Trends in Obesity Among Participants Aged 2–4 Years in the Special Supplemental Nutrition Program for Women, Infants, and Children — United States, 2000–2014

Pan, Liping; Freedman, David S.; Sharma, Andrea J.; Castellanos-Brown, Karen; Park, Sohyun; Smith, Ray B.; Blanck, Heidi M.

doi:10.15585/mmwr.mm6545a2

Cited by 92 publications

(82 citation statements)

References 5 publications

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“…Consistent with Statewide and National trends [18,19], the annual Autumn to Spring changes in child BMI percentile, BMI z-score, and incidence of overweight or obesity in children age 4 years were significantly more negative in both the intervention (CCHP + HAP) and control (CCHP + HAP Delayed) groups in 2013-2014, relative to baseline. The significantly steeper decrease in annual BMI change in the CCHP + HAP group vs CCHP + HAP Delayed in the Follow-up year, and the disappearance of this difference in Implementation year 2, after the CCHP + HAP Delayed group also received HAP resources, suggest a 'true' beneficial effect of the local HAP beyond background trends.…”

Section: Contextual Factorssupporting

confidence: 73%

“…The difference in outcomes was observed despite availability of free online resources [2,3], throughout the study period, and concurrent local, Statewide, and national diet and activity initiatives [18,19]. The results suggest that NAP SACC research, which was conducted with controlled experimental conditions and selected study population, may be effectively translated into public health programs to decrease the prevalence of childhood obesity.…”

Section: Discussionmentioning

confidence: 99%

“…The CCHP distributed child-sized pitchers of drinking water to child care providers to encourage children to drink water. Statewide, between 2010 and 2014, the prevalence of obesity among children ages 2 to 5 years enrolled in WIC decreased by −1.7 (−1.8, −1.6) percentage points from 18.4% to 16.6% [18]. California was one of 34 out of 56 States, nationwide, to observe a significant decrease in the prevalence of obesity among WIC enrolled children ages 2 to 5 years during the HAP pilot evaluation period [19].…”

Section: Contextual Factorsmentioning

confidence: 99%

“…Statewide and Federal efforts, such as the USDA's revision of the WIC food package, CDC's Early Care and Education Childhood Obesity program, and Let's Move! Initiative, could have contributed to decreases in child obesity during the HAP evaluation period [18,19]. To limit confounding effects of concurrent initiatives, correlated factors and/or trends, the HAP pilot evaluation used a randomized controlled design.…”

Section: Contextual Factorsmentioning

confidence: 99%

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Healthy apple program to support child care centers to alter nutrition and physical activity practices and improve child weight: a cluster randomized trial

et al. 2017

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Background: North Carolina Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) resources improve child body mass index (BMI) when the resources are introduced by nurses to child care providers, and offered with workshops and incentives. In San Francisco, public health and child care agencies partnered to adapt NAP SACC resources into an annual "Healthy Apple" quality improvement program (HAP). Methods: This cluster randomized controlled trial pilot-tested integration of the HAP with bi-annual public health screenings by nurses. All child care centers that participated in Child Care Health Program (CCHP) screenings in San Francisco in 2011-2012 were offered routine services plus HAP in 2012-2013 (CCHP + HAP, n = 19) or routine services with delayed HAP in 2014-2015 (CCHP + HAP Delayed, n = 24). Intention-to-treat analyses (robust SE or mixed models) used 4 years of screening data from 12 to 17 CCHP + HAP and 17 to 20 CCHP + HAP Delayed centers, regarding 791 to 945 children ages 2 to 5y, annually. Year-specific, child level models tested if children in CCHP + HAP centers had greater relative odds of exposure to 3 index best practices and smaller Autumn-to-Spring changes in BMI percentile and z-score than children in CCHP + HAP Delayed centers, controlling for age, sex, and Autumn status. Multi-year, child care center level models tested if HAP support modified year-to-year changes (2013-2014 and 2014-2015 vs 2011-2012) in child care center annual mean Autumn-to-Spring BMI changes.

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Section: Contextual Factorssupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Contextual Factorsmentioning

confidence: 99%

Section: Contextual Factorsmentioning

confidence: 99%

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Healthy apple program to support child care centers to alter nutrition and physical activity practices and improve child weight: a cluster randomized trial

et al. 2017

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“…1,2 However, in recent years, national data indicate that obesity rates have begun to stabilize among some subpopulations of children. 3 These stabilizations suggest recent progress in impacting the childhood obesity epidemic.…”

mentioning

confidence: 99%

Childhood Obesity Declines Project: An Exploratory Study of Strategies Identified in Communities Reporting Declines

et al. 2018

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Background: Although childhood obesity rates have been high in the last few decades, recent national reports indicate a stabilization of rates among some subpopulations of children. This study examines the implementation of initiatives, policies, and programs (referred to as strategies) in four communities that experienced declines in childhood obesity between 2003 and 2012.Methods and Results: The Childhood Obesity Decline project verified obesity declines and identified strategies that may have influenced and supported the decline in obesity. The project used an adaptation of the Systematic Screening and Assessment method to identify key informants in each site. Four settings were highlighted related to childhood: (1) communities, (2) schools, (3) early care and education, and (4) healthcare. The findings indicate that programs and policies were implemented across local settings (primarily in schools and early childhood settings) and at the state level, during a timeframe of supportive federal policies and initiatives.Conclusions: Multilevel approaches were aimed to improve the nutrition and physical activity environments where children spend most of their time. We hypothesized that other, more distal strategies amplified and reinforced the impact of the efforts that more directly targeted children. The simultaneous public health messaging and multilayered initiatives, supported by cross-sector partnerships and active, high-level champions, were identified as likely important contributors to success in attaining declines in rates of childhood obesity.

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Changes in Obesity Among US Children Aged 2 Through 4 Years Enrolled in WIC During 2010-2016

Pan

Freedman

Park

et al. 2019

JAMA

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Prevalence of childhood obesity is high in the United States, especially among children from lower-income families. 1 Among children aged 2 through 4 years enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), obesity prevalence increased between 2000 and 2010 but declined through 2014. 2 The decline was statistically significant among all racial/ethnic groups and in 34 of 56 state WIC agencies. The present study examines trends in overweight and obesity by age, sex, and race/ ethnicity using WIC data from 2010 to 2016.

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Trends in Obesity Among Participants Aged 2–4 Years in the Special Supplemental Nutrition Program for Women, Infants, and Children — United States, 2000–2014

Cited by 92 publications

References 5 publications

Healthy apple program to support child care centers to alter nutrition and physical activity practices and improve child weight: a cluster randomized trial

Healthy apple program to support child care centers to alter nutrition and physical activity practices and improve child weight: a cluster randomized trial

Childhood Obesity Declines Project: An Exploratory Study of Strategies Identified in Communities Reporting Declines

Changes in Obesity Among US Children Aged 2 Through 4 Years Enrolled in WIC During 2010-2016

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