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

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 and Joel Gittelsohn
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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

IJERPH, 2021, vol. 18, issue 22, 1-11

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.

Keywords: MLMC intervention; exposure; diet quality; healthy eating index; Native American (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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