142nd APHA Annual Meeting and Exposition

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310112
Applying a Novel Systems Science Approach to Understand Child Obesity Trends in Los Angeles County, 2002-2011

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

May-Choo Wang, DrPH, RD , Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, Los Angeles, CA
Michael Prelip, MPH, DPA , Fielding School of Public Health, UCLA, Los Angeles, CA
Onyebuchi Arah, MD, MSc, DSc, MPH, PhD , Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA
Mona AuYoung, PhD, MS, MPH , Department of Community Health Sciences, UCLA School of Public Health, Los Angeles, CA
Ricardo Basurto-Davila, PhD , Los Angeles County Department of Public Health, Los Angeles, CA
Catherine Crespi, PhD , Department of Biostatistics, UCLA School of Public Health, Los Angeles, CA
Mehrnaz Davoudi, MPH , Community Benefit, Kaiser Permanente, Southern California Region, Pasadena, CA
Tony Kuo, MD, MSHS , Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA
Roch Nianogo, MD, MPH , Epidemiology, 650 Charles E Young Dr S, Los Angeles, CA
Tabashir Sadegh-Nobari, MPH , Department of Community Health Sciences, UCLA School of Public Health, Los Angeles, CA
Suzanne M. Rauzon, MPH, RD , Dr. Robert C. and Veronica Atkins Center for Weight and Health, University of California Berkeley, Berkeley, CA
Lorrene Ritchie, PhD, RD , College of Natural Resources, Atkins Center for Weight and Health, UC-Berkeley, Berkeley, CA
Brenda Robles, MPH , Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA
Edmund Y. W. Seto, PhD , School of Public Health, University of Washington, Seattle, WA
Matt Sharp , California Food Policy Advocates, Los Angeles, CA
Margaret Shih, MD, PhD , Department of Public Health, Los Angeles County, Los Angeles, CA
Paul Simon, MD, MPH , Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Health Services, Los Angeles, CA
Wendy Slusser, MD, MS , Department of Pediatrics, University of California Los Angeles, Los Angeles, CA
Sallie Yoshida, DrPH, RD , The Sarah Samuels Center for Public Health Research & Evaluaion, Oakland, CA
Shannon E. Whaley, PhD , Research and Evaluation Unit, PHFE-WIC, Irwindale, CA

In Los Angeles County (LAC), considerable neighborhood variation in obesity rates among low income preschool-aged children who participate in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides an opportunity for investigating the impact of community interventions and policies on these children within various contextual settings. Using height and weight measurements on children aged 2-5 years who participated in LAC WIC, we first documented variation in neighborhood obesity prevalence trends between 2002 and 2011. We then developed an index of “community intervention dose” from quantifiable data on obesity-related interventions and policies gathered from key informant interviews with relevant funders and organizations, and related this index to child Body Mass Index (expressed as z scores using CDC sex- and age-specific BMI reference values) using causal inference methods which considered the potential confounding effects of individual-level factors such as socioeconomic status and ethnicity, and neighborhood-level factors such as the physical and social environments in which WIC families live. Individual-level data were available from a large database maintained on the approximately 500,000 families enrolled annually in LAC WIC. Neighborhood-level data such as median neighborhood income, racial/ethnic distribution, and accessibility to healthy and unhealthy foods and parks and facilities for physical activity were available from the U.S. Census, Dun & Bradstreet, and the local planning departments.  Of 1,195 census tracts that had ≥30 children enrolled in WIC every year between 2002 and 2011, 225 (19%) showed a decreasing trend in obesity prevalence, and 356 (30%) showed an increasing trend; the remaining 614 (51%) tracts showed a variable trend. An agent based modeling framework that integrated obesity-related interventions and policies (measured by the community intervention dose index) and relevant individual- and neighborhood-level data to simulate the effects of variable interventions on child obesity within different contextual settings will be presented.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe how systems science methods can be applied to child obesity research. Describe the use of causal inference methods and agent-based modeling for investigating the impact of multiple community interventions and policies on a health outcome.

Keyword(s): Obesity, Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Principal Investigator on this research project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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