A Review of Promising Multicomponent Environmental Child Obesity Prevention Intervention Strategies by the Children's Healthy Living Program.

Childhood obesity has increased rapidly over the last three decades in the U.S. Individual-level interventions targeting healthy eating and physical activity have not significantly impacted clinical measures of obesity in children. Focusing "upstream" on physical, social, cultural, political, and economic environments may be more effective. The purpose of this qualitative review is to analyze published environmental interventions that effectively prevented or reduced obesity in children ages 2­10 years by working within their family, school, and/or community environment to increase physical activity, reduce sedentary behaviors, or improve healthy diet. Through an electronic database search, 590 original articles were identified and 33 were read in full. Using Brennan and co-authors' (2011) rating system, 18 were rated as effective intervention studies. This analysis showed that interventions targeting multiple environments (e.g., family, school, and community) show promise in reducing childhood obesity. Further research is needed to test interventions targeting multiple environments in different communities and populations.

A community engagement process identifies environmental priorities to prevent early childhood obesity: the Children's Healthy Living (CHL) program for remote underserved populations in the US Affiliated Pacific Islands, Hawaii and Alaska.

Underserved minority populations in the US Affiliated Pacific Islands (USAPI), Hawaii, and Alaska display disproportionate rates of childhood obesity. The region's unique circumstance should be taken into account when designing obesity prevention interventions. The purpose of this paper is to (a), describe the community engagement process (CEP) used by the Children's Healthy Living (CHL) Program for remote underserved minority populations in the USAPI, Hawaii, and Alaska (b) report community-identified priorities for an environmental intervention addressing early childhood (ages 2-8 years) obesity, and (c) share lessons learned in the CEP. Four communities in each of five CHL jurisdictions (Alaska, American Samoa, Commonwealth of the Northern Mariana Islands, Guam, Hawai'i) were selected to participate in the community-randomized matched-pair trial. Over 900 community members including parents, teachers, and community leaders participated in the CEP over a 14 month period. The CEP was used to identify environmental intervention priorities to address six behavioral outcomes: increasing fruit/vegetable consumption, water intake, physical activity and sleep; and decreasing screen time and intake of sugar sweetened beverages. Community members were engaged through Local Advisory Committees, key informant interviews and participatory community meetings. Community-identified priorities centered on policy development; role modeling; enhancing access to healthy food, clean water, and physical activity venues; and healthy living education. Through the CEP, CHL identified culturally appropriate priorities for intervention that were also consistent with the literature on effective obesity prevention practices. Results of the CEP will guide the CHL intervention design and implementation. The CHL CEP may serve as a model for other underserved minority island populations.

Assessing intervention fidelity in a multi-level, multi-component, multi-site program: the Children's Healthy Living (CHL) program.

Addressing complex chronic disease prevention, like childhood obesity, requires a multi-level, multi-component culturally relevant approach with broad reach. Models are lacking to guide fidelity monitoring across multiple levels, components, and sites engaged in such interventions. The aim of this study is to describe the fidelity-monitoring approach of The Children's Healthy Living (CHL) Program, a multi-level multi-component intervention in five Pacific jurisdictions. A fidelity-monitoring rubric was developed. About halfway during the intervention, community partners were randomly selected and interviewed independently by local CHL staff and by Coordinating Center representatives to assess treatment fidelity. Ratings were compared and discussed by local and Coordinating Center staff. There was good agreement between the teams (Kappa = 0.50, p < 0.001), and intervention improvement opportunities were identified through data review and group discussion. Fidelity for the multi-level, multi-component, multi-site CHL intervention was successfully assessed, identifying adaptations as well as ways to improve intervention delivery prior to the end of the intervention.

Estudo da qualidade microbiológica, físico-química e sensorial de suco de laranja fresco envasado em garrafas plásticas / Study of microbiological, physic-chemical and sensorial quality of fresh juice marketed in plastic bottles

Avalia a qualidade microbiológica, físico-química e sensorial de algumas marcas de suco de laranja fresco envasado em garrafas plásticas. Quatro marcas de suco fresco provenientes de estabelecimentos diferentes foram analisadas. Realizou-se análise microbiológica, físico-química e sensorial. Os resultados do estudo mostraram que todas as amostras apresentaram coliformes totais e apenas duas apresentaram coliformes de origem fecal, porém em quantidades aceitáveis pela legislação brasileira. Todas as amostras estavam dentro dos padrões físico-químicos estabelecidos. No teste sensorial verificou-se que uma das amostras obteve a maior aceitação entre os provadores. Houve diferença sensorial significativa de todas as amostras comercializadas em relação à amostra padrão de suco fresco não envasado. Os resultados indicaram que a qualidade microbiológica e físico-química do suco influenciou diretamente nas características sensoriais do suco do mesmo. Por isso, a conservação adequada é muito importante para garantir ao consumidor um sabor original e agradável do suco de laranja fresco.