initials: JA
authors.lastname: Rorie
authors.affiliation: Boston University, School of Public Health, Partners in Health and Housing Prevention Research Center, Albany St, Talbot Building 120W, Boston, MA 02118, USA. Electronic address: dbowen@bu.edu.
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Bowen
mesh_terms: D000293:Adolescent; D000328:Adult; D001835:Body Weight; D001900:Boston; D002648:Child; D003150:Community Health Workers / Q000458:organization & administration; D004032:Diet; D015444:Exercise; D005192:Family Health; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000517:prevention & control / Q000628:therapy*; D018579:Patient Selection; D011638:Public Housing; D012107:Research Design; D012931:Social Environment; D061108:Social Media; D012959:Socioeconomic Factors
keywords: Environmental intervention; Family; Obesity; Public housing