Clinical trial NCT02181010: B'More Healthy; Communities for Kids (BHCK)
Official title: B'More Healthy: Communities for Kids (BHCK)
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Obesity
Keywords: African American
Adolescents
Urban
Food Desert
Food Insecurity
Obesity
Baltimore City
Peer mentors
Multi level
Policy
Caregivers
Systems
Agent Based Model
Systems Dynamic Model
Corner Store
Carryout
Recreation Center
Text Messaging
Social Media
Mapping
Lead sponsor: Johns Hopkins Bloomberg School of Public Health
Sponsor class: OTHER
First posted: 2014-07-03
Enrollment: 890
Sex: ALL
Minimum age (years): 9
Maximum age (years): 100
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: FACTORIAL
Primary purpose: PREVENTION

Brief summary: The BHCK study will develop, implement, and evaluate a community-based obesity prevention program, which operates at multiple levels of an urban food system (policy, wholesaler, corner stores, carryout, household, individual; in Baltimore, MD), and will improve the healthy food supply chain to increase affordability, availability, purchasing and consumption of healthy foods within low-income, minority neighborhoods.

Detailed description: Our overarching goal is to develop and evaluate a community-based obesity prevention program, which operates at multiple levels of an urban food system (policy, wholesaler, corner stores, carryout, household, individual; in Baltimore, MD), and will improve the healthy food supply chain to increase affordability, availability, purchasing and consumption of healthy foods within low-income minority neighborhoods. Our research will include stakeholders/ partners at different levels, e.g., the policy, wholesaler, retailer, adult caregiver, and individual child levels, and then develop, implement, and assess a two year multi-level systems-based child obesity prevention strategy targeting minority and low-income children (predominantly AA). Thirty low-income, predominantly AA geographic zones will be identified ("healthy eating zones"). Half of these zones will be randomized to intervention, while the other half will be control. Within each intervention zone we will work with 3-5 small food stores and prepared food sources to increase access to healthy foods through wholesaler discounts, display point of purchase promotional materials, and provide nutrition and food preparation education targeting youth and caregivers. We will work with local policymakers to institutionalize and sustain these changes.

The project will evaluate the impact of the program on: a) healthy food pricing and availability, b) low income African American adult food purchasing and preparation, and c) low-income African American youth diet, and associated psychosocial factors.

Eligibility criteria: Inclusion Criteria for Child participants:

9-14 years of age Living within one of the intervention neighborhoods Family does not anticipate moving outside of the study area during the duration of intervention

Inclusion Criteria for Adult Caregiver participants:

Parent/ legal guardian of a child ages 9-14 years of age Living within one of the intervention neighborhoods Family does not anticipate moving outside of the study area during the duration of intervention

Exclusion criteria:

Families that do not have a child within the age range Families that do not live within the neighborhoods in the study area Families who will move outside the study area within the intervention timeframe

Primary outcomes:
measure: Small Retail Food Store - Healthy Food Availability
timeFrame: Up to 4 years
Secondary outcomes:
measure: Household Healthy Food Purchasing
timeFrame: Up to 4 years
Other outcomes:
measure: Dietary intake of urban, African American youth participants (specifically total calories and fat consumption.)
timeFrame: Up to 4 years
Locations:
city: Baltimore
country: United States
facility: Johns Hopkins University
state: Maryland
Study officials:
affiliation: Johns Hopkins Bloomberg School of Public Health
name: Joel Gittelsohn, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Coakley HL, Steeves EA, Jones-Smith JC, Hopkins L, Braunstein N, Mui Y, Gittelsohn J. Combining Ground-Truthing and Technology to Improve Accuracy in Establishing Children's Food Purchasing Behaviors. J Hunger Environ Nutr. 2014;9(3):418-430. doi: 10.1080/19320248.2014.898173.
citation: Gittelsohn J, Anderson Steeves E, Mui Y, Kharmats AY, Hopkins LC, Dennis D. B'More Healthy Communities for Kids: design of a multi-level intervention for obesity prevention for low-income African American children. BMC Public Health. 2014 Sep 11;14:942. doi: 10.1186/1471-2458-14-942.
citation: Anderson Steeves E, Martins PA, Gittelsohn J. Changing the Food Environment for Obesity Prevention: Key Gaps and Future Directions. Curr Obes Rep. 2014 Dec;3(4):451-8. doi: 10.1007/s13679-014-0120-0.
citation: Gudzune KA, Welsh C, Lane E, Chissell Z, Anderson Steeves E, Gittelsohn J. Increasing access to fresh produce by pairing urban farms with corner stores: a case study in a low-income urban setting. Public Health Nutr. 2015 Oct;18(15):2770-4. doi: 10.1017/S1368980015000051. Epub 2015 Feb 4.
citation: Gittelsohn J, Mui Y, Adam A, Lin S, Kharmats A, Igusa T, Lee BY. Incorporating Systems Science Principles into the Development of Obesity Prevention Interventions: Principles, Benefits, and Challenges. Curr Obes Rep. 2015 Jun;4(2):174-81. doi: 10.1007/s13679-015-0147-x.
citation: Sattler M, Hopkins L, Anderson Steeves E, Cristello A, Mccloskey M, Gittelsohn J, Hurley K. Characteristics of Youth Food Preparation in Low-Income, African American Homes: Associations with Healthy Eating Index Scores. Ecol Food Nutr. 2015;54(4):380-96. doi: 10.1080/03670244.2014.1001982. Epub 2015 Feb 23.
citation: Vedovato GM, Surkan PJ, Jones-Smith J, Steeves EA, Han E, Trude AC, Kharmats AY, Gittelsohn J. Food insecurity, overweight and obesity among low-income African-American families in Baltimore City: associations with food-related perceptions. Public Health Nutr. 2016 Jun;19(8):1405-16. doi: 10.1017/S1368980015002888. Epub 2015 Oct 6.
citation: Anderson Steeves E, Jones-Smith J, Hopkins L, Gittelsohn J. Perceived Social Support From Friends and Parents for Eating Behavior and Diet Quality Among Low-Income, Urban, Minority Youth. J Nutr Educ Behav. 2016 May;48(5):304-310.e1. doi: 10.1016/j.jneb.2015.12.014. Epub 2016 Feb 8.
citation: Gittelsohn J, Trude A. Environmental Interventions for Obesity and Chronic Disease Prevention. J Nutr Sci Vitaminol (Tokyo). 2015;61 Suppl(Suppl):S15-6. doi: 10.3177/jnsv.61.S15.
citation: Mui Y, Lee BY, Adam A, Kharmats AY, Budd N, Nau C, Gittelsohn J. Healthy versus Unhealthy Suppliers in Food Desert Neighborhoods: A Network Analysis of Corner Stores' Food Supplier Networks. Int J Environ Res Public Health. 2015 Nov 30;12(12):15058-74. doi: 10.3390/ijerph121214965.
citation: Wong MS, Nau C, Kharmats AY, Vedovato GM, Cheskin LJ, Gittelsohn J, Lee BY. Using a computational model to quantify the potential impact of changing the placement of healthy beverages in stores as an intervention to "Nudge" adolescent behavior choice. BMC Public Health. 2015 Dec 23;15:1284. doi: 10.1186/s12889-015-2626-0.
citation: Sato PM, Steeves EA, Carnell S, Cheskin LJ, Trude AC, Shipley C, Mejia Ruiz MJ, Gittelsohn J. A youth mentor-led nutritional intervention in urban recreation centers: a promising strategy for childhood obesity prevention in low-income neighborhoods. Health Educ Res. 2016 Apr;31(2):195-206. doi: 10.1093/her/cyw011. Epub 2016 Mar 2.
citation: Ewart-Pierce E, Mejia Ruiz MJ, Gittelsohn J. "Whole-of-Community" Obesity Prevention: A Review of Challenges and Opportunities in Multilevel, Multicomponent Interventions. Curr Obes Rep. 2016 Sep;5(3):361-74. doi: 10.1007/s13679-016-0226-7.
citation: Trude ACB, Surkan PJ, Cheskin LJ, Gittelsohn J. A multilevel, multicomponent childhood obesity prevention group-randomized controlled trial improves healthier food purchasing and reduces sweet-snack consumption among low-income African-American youth. Nutr J. 2018 Oct 29;17(1):96. doi: 10.1186/s12937-018-0406-2.
citation: Trude ACB, Kharmats AY, Jones-Smith JC, Gittelsohn J. Exposure to a multi-level multi-component childhood obesity prevention community-randomized controlled trial: patterns, determinants, and implications. Trials. 2018 May 22;19(1):287. doi: 10.1186/s13063-018-2663-y.