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Exposure to a Multilevel, Multicomponent Obesity Prevention Intervention (OPREVENT2) in Rural Native American Communities: Variability and Association with Change in Diet Quality

Author

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  • Michelle Estradé

    (Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA)

  • Ellen J. I. van Dongen

    (Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA)

  • Angela C. B. Trude

    (Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USA)

  • Lisa Poirier

    (Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA)

  • Sheila Fleischhacker

    (Georgetown University Law Center, Washington, DC 20001, USA)

  • Caroline R. Wensel

    (Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA)

  • Leslie C. Redmond

    (School of Allied Health, University of Alaska Anchorage, Anchorage, AK 99508, USA)

  • Marla Pardilla

    (Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA)

  • Jacqueline Swartz

    (Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA)

  • Margarita S. Treuth

    (Department of Kinesiology, School of Pharmacy and Health Professions, University of Maryland Eastern Shore, Princess Anne, MD 21853, USA)

  • Joel Gittelsohn

    (Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA)

Abstract

The OPREVENT2 obesity prevention trial was a multilevel multicomponent (MLMC) intervention implemented in rural Native American communities in the Midwest and Southwest U.S. Intervention components were delivered through local food stores, worksites, schools, community action coalitions, and by social and community media. Due to the complex nature of MLMC intervention trials, it is useful to assess participants’ exposure to each component of the intervention in order to assess impact. In this paper, we present a detailed methodology for evaluating participant exposure to MLMC intervention, and we explore how exposure to the OPREVENT2 trial impacted participant diet quality. There were no significant differences in total exposure score by age group, sex, or geographic region, but exposure to sub-components of the intervention differed significantly by age group, sex, and geographical region. Participants with the highest overall exposure scores showed significantly more improvement in diet quality from baseline to follow up compared to those who were least exposed to the intervention. Improved diet quality was also significantly positively associated with several exposure sub-components. While evaluating exposure to an entire MLMC intervention is complex and imperfect, it can provide useful insight into an intervention’s impact on key outcome measures, and it can help identify which components of the intervention were most effective.

Suggested Citation

  • Michelle Estradé & Ellen J. I. van Dongen & Angela C. B. Trude & Lisa Poirier & Sheila Fleischhacker & Caroline R. Wensel & Leslie C. Redmond & Marla Pardilla & Jacqueline Swartz & Margarita S. Treuth, 2021. "Exposure to a Multilevel, Multicomponent Obesity Prevention Intervention (OPREVENT2) in Rural Native American Communities: Variability and Association with Change in Diet Quality," IJERPH, MDPI, vol. 18(22), pages 1-11, November.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:22:p:12128-:d:682677
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    References listed on IDEAS

    as
    1. Cobb, N. & Espey, D. & King, J., 2014. "Health behaviors and risk factors among American Indians and Alaska natives, 2000û2010," American Journal of Public Health, American Public Health Association, vol. 104(S3), pages 481-489.
    2. Joel Gittelsohn & Rachel Novotny & Angela Cristina Bizzotto Trude & Jean Butel & Bent Egberg Mikkelsen, 2018. "Challenges and Lessons Learned from Multi-Level Multi-Component Interventions to Prevent and Reduce Childhood Obesity," IJERPH, MDPI, vol. 16(1), pages 1-14, December.
    3. Rebecca Newlin Hutchinson & Sonya Shin, 2014. "Systematic Review of Health Disparities for Cardiovascular Diseases and Associated Factors among American Indian and Alaska Native Populations," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-9, January.
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