Abstract
Abstract Background Alabama, one of the southeastern states in the US, suffers from a heavy burden of obesity. In 2014, Alabama launched a state program named ’ALProHealth’, aiming to prevent and reduce obesity prevalence. The objective of this study is to evaluate the potential impact of the ALProHealth Program on the prevalence of obesity in Alabama from 2014 to 2017. Methods Data for this study come from the Behavioral Risk Factor Surveillance System (BRFSS). An interrupted time series design was employed. The state obesity prevalence trend for the pre-program period (2011-2014) was estimated and compared with the post-program period (2015-2017). Statistical analyses were conducted using segmented linear regression. Indiana was chosen as the control group in this study. Results The obesity prevalence in Alabama significantly increased from 31.8% in 2011 to 36.2% in 2017, increasing by 0.81% on average each year (95% CI: 0.47 to 1.15, p = 0.002). Before the ALProHealth Program, the obesity prevalence increased by 0.59% (p = 0.11) and 0.32% (p = 0.34) in both Alabama and Indiana respectively, though it is not statistically significant. After the program implementation, the slope of obesity prevalence increased by 0.43 (p = 0.45) and 0.03 (p = 0.96) in Alabama and Indiana respectively, though change is not significant. When comparing Alabama and Indiana, the rate of slope change is higher in Alabama (0.73) compared with Indiana (0.093), indicating the rate of slope change in obesity prevalence increased faster in Alabama than Indiana. Conclusions To sum up, the study found no evidence that the ALProHealth Program contributed to the decrease of obesity prevalence in Alabama. One possible reason is that there was low program coverage. Future studies should examine the potential effectiveness of other programs using a similar conceptual model as ALProHealth Program. Key messages In 2014, Alabama launched a state program named ‘ALProHealth’, aiming to prevent and reduce obesity prevalence. The study found no evidence that the ALProHealth Program contributed to the statewide decrease of obesity prevalence in Alabama, which may attribute to low program coverage.
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