title: "Whole-of-Community" Obesity Prevention: A Review of Challenges and Opportunities in Multilevel, Multicomponent Interventions.
abstract: The causes of obesity worldwide are complex and multilevel, including changing food environments, physical activity levels, policies, and food production systems. This intricate context requires multilevel and multicomponent (MLMC) interventions to improve health outcomes. We conducted a literature review of MLMC interventions for obesity prevention and mitigation; 14 studies meeting search criteria were identified. We found examples of successes in preventing obesity, reducing overweight, improving healthful behaviors, and enhancing some psychosocial indicators. Of eight studies that reported health and behavioral results, five showed no significant impact and three showed reductions in obesity. Four studies showed significant improvement in dietary behavior, and five reported significant desirable effects in physical activity or screen time. Five studies reported psychosocial impacts, and three of these showed significant improvements. MLMC approaches show promising results, particularly when they are able to integrate components at the policy, community, and interpersonal levels.
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA. eewart1@jhu.edu.
authors.forename: Ella
authors.initials: E
authors.lastname: Ewart-Pierce
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA.
authors.forename: María José
authors.initials: MJ
authors.lastname: Mejía Ruiz
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA.
authors.forename: Joel
authors.initials: J
authors.lastname: Gittelsohn
mesh_terms: D003153:Community Health Services / Q000458:organization & administration*; D015444:Exercise; D006266:Health Education / Q000458:organization & administration*; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D009765:Obesity / Q000517:prevention & control*; D011634:Public Health; D040242:Risk Reduction Behavior; D012959:Socioeconomic Factors
keywords: Adult; Child; Community-based interventions; Health behavior; Health promotion; Lifestyle; Minority populations; Multicomponent; Multilevel; Obesity; Prevention; Research design; Review