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Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Study protocol

B’More healthy communities for kids: design of a multi-level intervention for obesity prevention for low-income African American children

Authors: Joel Gittelsohn, Elizabeth Anderson Steeves, Yeeli Mui, Anna Y Kharmats, Laura C Hopkins, Donna Dennis

Published in: BMC Public Health | Issue 1/2014

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Abstract

Background

Childhood obesity rates in the U.S. have reached epidemic proportions, and an urgent need remains to identify evidence-based strategies for prevention and treatment. Multi-level, multi-component interventions are needed due to the multi-factorial nature of obesity, and its proven links to both the social and built environment. However, there are huge gaps in the literature related to doing these kinds of interventions among low-income, urban, minority groups.

Methods

The B’More Healthy Communities for Kids (BHCK) intervention is a multi-level, multi-component intervention, targeting low-income African American youth ages 10–14 and their families in Baltimore, Maryland. This intervention prevents childhood obesity by working at multiple levels of the food and social environments to increase access to, demand for, and consumption of healthier foods. BHCK works to create systems-level change by partnering with city policy-makers, multiple levels of the food environment (wholesalers, corner stores, carryout restaurants), and the social environment (peers and families). In addition, extensive evaluation will be conducted at each level of the intervention to assess intervention effectiveness via both process and impact measures.

Discussion

This project is novel in multiple ways, including: the inclusion of stakeholders at multiple levels (policy, institutional, and at multiple levels of the food system); that it uses novel computational modeling methodologies to engage policy makers and guide informed decisions of intervention effectiveness; it emphasizes both the built environment (intervening with food sources) and the social environment (intervening with families and peers). The design of the intervention and the evaluation plan of the BHCK project are documented here.

Trial registration

NCT02181010 (July 2, 2014).
Appendix
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Literature
1.
go back to reference Ogden CL, Carroll MD, Kit BK, Flegal KM: Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA. 2014, 311: 806-814. 10.1001/jama.2014.732.CrossRefPubMedPubMedCentral Ogden CL, Carroll MD, Kit BK, Flegal KM: Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA. 2014, 311: 806-814. 10.1001/jama.2014.732.CrossRefPubMedPubMedCentral
2.
go back to reference Sallis JF, Glanz K: Physical activity and food environments: solutions to the obesity epidemic. Milbank Q. 2009, 87: 123-154. 10.1111/j.1468-0009.2009.00550.x.CrossRefPubMedPubMedCentral Sallis JF, Glanz K: Physical activity and food environments: solutions to the obesity epidemic. Milbank Q. 2009, 87: 123-154. 10.1111/j.1468-0009.2009.00550.x.CrossRefPubMedPubMedCentral
3.
go back to reference Swinburn BA, Sacks G, Hall KD, McPherson K, Finegood DT, Moodie ML, Gortmaker SL: The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011, 378: 804-814. 10.1016/S0140-6736(11)60813-1.CrossRefPubMed Swinburn BA, Sacks G, Hall KD, McPherson K, Finegood DT, Moodie ML, Gortmaker SL: The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011, 378: 804-814. 10.1016/S0140-6736(11)60813-1.CrossRefPubMed
4.
go back to reference Glanz K, Sallis JF, Saelens BE, Frank LD: Healthy nutrition environments: concepts and measures. Am J Heal Promot. 2005, 19: 330-333. 10.4278/0890-1171-19.5.330. iiCrossRef Glanz K, Sallis JF, Saelens BE, Frank LD: Healthy nutrition environments: concepts and measures. Am J Heal Promot. 2005, 19: 330-333. 10.4278/0890-1171-19.5.330. iiCrossRef
5.
go back to reference Larson NI, Story MT, Nelson MC: Neighborhood environments: disparities in access to healthy foods in the U.S. Am J Prev Med. 2009, 36: 74-81. 10.1016/j.amepre.2008.09.025.CrossRefPubMed Larson NI, Story MT, Nelson MC: Neighborhood environments: disparities in access to healthy foods in the U.S. Am J Prev Med. 2009, 36: 74-81. 10.1016/j.amepre.2008.09.025.CrossRefPubMed
6.
go back to reference Morland KB, Evenson KR: Obesity prevalence and the local food environment. Health Place. 2009, 15: 491-495. 10.1016/j.healthplace.2008.09.004.CrossRefPubMed Morland KB, Evenson KR: Obesity prevalence and the local food environment. Health Place. 2009, 15: 491-495. 10.1016/j.healthplace.2008.09.004.CrossRefPubMed
7.
go back to reference Morland K, Diez Roux AV, Wing S: Supermarkets, other food stores, and obesity: the atherosclerosis risk in communities study. Am J Prev Med. 2006, 30: 333-339. 10.1016/j.amepre.2005.11.003.CrossRefPubMed Morland K, Diez Roux AV, Wing S: Supermarkets, other food stores, and obesity: the atherosclerosis risk in communities study. Am J Prev Med. 2006, 30: 333-339. 10.1016/j.amepre.2005.11.003.CrossRefPubMed
8.
go back to reference Powell LM, Auld MC, Chaloupka FJ, O’Malley PM, Johnston LD: Associations between access to food stores and adolescent body mass index. Am J Prev Med. 2007, 33 (4 Suppl): S301-S307.CrossRefPubMed Powell LM, Auld MC, Chaloupka FJ, O’Malley PM, Johnston LD: Associations between access to food stores and adolescent body mass index. Am J Prev Med. 2007, 33 (4 Suppl): S301-S307.CrossRefPubMed
9.
go back to reference Gibson DM: The neighborhood food environment and adult weight status: estimates from longitudinal data. Am J Public Health. 2011, 101: 71-78. 10.2105/AJPH.2009.187567.CrossRefPubMedPubMedCentral Gibson DM: The neighborhood food environment and adult weight status: estimates from longitudinal data. Am J Public Health. 2011, 101: 71-78. 10.2105/AJPH.2009.187567.CrossRefPubMedPubMedCentral
10.
go back to reference Powell LM, Slater S, Mirtcheva D, Bao Y, Chaloupka FJ: Food store availability and neighborhood characteristics in the United States. Prev Med (Baltim). 2007, 44: 189-195. 10.1016/j.ypmed.2006.08.008.CrossRef Powell LM, Slater S, Mirtcheva D, Bao Y, Chaloupka FJ: Food store availability and neighborhood characteristics in the United States. Prev Med (Baltim). 2007, 44: 189-195. 10.1016/j.ypmed.2006.08.008.CrossRef
11.
go back to reference Franco M, Diez Roux AV, Glass TA, Caballero B, Brancati FL: Neighborhood characteristics and availability of healthy foods in Baltimore. Am J Prev Med. 2008, 35: 561-567. 10.1016/j.amepre.2008.07.003.CrossRefPubMedPubMedCentral Franco M, Diez Roux AV, Glass TA, Caballero B, Brancati FL: Neighborhood characteristics and availability of healthy foods in Baltimore. Am J Prev Med. 2008, 35: 561-567. 10.1016/j.amepre.2008.07.003.CrossRefPubMedPubMedCentral
12.
go back to reference Gordon C, Purciel-Hill M, Ghai NR, Kaufman L, Graham R, Van Wye G: Measuring food deserts in New York City’s low-income neighborhoods. Health Place. 2011, 17: 696-700. 10.1016/j.healthplace.2010.12.012.CrossRefPubMed Gordon C, Purciel-Hill M, Ghai NR, Kaufman L, Graham R, Van Wye G: Measuring food deserts in New York City’s low-income neighborhoods. Health Place. 2011, 17: 696-700. 10.1016/j.healthplace.2010.12.012.CrossRefPubMed
13.
go back to reference Steinberger J, Daniels SR: Obesity, insulin resistance, diabetes, and cardiovascular risk in children: an American Heart Association scientific statement from the Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young) and. Circulation. 2003, 107: 1448-1453. 10.1161/01.CIR.0000060923.07573.F2.CrossRefPubMed Steinberger J, Daniels SR: Obesity, insulin resistance, diabetes, and cardiovascular risk in children: an American Heart Association scientific statement from the Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young) and. Circulation. 2003, 107: 1448-1453. 10.1161/01.CIR.0000060923.07573.F2.CrossRefPubMed
14.
go back to reference Zenk SN, Schulz AJ, Israel BA, James SA, Bao S, Wilson ML: Fruit and vegetable access differs by community racial composition and socioeconomic position in Detroit, Michigan. Ethn Dis. 2006, 16: 275-280.PubMed Zenk SN, Schulz AJ, Israel BA, James SA, Bao S, Wilson ML: Fruit and vegetable access differs by community racial composition and socioeconomic position in Detroit, Michigan. Ethn Dis. 2006, 16: 275-280.PubMed
15.
go back to reference Daroszewski EB: Dietary fat consumption, readiness to change, and ethnocultural association in midlife African American women. J Community Health Nurs. 2004, 21: 63-75. 10.1207/s15327655jchn2102_01.CrossRefPubMed Daroszewski EB: Dietary fat consumption, readiness to change, and ethnocultural association in midlife African American women. J Community Health Nurs. 2004, 21: 63-75. 10.1207/s15327655jchn2102_01.CrossRefPubMed
16.
go back to reference Powell LM, Zhao Z, Wang Y: Food prices and fruit and vegetable consumption among young American adults. Health Place. 2009, 15: 1064-1070. 10.1016/j.healthplace.2009.05.002.CrossRefPubMed Powell LM, Zhao Z, Wang Y: Food prices and fruit and vegetable consumption among young American adults. Health Place. 2009, 15: 1064-1070. 10.1016/j.healthplace.2009.05.002.CrossRefPubMed
17.
go back to reference Casagrande SS, Wang Y, Anderson C, Gary TL: Have Americans increased their fruit and vegetable intake? The trends between 1988 and 2002. Am J Prev Med. 2007, 32: 257-263. 10.1016/j.amepre.2006.12.002.CrossRefPubMed Casagrande SS, Wang Y, Anderson C, Gary TL: Have Americans increased their fruit and vegetable intake? The trends between 1988 and 2002. Am J Prev Med. 2007, 32: 257-263. 10.1016/j.amepre.2006.12.002.CrossRefPubMed
18.
go back to reference Zenk SN, Schulz AJ, Hollis-Neely T, Campbell RT, Holmes N, Watkins G, Nwankwo R, Odoms-Young A: Fruit and vegetable intake in African Americans income and store characteristics. Am J Prev Med. 2005, 29: 1-9.CrossRefPubMed Zenk SN, Schulz AJ, Hollis-Neely T, Campbell RT, Holmes N, Watkins G, Nwankwo R, Odoms-Young A: Fruit and vegetable intake in African Americans income and store characteristics. Am J Prev Med. 2005, 29: 1-9.CrossRefPubMed
19.
go back to reference Sharma S, Cao X, Arcan C, Mattingly M, Jennings S, Song H-J, Gittelsohn J: Assessment of dietary intake in an inner-city African American population and development of a quantitative food frequency questionnaire to highlight foods and nutrients for a nutritional invention. Int J Food Sci Nutr. 2009, 60 (Suppl 5): 155-167.CrossRefPubMed Sharma S, Cao X, Arcan C, Mattingly M, Jennings S, Song H-J, Gittelsohn J: Assessment of dietary intake in an inner-city African American population and development of a quantitative food frequency questionnaire to highlight foods and nutrients for a nutritional invention. Int J Food Sci Nutr. 2009, 60 (Suppl 5): 155-167.CrossRefPubMed
20.
go back to reference Gittelsohn J, Kumar M: Preventing childhood obesity and diabetes: is it time to move out of the school?. Diabetes. 2007, 76: 485-495. Gittelsohn J, Kumar M: Preventing childhood obesity and diabetes: is it time to move out of the school?. Diabetes. 2007, 76: 485-495.
21.
go back to reference Gittelsohn J, Park S: School and Community-Based Interventions. Pediatr Obes Etiol Pathog Treat. Edited by: Freemark M. 2010, New York, New York: Humana Press, 315-336.CrossRef Gittelsohn J, Park S: School and Community-Based Interventions. Pediatr Obes Etiol Pathog Treat. Edited by: Freemark M. 2010, New York, New York: Humana Press, 315-336.CrossRef
22.
go back to reference Economos C, Hyatt R, Goldberg J, Must A, Naumova E, Collins J, Nelson M: A community-based environmental change intervention reduces BMI z-scores in children: Shape up Somerville first year results. Prev Med. 2004, 2: S108-S136. Economos C, Hyatt R, Goldberg J, Must A, Naumova E, Collins J, Nelson M: A community-based environmental change intervention reduces BMI z-scores in children: Shape up Somerville first year results. Prev Med. 2004, 2: S108-S136.
23.
go back to reference Sallis J, Cervero R, Ascher W, Henderson K, Kraft MK, Kerr J: An ecological approach to creating active living communities. Annu Rev Public Health. 2006, 27: 297-322. 10.1146/annurev.publhealth.27.021405.102100.CrossRefPubMed Sallis J, Cervero R, Ascher W, Henderson K, Kraft MK, Kerr J: An ecological approach to creating active living communities. Annu Rev Public Health. 2006, 27: 297-322. 10.1146/annurev.publhealth.27.021405.102100.CrossRefPubMed
24.
go back to reference Bronfenbrenner U: Ecology of the Family as a Contect for Human Development: Research Perspectives. Dev Psychol. 1986, 22: 723-742.CrossRef Bronfenbrenner U: Ecology of the Family as a Contect for Human Development: Research Perspectives. Dev Psychol. 1986, 22: 723-742.CrossRef
25.
go back to reference Bandura A: Social Foundations of Thought and Action a Social Cognitive Theory. 1986, Prentice Hall: Engelwood, NJ Bandura A: Social Foundations of Thought and Action a Social Cognitive Theory. 1986, Prentice Hall: Engelwood, NJ
26.
go back to reference Bandura A: Social Learning Theory. 1977, Prentice Hall: Engelwood, NJ Bandura A: Social Learning Theory. 1977, Prentice Hall: Engelwood, NJ
27.
go back to reference Rimal R: Intergenerational transmission of health: the role of intrapersonal, interpersonal, and communicative factors. Heal Ecuation Behav. 2003, 30: 10-28. 10.1177/1090198102239256.CrossRef Rimal R: Intergenerational transmission of health: the role of intrapersonal, interpersonal, and communicative factors. Heal Ecuation Behav. 2003, 30: 10-28. 10.1177/1090198102239256.CrossRef
28.
go back to reference Rimal R: Longitudinal influences of knowledge and self-efficacy on exercise behavior: Tests of a mutual reinforcement model. J Heal Psychol. 2001, 6 (1): 31-46. 10.1177/135910530100600103.CrossRef Rimal R: Longitudinal influences of knowledge and self-efficacy on exercise behavior: Tests of a mutual reinforcement model. J Heal Psychol. 2001, 6 (1): 31-46. 10.1177/135910530100600103.CrossRef
29.
go back to reference McLeroy K, Bibeau D, Stechler A, Glanz K: An ecological perspective on health promotion programs. Health Educ Q. 1998, 15: 351-377.CrossRef McLeroy K, Bibeau D, Stechler A, Glanz K: An ecological perspective on health promotion programs. Health Educ Q. 1998, 15: 351-377.CrossRef
30.
go back to reference Kremers S, de Bruijn G-J, Visscher T, V MW, de Vries N, Brug J: Environmental influences on energy balance-related behaviors: a dual-process view. Int J Behav Nutr Phys Act. 2006, 3: 9-10.1186/1479-5868-3-9.CrossRefPubMedPubMedCentral Kremers S, de Bruijn G-J, Visscher T, V MW, de Vries N, Brug J: Environmental influences on energy balance-related behaviors: a dual-process view. Int J Behav Nutr Phys Act. 2006, 3: 9-10.1186/1479-5868-3-9.CrossRefPubMedPubMedCentral
31.
go back to reference Stokols D: Establishing and maintaining healthy environments: toward a social ecology of health promotion. Am Psychol. 1992, 47: 6-22.CrossRefPubMed Stokols D: Establishing and maintaining healthy environments: toward a social ecology of health promotion. Am Psychol. 1992, 47: 6-22.CrossRefPubMed
32.
go back to reference Cotterill R: Dynamic Explanations of Industry Structure and Performance. 2000, 53- Cotterill R: Dynamic Explanations of Industry Structure and Performance. 2000, 53-
33.
go back to reference Orr MG, Galea S, Riddle M, Kaplan GA: Reducing racial disparities in obesity: simulating the effects of improved education and social network influence on diet behavior. Ann Epidemiol. 2014, 24 (8): 563-569. 10.1016/j.annepidem.2014.05.012.CrossRefPubMed Orr MG, Galea S, Riddle M, Kaplan GA: Reducing racial disparities in obesity: simulating the effects of improved education and social network influence on diet behavior. Ann Epidemiol. 2014, 24 (8): 563-569. 10.1016/j.annepidem.2014.05.012.CrossRefPubMed
34.
go back to reference Smith LH: Piloting the use of teen mentors to promote a healthy diet and physical activity among children in Appalachia. J Spec Pediatr Nurs. 2011, 16: 16-26. 10.1111/j.1744-6155.2010.00264.x.CrossRefPubMed Smith LH: Piloting the use of teen mentors to promote a healthy diet and physical activity among children in Appalachia. J Spec Pediatr Nurs. 2011, 16: 16-26. 10.1111/j.1744-6155.2010.00264.x.CrossRefPubMed
35.
go back to reference Gittelsohn J, Franceschini MCT, Rasooly IR, Ries AV, Ho LS, Pavlovich W, Santos VT, Jennings SM, Frick KD: Understanding the Food Environment in a Low-Income Urban Setting: Implications for Food Store Interventions. J Hunger Environ Nutr. 2008, 2: 33-50. 10.1080/19320240801891438.CrossRef Gittelsohn J, Franceschini MCT, Rasooly IR, Ries AV, Ho LS, Pavlovich W, Santos VT, Jennings SM, Frick KD: Understanding the Food Environment in a Low-Income Urban Setting: Implications for Food Store Interventions. J Hunger Environ Nutr. 2008, 2: 33-50. 10.1080/19320240801891438.CrossRef
36.
go back to reference Dodson JL, Hsiao Y-C, Kasat-Shors M, Murray L, Nguyen NK, Richards AK, Gittelsohn J: Formative research for a healthy diet intervention among inner-city adolescents: the importance of family, school and neighborhood environment. Ecol Food Nutr. 2001, 48: 39-58.CrossRef Dodson JL, Hsiao Y-C, Kasat-Shors M, Murray L, Nguyen NK, Richards AK, Gittelsohn J: Formative research for a healthy diet intervention among inner-city adolescents: the importance of family, school and neighborhood environment. Ecol Food Nutr. 2001, 48: 39-58.CrossRef
37.
go back to reference Gittelsohn J, Song H-J, Suratkar S, Kumar MB, Henry EG, Sharma S, Mattingly M, Anliker JA: An urban food store intervention positively affects food-related psychosocial variables and food behaviors. Health Educ Behav. 2010, 37: 390-402. 10.1177/1090198109343886.CrossRefPubMed Gittelsohn J, Song H-J, Suratkar S, Kumar MB, Henry EG, Sharma S, Mattingly M, Anliker JA: An urban food store intervention positively affects food-related psychosocial variables and food behaviors. Health Educ Behav. 2010, 37: 390-402. 10.1177/1090198109343886.CrossRefPubMed
38.
go back to reference Song H-J, Gittelsohn J, Kim M, Suratkar S, Sharma S, Anliker J: A corner store intervention in a low-income urban community is associated with increased availability and sales of some healthy foods. Public Health Nutr. 2009, 12: 2060-2067. 10.1017/S1368980009005242.CrossRefPubMedPubMedCentral Song H-J, Gittelsohn J, Kim M, Suratkar S, Sharma S, Anliker J: A corner store intervention in a low-income urban community is associated with increased availability and sales of some healthy foods. Public Health Nutr. 2009, 12: 2060-2067. 10.1017/S1368980009005242.CrossRefPubMedPubMedCentral
39.
go back to reference Song H-J, Gittelsohn J, Anliker J, Sharma S, Suratkar S, Mattingly M, Kim MT: Understanding a Key Feature of Urban Food Stores to Develop Nutrition Intervention. J Hunger Environ Nutr. 2012, 7: 77-90. 10.1080/19320248.2012.650968.CrossRef Song H-J, Gittelsohn J, Anliker J, Sharma S, Suratkar S, Mattingly M, Kim MT: Understanding a Key Feature of Urban Food Stores to Develop Nutrition Intervention. J Hunger Environ Nutr. 2012, 7: 77-90. 10.1080/19320248.2012.650968.CrossRef
40.
go back to reference Lee-Kwan SH, Goedkoop S, Yong R, Batorsky B, Hoffman V, Jeffries J, Hamouda M, Gittelsohn J: Development and implementation of the Baltimore healthy carry-outs feasibility trial: process evaluation results. BMC Public Health. 2013, 13: 638-10.1186/1471-2458-13-638.CrossRefPubMedPubMedCentral Lee-Kwan SH, Goedkoop S, Yong R, Batorsky B, Hoffman V, Jeffries J, Hamouda M, Gittelsohn J: Development and implementation of the Baltimore healthy carry-outs feasibility trial: process evaluation results. BMC Public Health. 2013, 13: 638-10.1186/1471-2458-13-638.CrossRefPubMedPubMedCentral
41.
go back to reference Jeffries JK, Lee SH, Frick KD, Gittelsohn J: Preferences for healthy carryout meals in low-income neighborhoods of Baltimore city. Health Promot Pract. 2013, 14: 293-300. 10.1177/1524839912465290.CrossRefPubMed Jeffries JK, Lee SH, Frick KD, Gittelsohn J: Preferences for healthy carryout meals in low-income neighborhoods of Baltimore city. Health Promot Pract. 2013, 14: 293-300. 10.1177/1524839912465290.CrossRefPubMed
42.
go back to reference Hoffman VA, Lee SH, Bleich SN, Goedkoop S, Gittelsohn J: Relationship between BMI and food purchases in low-income, urban adult carry-out customers. J Hunger Environ Nutr. 2013, 8: 533-545. 10.1080/19320248.2013.816985.CrossRef Hoffman VA, Lee SH, Bleich SN, Goedkoop S, Gittelsohn J: Relationship between BMI and food purchases in low-income, urban adult carry-out customers. J Hunger Environ Nutr. 2013, 8: 533-545. 10.1080/19320248.2013.816985.CrossRef
43.
go back to reference Lee-Kwan SH, Bleich SN, Kim H, Colantuoni E, Gittelsohn J: Environmental Intervention in Carryout Restaurants Increases Sales of Healthy Menu Items in a Low-Income Urban Setting. Am J Health Promot. 2014, [Epub ahead of print] Lee-Kwan SH, Bleich SN, Kim H, Colantuoni E, Gittelsohn J: Environmental Intervention in Carryout Restaurants Increases Sales of Healthy Menu Items in a Low-Income Urban Setting. Am J Health Promot. 2014, [Epub ahead of print]
44.
go back to reference Pottier N: Newcomer E. 2014, TextIt: Kwizera N Pottier N: Newcomer E. 2014, TextIt: Kwizera N
45.
go back to reference Bickel G, Nord M, Price C, Hamilton W, Cook J: Guide to Measuring Household Food Security. 2000, Alexandria, Virginia: U.S. Department of Agriculture, Food and Nutrition Service, 1-76. Bickel G, Nord M, Price C, Hamilton W, Cook J: Guide to Measuring Household Food Security. 2000, Alexandria, Virginia: U.S. Department of Agriculture, Food and Nutrition Service, 1-76.
46.
go back to reference Cullen KW, Watson K, Zakeri I: Relative reliability and validity of the Block Kids Questionnaire among youth aged 10 to 17 years. J Am Diet Assoc. 2008, 108: 862-866. 10.1016/j.jada.2008.02.015.CrossRefPubMed Cullen KW, Watson K, Zakeri I: Relative reliability and validity of the Block Kids Questionnaire among youth aged 10 to 17 years. J Am Diet Assoc. 2008, 108: 862-866. 10.1016/j.jada.2008.02.015.CrossRefPubMed
Metadata
Title
B’More healthy communities for kids: design of a multi-level intervention for obesity prevention for low-income African American children
Authors
Joel Gittelsohn
Elizabeth Anderson Steeves
Yeeli Mui
Anna Y Kharmats
Laura C Hopkins
Donna Dennis
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-942

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