Individual, home and neighborhood factors related to childhood obesity intervention
Obesity is one of the most pressing global population health issues, and importantly one that affects racial/ethnic minorities and those of low socioeconomic status disproportionately. Obesity tracks from childhood into adulthood and is related to serious medical and economic consequences throughout the life course. Childhood obesity is well recognized as a complex and multifaceted problem influenced by broader social, geographic and environmental factors. A social ecological framework that is transdisciplinary is needed to address individual-level influences and choices that lead to energy imbalance, but also to address the complex interactions among home and neighborhood environmental features that provide the context for health-related behavior change. The overall goal of this dissertation is to investigate multilevel factors that could influence outcomes of an intervention program aimed at addressing childhood obesity. Including studies that investigated the use of clear communication strategies to facilitate parents comprehension, home media environment related to change in children weight status and the neighborhood environmental context of families. This dissertation draws upon a social ecological model that acknowledges multiple levels of human interaction with the environment and represents a comprehensive approach to designing, implementing and evaluating interventions that which target multiple influences on health behaviors. The iChoose is a 3-month family-based childhood obesity treatment program developed under a community-based participatory research approach led by the Partnering for Obesity Planning and Sustainability (POPS) Community Advisory Board (CAB). The studies within this dissertation use clear communication evaluation and qualitative feedback from focus groups, intervention outcome data and home environmental surveys, as well as environmental audits of neighborhoods. To investigate multilevel factors could influence intervention outcomes, we used both multiple statistical analytical techniques and a Geographic Information System (GIS) spatial analysis to evaluate the iChoose program.