title: Multilevel Correlates of Healthy BMI Maintenance and Return to a Healthy BMI among Children in Massachusetts.
abstract: To examine predictors of healthy BMI maintenance (HBM) or return to a healthy BMI (RHB) among children.
  
  
  
  We studied 33,272 children in Massachusetts between 2008 and 2012. We used multinomial logistic regression to examine associations of individual- and neighborhood-level factors with the odds of: (1) HBM: maintenance of a healthy BMI ≥5th to <85th percentile and (2) RHB: transition to a healthy BMI range from an initial BMI ≥85th percentile between two clinic visits spanning an average of 3.5 years.
  
  
  
  Racial/ethnic minorities had lower odds of HBM and RHB than non-Hispanic white children. Higher neighborhood educational attainment was associated with an increased odds of HBM and RHB. Higher neighborhood median household income, proximity to a supermarket, and access to more open recreational space were associated with a higher odds of HBM. Children of ages 2-5 years at baseline had higher odds of RHB and HBM than children 13 years and older.
  
  
  
  Early childhood interventions and efforts to create health-promoting neighborhoods including improving access to supermarkets and open recreational space could have important effects on obesity prevention and management.
authors.affiliation: 1 Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children , Boston, MA.|2 Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, MassGeneral Hospital for Children , Boston, MA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Fiechtner
authors.affiliation: 3 Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine , Indianapolis, IN.
authors.forename: Erika R
authors.initials: ER
authors.lastname: Cheng
authors.affiliation: 4 University of California Los Angeles David Geffen School of Medicine , Los Angeles, CA.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Lopez
authors.affiliation: 5 Section of General Pediatrics, Department of Pediatrics, Yale University School of Medicine , New Haven, CT.
authors.forename: Mona
authors.initials: M
authors.lastname: Sharifi
authors.affiliation: 1 Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children , Boston, MA.|6 Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
authors.forename: Elsie M
authors.initials: EM
authors.lastname: Taveras
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D006293:Health Promotion; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D063766:Pediatric Obesity / Q000453:epidemiology* / Q000517:prevention & control*; D011998:Recreation; D012111:Residence Characteristics; D012307:Risk Factors; D012959:Socioeconomic Factors
keywords: built environment; childhood obesity; return to healthy weight