Capturing what's missing: A comprehensive protocol to monitor changes in the food and physical activity environment for studying their impact on childhood obesity

Introduction: The contribution of factors in the food and physical activity (PA) environment to weight status has been widely acknowledged and is reflected in activities and initiatives by private, government, and community-based organizations. Previous efforts to capture changes in the environment, often relying on commercial data and neighborhood audits, are likely to be insufficiently comprehensive for studying the consequences of natural experiments for weight status where researchers do not have prior knowledge about the types of changes that are taking place.

Approach: The current project seeks to implement an innovative protocol documenting changes in the food and PA environment over a five year period, in five low-income communities in New Jersey where diverse childhood obesity prevention initiatives are ongoing.

Results: A comprehensive protocol will be presented documenting new opportunities for healthy eating and PA (e.g., new supermarkets, playgrounds); significant enhancement of existing ones (e.g., addition of healthy foods to convenience stores, improvements in sidewalks and walkability); and unintended changes (e.g., food outlets that close due to market conditions). Attention will be devoted to criteria for documenting change; implementation of the protocol; and the role of various agencies in the data collection process.

Discussion: This protocol will be useful to other communities for documenting relevant changes in the food and PA environment; tracking progress of ongoing prevention initiatives; generating essential data for research to advance knowledge of obesity prevention; and providing robust evidence for policy makers to inform their decisions about policies and interventions to reduce childhood obesity.