Open Access Research article

Changes in diet and physical activity resulting from the Shape Up Somerville community intervention

Sara C Folta1*, Julia F Kuder1, Jeanne P Goldberg1, Raymond R Hyatt2, Aviva Must2, Elena N Naumova3, Miriam E Nelson1 and Christina D Economos1

Author Affiliations

1 John Hancock Research Center on Physical Activity, Nutrition, and Obesity Prevention, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA 02111, USA

2 Department of Public Health and Community Medicine, School of Medicine, Tufts University, Medford, USA

3 Department of Civil and Environmental Engineering, School of Engineering, Tufts University, Medford, USA

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BMC Pediatrics 2013, 13:157  doi:10.1186/1471-2431-13-157

Published: 4 October 2013



The purpose of this study is to describe the behavioral changes in children resulting from Shape Up Somerville (SUS), a community-based, participatory obesity prevention intervention that used a multi-level, systems-based approach. It was set in Somerville, an urban, culturally diverse community in Massachusetts, USA.


This was a non-randomized, controlled 2-year community-based intervention trial with children enrolled in grades 1 to 3 (ages 6-8 years). Overall, the SUS intervention was designed to create environmental and policy change to impact all aspects of a child’s day. Pre-post outcomes were compared between Somerville and two control communities that were chosen based on socio-demographic similarities. Behavioral outcomes were fruit and vegetable and sugar-sweetened beverage consumption; number of organized sports and physical activities per year; walking to and from school; screen and television time; television in bedroom; and dinner in room with television on. These measures were assessed by parent/caregiver report using a 68-item Family Survey Form. Data were analyzed using multiple linear regression, accounting for covariates and clustering by community.


Intervention group children, compared to the control group, significantly reduced sugar-sweetened beverage consumption (-2.0 ounces per day; 95% CI -3.8 to -0.2), increased participation in organized sports and physical activities (0.20 sports or activities per year; 95% CI 0.06 to 0.33), and reduced their screen time (-0.24 hours per day; 95% CI -0.42 to -0.06).


Results of this study, particularly intake of sugar-sweetened beverages and screen time, are similar to others that used a multi-level approach to realize change in behavior. These results support the efficacy of a multi-level and systems-based approach for promoting the behavioral changes necessary for childhood obesity prevention. This study is registered at as NCT00153322.

Eco-social model; Childhood obesity; Diet; Physical activity; Screen time