Edward Frongillo:

Document Type


Subject Area(s)

Body Mass Index; Child; Child, Preschool; Exercise; Female; Health Policy; Health Promotion (organization & administration); Humans; Male; Pediatric Obesity (prevention & control); Public Health (methods); Residence Characteristics (statistics & numerical data)



Expert opinion suggests that efforts to address childhood obesity should seek to transform the environments in which children operate. The objective of this study was to describe the extent to which multisetting programs and policies interact with community and child predictors and are associated with child body mass index (BMI) in the 130 US communities participating in the Healthy Communities Study.


For 2 years beginning in fall 2013, we collected data through key informant interviews on community programs and policies related to healthy weight among children that occurred in the 10 years before the interview. We characterized community programs and policies by intensity of efforts and the number of settings in which a program or policy was implemented. Child height and weight were measured during household data collection. We used multilevel modeling to examine associations of community programs and policies in multiple settings and child and community predictors with BMI z scores of children.


The mean number of settings in which community policies and programs were implemented was 7.3 per community. Of 130 communities, 31 (23.8%) implemented community programs and policies in multiple settings. Higher-intensity community programs and policies were associated with lower BMI in communities that used multiple settings but not in communities that implemented programs and policies in few settings. CONCLUSION: Efforts to prevent childhood obesity may be more effective when community programs and policies are both intensive and are implemented in multiple settings in which children live, learn, and play.

Digital Object Identifier (DOI)


This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited.

APA Citation

Collie-Akers, V., Fawcett, S., Schultz, J., Fleming, K., Swinburne Romine, R., & Ritchie, L. et al. (2020). Association of Multisetting Community Programs and Policies With Child Body Mass Index: The Healthy Communities Study. Preventing Chronic Disease, 17.