Essays on community based behavior change interventions for obesity prevention

Date

2014-08

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Abstract

Unlike the traditional way of addressing obesity as an individual’s concern, it is now often addressed using a community approach for a societal-level effect. A conceptual framework, by studying obesity as a market failure, was developed for the potential of behavior change interventions in obesity prevention. Then, a multi-tiered supermarket and community based obesity prevention model, implemented in a small community, was evaluated for its effect on 1) cancer knowledge and BMI, and 2) supermarket sales of fresh fruits and vegetables (produce) and selected healthier items. The first evaluation was done by comparing food behavior and attitude before and after the project and by analyzing the intervention effect on cancer knowledge and BMI. The results suggests that this community-based model has a good potential for bringing long term change in obesity through targeting the behaviors associated with obesity and should have sustainable impact. The second evaluation was done by comparing the change in sales from the pre-trial to trial period in the intervention store with the change in the control store. The findings suggest that supermarket interventions have potential in changing food behavior. Finally, a systematic review and meta-analysis of community-based behavior change interventions was done. A narrative analysis and meta-analysis suggests that community-based behavior change interventions have promise for changing behaviors towards obesity prevention and to some extent changing (decreasing) BMI. Additionally, the difference in project impact between large-scale, less-intense and small-scale, more-intense interventions suggests that designers of community-based obesity prevention intervention should carefully consider between large-scale, less-intense and small-scale more-intense interventions for desired outcomes.

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Keywords

Body mass index (BMI), Obesity, Community-based, Behavior change, Meta-analysis, Supermarket

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