title: Effects of Proximity to Supermarkets on a Randomized Trial Studying Interventions for Obesity.
abstract: OBJECTIVE
  To determine whether proximity to a supermarket modified the effects of an obesity intervention.
  
  
  METHODS
  We examined 498 children aged 6 to 12 years with a body mass index (BMI) at or above the 95th percentile participating in an obesity trial in Massachusetts in 2011 to 2013. The practice-based interventions included computerized clinician decision support plus family self-guided behavior change or health coaching. Outcomes were 1-year change in BMI z-score, sugar-sweetened beverage intake, and fruit and vegetable intake. We examined distance to the closest supermarket as an effect modifier.
  
  
  RESULTS
  Distance to supermarkets was an effect modifier of 1-year change in BMI z-score and fruit and vegetable intake but not sugar-sweetened beverage intake. With each 1-mile shorter distance to a supermarket, intervention participants increased their fruit and vegetable intake by 0.29 servings per day and decreased their BMI z-score by -0.04 units relative to controls.
  
  
  CONCLUSIONS
  Living closer to a supermarket is associated with greater improvements in fruit and vegetable intake and weight status in an obesity intervention.
authors.affiliation: Lauren Fiechtner, Mona Sharifi, and Elsie M. Taveras are with the Department of Pediatrics, Massachusetts General Hospital for Children, Boston. Erika R. Cheng is with the Department of Pediatrics, Indiana University School of Medicine, Indianapolis. Ken Kleinman and Jason Block are with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston. Steven J. Melly is with the Department of Environmental Health, Harvard School of Public Health, Boston. Richard Marshall is with the Harvard Vanguard Medical Associates, Boston.
authors.forename: Lauren
authors.initials: L
authors.lastname: Fiechtner
authors.affiliation: Lauren Fiechtner, Mona Sharifi, and Elsie M. Taveras are with the Department of Pediatrics, Massachusetts General Hospital for Children, Boston. Erika R. Cheng is with the Department of Pediatrics, Indiana University School of Medicine, Indianapolis. Ken Kleinman and Jason Block are with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston. Steven J. Melly is with the Department of Environmental Health, Harvard School of Public Health, Boston. Richard Marshall is with the Harvard Vanguard Medical Associates, Boston.
authors.forename: Ken
authors.initials: K
authors.lastname: Kleinman
authors.affiliation: Lauren Fiechtner, Mona Sharifi, and Elsie M. Taveras are with the Department of Pediatrics, Massachusetts General Hospital for Children, Boston. Erika R. Cheng is with the Department of Pediatrics, Indiana University School of Medicine, Indianapolis. Ken Kleinman and Jason Block are with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston. Steven J. Melly is with the Department of Environmental Health, Harvard School of Public Health, Boston. Richard Marshall is with the Harvard Vanguard Medical Associates, Boston.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Melly
authors.affiliation: Lauren Fiechtner, Mona Sharifi, and Elsie M. Taveras are with the Department of Pediatrics, Massachusetts General Hospital for Children, Boston. Erika R. Cheng is with the Department of Pediatrics, Indiana University School of Medicine, Indianapolis. Ken Kleinman and Jason Block are with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston. Steven J. Melly is with the Department of Environmental Health, Harvard School of Public Health, Boston. Richard Marshall is with the Harvard Vanguard Medical Associates, Boston.
authors.forename: Mona
authors.initials: M
authors.lastname: Sharifi
authors.affiliation: Lauren Fiechtner, Mona Sharifi, and Elsie M. Taveras are with the Department of Pediatrics, Massachusetts General Hospital for Children, Boston. Erika R. Cheng is with the Department of Pediatrics, Indiana University School of Medicine, Indianapolis. Ken Kleinman and Jason Block are with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston. Steven J. Melly is with the Department of Environmental Health, Harvard School of Public Health, Boston. Richard Marshall is with the Harvard Vanguard Medical Associates, Boston.
authors.forename: Richard
authors.initials: R
authors.lastname: Marshall
authors.affiliation: Lauren Fiechtner, Mona Sharifi, and Elsie M. Taveras are with the Department of Pediatrics, Massachusetts General Hospital for Children, Boston. Erika R. Cheng is with the Department of Pediatrics, Indiana University School of Medicine, Indianapolis. Ken Kleinman and Jason Block are with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston. Steven J. Melly is with the Department of Environmental Health, Harvard School of Public Health, Boston. Richard Marshall is with the Harvard Vanguard Medical Associates, Boston.
authors.forename: Jason
authors.initials: J
authors.lastname: Block
authors.affiliation: Lauren Fiechtner, Mona Sharifi, and Elsie M. Taveras are with the Department of Pediatrics, Massachusetts General Hospital for Children, Boston. Erika R. Cheng is with the Department of Pediatrics, Indiana University School of Medicine, Indianapolis. Ken Kleinman and Jason Block are with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston. Steven J. Melly is with the Department of Environmental Health, Harvard School of Public Health, Boston. Richard Marshall is with the Harvard Vanguard Medical Associates, Boston.
authors.forename: Erika R
authors.initials: ER
authors.lastname: Cheng
authors.affiliation: Lauren Fiechtner, Mona Sharifi, and Elsie M. Taveras are with the Department of Pediatrics, Massachusetts General Hospital for Children, Boston. Erika R. Cheng is with the Department of Pediatrics, Indiana University School of Medicine, Indianapolis. Ken Kleinman and Jason Block are with the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston. Steven J. Melly is with the Department of Environmental Health, Harvard School of Public Health, Boston. Richard Marshall is with the Harvard Vanguard Medical Associates, Boston.
authors.forename: Elsie M
authors.initials: EM
authors.lastname: Taveras
mesh_terms: D015992:Body Mass Index; D002648:Child; D003661:Decision Support Techniques; D004032:Diet; D015444:Exercise; D005190:Family; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D005638:Fruit; D015438:Health Behavior; D006801:Humans; D008297:Male; D008404:Massachusetts; D009765:Obesity / Q000628:therapy*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D057185:Sedentary Behavior; D012890:Sleep; D012959:Socioeconomic Factors; D014675:Vegetables