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Abstract
There have been no significant changes in obesity prevalence in the last decade and obesity prevalence remains high in children. In 2011-2012 17.7% of children ages 6-11 in the United States were obese. Rural children in Georgia have higher obesity and overweight prevalence than children nationally. The home food environment plays a critical role in the nutrition related behavior and weight status of children. Many school-based interventions target childrens behavior, but fewer seek to change the home environment, which may represent an important target for interventions. Furthermore, there are notable disparities in childhood obesity by race and ethnicity, and these disparities may extend to aspects of the home environment. Understanding racial and ethnic disparities in the home environment may provide a richer understanding of how these disparities in childhood obesity come about. The Action Pack Families Study was a group-randomized trial designed to test the effectiveness of a school and home based intervention for the primary prevention of obesity in rural children. This intervention used children as agents of change for their family and community. Cross-sectional baseline analyses indicate that there are associations among food availability, child dietary intake, and child weight status and these associations differ by race and ethnicity. Parent weight status is a strong predictor of child weight status, which underscores the importance of interventions that target parents in order to achieve the best outcomes for children. In these interventions, the home food environment may be an important target for change. A longitudinal analysis of home environment outcomes over the course of one year of the intervention showed that most home environment outcomes did not change significantly over the course of the first year of the intervention. Similarly, there was not a significant change in child weight status although the prevalence of obesity in the intervention group remained stable. These results emphasize the importance of longer-term interventions that target not only the child but also the school, family and home environment, and community.