title: Impact of Baltimore Healthy Eating Zones: an environmental intervention to improve diet among African American youth.
abstract: This study assessed the impact of a youth-targeted multilevel nutrition intervention in Baltimore City. The study used a clustered randomized design in which 7 recreation centers and 21 corner stores received interventions and 7 additional recreation centers served as comparison. The 8-month intervention aimed to increase availability and selection of healthful foods through nutrition promotion and education using point-of purchase materials such as posters and flyers in stores and interactive sessions such as taste test and cooking demonstrations. Two hundred forty-two youth-caregiver dyads residing in low-income areas of Baltimore City recruited from recreation centers were surveyed at baseline using detailed instruments that contained questions about food-related psychosocial indicators (behavioral intentions, self-efficacy, outcome expectancies, and knowledge), healthful food purchasing and preparation methods, and anthropometric measures (height and weight). The Baltimore Healthy Eating Zones intervention was associated with reductions in youth body mass index percentile (p = .04). In subgroup analyses among overweight and obese girls, body mass index for age percentile decreased significantly in girls assigned to the intervention group (p = .03) and in girls with high exposure to the intervention (p = .013), as opposed to those in comparison or lower exposure groups. Intervention youth significantly improved food-related outcome expectancies (p = .02) and knowledge (p < .001). The study results suggest that the Baltimore Healthy Eating Zones multilevel intervention had a modest impact in reducing overweight or obesity among already overweight low-income African American youth living in an environment where healthful foods are less available. Additional studies are needed to determine the relative impact of health communications and environmental interventions in this population, both alone and in combination.
authors.affiliation: Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Ahyoung
authors.initials: A
authors.lastname: Shin
authors.affiliation: Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Surkan
authors.affiliation: Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Anastasia J
authors.initials: AJ
authors.lastname: Coutinho
authors.affiliation: Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Sonali R
authors.initials: SR
authors.lastname: Suratkar
authors.affiliation: Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Rebecca K
authors.initials: RK
authors.lastname: Campbell
authors.affiliation: Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Rowan
authors.affiliation: University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Sangita
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Lauren A
authors.initials: LA
authors.lastname: Dennisuk
authors.affiliation: Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Micaela
authors.initials: M
authors.lastname: Karlsen
authors.affiliation: Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Gass
authors.affiliation: Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA jgittels@jhsph.edu.
authors.forename: Joel
authors.initials: J
authors.lastname: Gittelsohn
mesh_terms: D000293:Adolescent; D001741:Black or African American; D000367:Age Factors; D015142:Baltimore; D015992:Body Mass Index; D001837:Body Weights and Measures; D002648:Child; D003296:Cooking; D004032:Diet; D005260:Female; D005523:Food Supply; D006266:Health Education / Q000379:methods; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008297:Male; D009753:Nutritive Value; D009765:Obesity / Q000517:prevention & control / Q000628:therapy; D050177:Overweight / Q000517:prevention & control / Q000628:therapy*; D011203:Poverty; D020377:Self Efficacy; D012737:Sex Factors
keywords: African American youth; childhood obesity; adolescent health; community-based research; corner store intervention; social cognitive theory