A community-based intervention increases physical activity and reduces obesity in school-age children in North Carolina.
BACKGROUND
Community-based interventions are promising approaches to obesity prevention, but few studies have prospectively evaluated them. The aim of this study was to evaluate a natural experiment—a community intervention designed to promote active living and decrease obesity within a small southern town.


METHODS
In 2011, community leaders implemented the Mebane on the Move intervention—a community-wide effort to promote physical activity (PA) and decrease obesity among residents of Mebane, North Carolina. We measured child PA and BMI before and after the intervention, using a nearby town not implementing an intervention as the comparison. In total, we assessed 64 children from Mebane and 40 from the comparison community 6 months before, as well as 34 and 18 children 6 months after the intervention. We assessed PA with accelerometers worn for 7 days and calculated BMI z-scores using children's height and weight. We conducted multivariable linear regressions examining pre- to postintervention change in minutes of PA and BMI z-score, adjusting for confounders.


RESULTS
At follow-up, children in Mebane modestly increased their moderate-to-vigorous PA (1.3 minutes per hour; 95% confidence interval (CI): 0.2, 2.3; p=0.03) and vigorous activity (0.8 minutes per hour; 95% CI: 0.1, 1.5; p=0.04) more than comparison children. In intervention children, BMI z-scores decreased 0.5 units (kg/m(2); 95% CI: -0.9, -0.02; p=0.045), compared to children in the comparison community.


CONCLUSIONS
We observed positive effects on PA level and weight status of children in Mebane, despite high rates of attrition, suggesting that the community-based intervention may have been successful.
1Department of Community and Family Medicine, Duke University Medical Center, Duke University, Durham, NC.|2Duke Global Health Institute, Durham, NC.
Sara E
SE
Benjamin Neelon
2Duke Global Health Institute, Durham, NC.
Rebecca J
RJ
Namenek Brouwer
1Department of Community and Family Medicine, Duke University Medical Center, Duke University, Durham, NC.|2Duke Global Health Institute, Durham, NC.
Truls
T
Østbye
3Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC.
Kelly R
KR
Evenson
4Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC.
Brian
B
Neelon
5Alamance County Health Department, Burlington, NC.
Annie
A
Martinie
6Department of Psychology and Neuroscience, Duke University, Durham, NC.
Gary
G
Bennett
D015992:Body Mass Index; D002648:Child; D003153:Community Health Services / Q000379:methods; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D008297:Male; D009657:North Carolina / Q000453:epidemiology; D063766:Pediatric Obesity / Q000453:epidemiology / Q000517:prevention & control*; D015431:Weight Loss