An Ecological Approach to Addressing Childhood Obesity Issues in Imperial County

Our Choice is a partnership between a university-affiliated research institute, a federally qualified health center, and a county public health department. We used formative research, advisory committee members' recommendations, and previous research to inform the development of the Our Choice project. Our theory-informed multi-sector, multi-level intervention targets improvements in four health behaviors: fruit, vegetable, and water consumption, physical activity, and sleep. Intervention partners include 1200 families, a federally qualified health center (including three clinics), 26 early care and education centers, two elementary school districts (and 20 elementary schools), three community recreation centers, and three restaurants. Intervention components in all sectors target changes in behaviors, policies, systems, and the social and physical environment. Evaluation activities include assessment of the primary outcome, BMI z-score, at baseline, 12- and 18-months post-baseline, and sector evaluations at baseline, 12, and 24-months.

Inclusion criteria

• If family had school-age child, child must attend one of the designated Our Choice schools located in one of three designated cities.
• If family had preschool-age child, family must reside in one of three designated cities.
• Children ages 2-11 years old
• Maximum two children per household
• Children above the 5th percentile body mass index
• Family agrees to remain in the area throughout the duration of the study
• Participating parent had to understand English or Spanish

Exclusion criteria

• Child has any condition that significantly limits eating or physical activity in a way that interventions would be impacted