Essay about Public Health and Child Care Programs

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Impact of Let’s Go! 5-2-1-0: A Community-Based, Multisetting
Childhood Obesity Prevention Program
Victoria W. Rogers,1 MD, Patricia H. Hart,2 MS, Elizabeth Motyka,1 MPH, Emily N. Rines,3 MPH,
MCHES, Jackie Vine,1 MS, and Deborah A. Deatrick,4 MPH

The Barbara Bush Children’s Hospital at Maine Medical Center, 2Hart Consulting, Inc., Gardiner, Maine,


United Way of Greater Portland, Portland, Maine, and 4MaineHealth, Portland, Maine

All correspondence concerning this article should be addressed to Victoria W. Rogers, MD, Director,
Let’s Go!, The Barbara Bush Children’s Hospital at Maine Medical Center, 22 Bramhall Street, Portland,
ME 04102, USA. E-mail:
Received September 26, 2012; revisions received May 3, 2013; accepted June 27, 2013
Objective Document the impact of Let’s Go!, a multisetting community-based childhood obesity prevention program on participants in 12 communities in Maine. Methods The study used repeated random telephone surveys with 800 parents of children to measure awareness of messages and child behaviors. Surveys were conducted in schools, child care programs, and afterschool programs to track changes in policies and environments. Results Findings show improvements from 2007 to 2011: Children consuming fruits and vegetables increased from 18%, 95% CI [15, 21], to 26% [23, 30] (p < .001); children limiting sugary drinks increased from 63% [59, 67] to 69% [65, 73] (p ¼ .011); and parent awareness of the program grew from
10% [7, 12] to 47% [43, 51] (p < .001). Participating sites implemented widespread changes to promote healthy behaviors. Conclusions A multisetting, community-based intervention with a consistent message can positively impact behaviors that lead to childhood obesity.
Key words

health education; health promotion and prevention; obesity; public health.

The obesity epidemic is widely acknowledged as one of the greatest public health challenges in the United States for children (Stroup, Johnson, Hahn, & Proctor, 2009). Over the past 30 years, obesity rates among children and adolescents aged 2–19 increased nearly threefold from 6 to
17% (Fryar, Carroll, & Ogden, 2012). Obesity now affects more than one in six children in the United States. The situation is similar in Maine, with a 2011 youth health surveillance study recording 23% of kindergarten students, and 24% of fifth grade as obese. Adding those students who were also overweight, Maine’s study showed 38% of students in kindergarten, and 44% of students in fifth grade were either overweight or obese (Maine Department of Health and Human Services & Maine Department of
Education, 2011).
The effects of being overweight are acute among children. Overweight and obese children are much more likely

than their healthy weight peers to become obese adults,
(Freedman et al., 2005; Guo et al., 2000; Singh, Mulder,
Twisk, Van Mechelen, & Chinapaw, 2008), and they face increased risks for many chronic health and mental health conditions (Bray, 2004; Dietz, 1998; Freedman, Dietz,
Srinivasan, & Berenson, 1999; Loth, Mond, Wall, &
Neumark-Sztainer, 2011; Must, Jacques, Dallal, Bajema,
& Dietz, 1992).
The dramatic rise in obesity over the past three decades occurred at the same time as major environmental, social, and lifestyle changes. These days, Americans consume more fast foods and sugary drinks than ever before; processed foods are low-cost and readily available; and people engage in more sedentary leisure time activities such as viewing television or using electronic devices
(Hill, Wyatt, Reed, & Peters, 2003). Overweight is a result of a calorie imbalance, genetics, and health status

Journal of Pediatric Psychology 38(9) pp. 1010–1020, 2013 doi:10.1093/jpepsy/jst057 Advance Access publication August 11, 2013
Journal of Pediatric Psychology vol. 38 no. 9 ß The Author 2013. Published by Oxford University Press on behalf of the Society of Pediatric Psychology.
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