Application of the Epidemiological Model: Community-based Interventions for the Management of Obesity in Children and Young Adults

Healthy People 2010 identifies that one of the ten leading health indicators representative of the relative state of health of Americans is overweight and obesity (www.healthypeople.gov). The Institute for Medicine (IOM, 2005) has identified obesity in children and young adults as having reached epidemic proportions in the United States. This problem is noted nationally throughout the United States and is evidenced on individual state (i.e. Virginia), regional (i.e. the Hampton Roads area of Virginia) and local levels (i.e. Norfolk and Virginia Beach). The epidemic proportions of the obesity in children and young adults require interventions beyond that of the traditional one-toone intervention format. A community focused intervention strategy must be employed to target aggregate level health promotion. This community-based format supports approaches aimed at intervention at points in the natural history of obesity in the prepathogenic stages; this primary prevention can be planned and implemented with focus on modification of agent, host or environmental factors that are significant in the presence of obesity in children and young adults in a particular community. Obesity prevention strategies such as nutritional intervention following an epidemiologic model can be implemented on the local and regional levels to address the health problems related to obesity. Integration of the epidemiologic model within community-based programs provides the format for focusing on the obesity epidemic. Selected exemplars will be presented to illustrate these approaches.