Community-Level Impacts of Strategies to Reduce Early Childhood Obesity

• In Event: 2-144 - Reach, Implementation, and Impacts of Efforts to Reduce Early Childhood Obesity In LA County

Integrative Statement

As of 2011, one in five children in LA County receiving WIC benefits was categorized as obese (Sekhobo, 2013), and it has been widely demonstrated that childhood obesity has negative impacts on children’s health and wellbeing both immediately and later in life (Reilly and Kelly, 2011). There are a variety of strategies, available for combatting childhood obesity (Keener et al., 2009). As part of the Reducing Early Childhood Obesity (RECO) initiative in LA County, over 1,000 activities using a wide variety of child obesity-reduction strategies took place in different communities and in different time periods over the course of six years (2011-2017). This study capitalizes on the variation in strategy, timing, and location of the RECO activities and has two primary goals 1) describe the RECO strategies used to target early child obesity in communities across LA County and 2) assess the community-level impact of these strategies, individually and combined.

The study team gathered data on RECO activities and their timing and location through review of stakeholder documents and interviews with organizations implementing RECO activities. We then categorized all activities based on the strategies identified by the Centers for Disease Control and Prevention – Strategy 1: Encourage Communities to Organize for Change, Strategy 2: Promote the Availability of Affordable Healthy Foods and Beverages, Strategy 3: Promote Healthy Food and Beverage Choices, Strategy 4: Encourage Physical Activity, Strategy 5: Create Safe Communities that Support Physical Activities, and Strategy 6: Encourage Breastfeeding (Keener et al., 2009). Census-tract level child overweight and obesity data (n=1,223 census tracts) are aggregated from the Public Health Foundation Enterprises (PHFE) WIC administrative data, which include information on more than 400,000 WIC participants and have accurate measures of overweight and obesity for young children ages 2-5 years. Data from the American Community Survey on census tract demographics provided covariates.

Addressing our first goal, we found that RECO activities adopted all six strategies (see Table 1). Those used across the most census-tracts were Supporting Healthy Food and Beverage Choices and Promoting the Availability of Affordable Healthy Food and Beverages. Encouraging Communities to Organize for Change, was employed in the fewest tracts. Figure 1 shows a sample map of the locations of one strategy in one region in LA County.

To address our second goal, we utilize a Comparative Interrupted Time Series (C-ITS) approach, comparing trends in outcomes before and after a specific RECO activity was implemented within a community, as well as trends across other communities in LA County not affected by the activity in that timeframe as an additional point of comparison. We use this model to characterize the community-level impact on early childhood obesity of the individual and combined strategies used through the RECO initiative.

Discussion will focus on the relative effectiveness of different strategies for addressing child obesity and the implications of these results for future efforts to support healthy child development.

Authors

• Molly Brune, Abt Associates
  Presenting Author

• Lauren Olsho, Abt Associates Inc.
  Non-Presenting Author

• Michelle Blocklin, Abt Associates
  Non-Presenting Author