Abstract
Background: Multi-component interventions in large communities such as Philadelphia can effectively lower childhood obesity rates. It is less clear whether this type of intervention can be successful in smaller communities with more limited resources. Norwood, Ohio is a small Midwestern city with a population of 19,207. In 2010, Ohio passed a school health law requiring Body Mass Index (BMI) screening of students in kindergarten and grades 3, 5 and 9 along with restrictions on competitive foods and vending machine products and a physical education requirement of 30 min per day. In 2014, Norwood implemented a multi-component childhood obesity prevention and treatment bundle of interventions. Our objective was to describe the effects if this bundle on childhood overweight/obesity (OW/OB) rates. We hypothesized that implementation of the bundle would lower the prevalence of OW/OB in Norwood school children. Methods: In 2012, the Healthy Kids Ohio Act was fully implemented in the Norwood City School District (NCSD). In 2014 a comprehensive bundle was implemented that included: 1. A student gardening program; 2. Supplementation of fresh produce to a local food pantry and a family shelter; 3. A farmers market; 4. A health newsletter; 5. Incentives in the school cafeterias to promote healthy food selection; 6. A 100-mile walking club; 7. “Cook for America” (a “cooked from scratch” intervention for school cafeterias); 8. A school-based obesity treatment clinic; Results: The OW/OB rate in the NCSD was 43% at the time of the Bundle implementation in 2014 and 37% in 2016 (p = 0.029). Conclusions: A childhood OW/OB prevention bundle can be implemented in a small city and is associated with a favorable change in BMI.
Highlights
Obesity continues to be an increasing problem in the US for both adults and children [1,2]
Body Mass Index (BMI) data of Norwood City School District (NCSD) and CPS are displayed in Figure 1; Figure 2
41% of NCSD children were OW/OB after the Healthy Choices for Healthy Kids Act was implemented and was without significant change at 43% in 2014–2015 school year, but after implementation of the Norwood Bundle, OW/OB decreased to 37% during the
Summary
Obesity continues to be an increasing problem in the US for both adults and children [1,2]. Interventions that focus on individual behavior changes have had limited impact and this has led to greater interest in wider, community-based interventions that more definitely address environmental factors [6,7] With this in mind and recognizing that many factors led to the dramatic increase in overweight and obesity (OW/OB) rates, several communities implemented multi-component programs or “Bundles” to reverse this alarming trend [8,9,10]. Multi-component interventions in large communities such as Philadelphia can effectively lower childhood obesity rates. It is less clear whether this type of intervention can be successful in smaller communities with more limited resources. In 2014, Norwood implemented a multi-component childhood obesity prevention and treatment bundle of interventions.
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