(P19-023-24) Regional Causal Loop Diagram With Action Ideas for Improving Child Diet Quality and Weight Status in the Children’s Healthy Living Food Systems (CHLFS) Program

Objectives: This study developed a regional causal loop diagram (CLD) and action ideas for understanding how multilevel factors may interact and help to explain (1) successful intervention effects from the Children’s Healthy Living (CHL) community randomized intervention trial on diets and obesity of children, and (2) how the CLD can guide actions for resilient and sustainable food systems and improved nutrition and health for children.

Methods: One-day, in-person regional group model building (GMB) workshops with follow-up consultation were conducted across five Pacific jurisdictions - Alaska, American Samoa, Commonwealth of the Northern Mariana Islands, Guam and Hawai'i. The GMB workshops were co-led by trained, local co-investigators who customized. Participants worked in food systems and child food and nutrition programs. GMB workshops included the CHL intervention and maintenance effects on diet and health; preliminary CHL findings on dietary components (and relationship to child overweight and obesity, and acanthosis nigricans); and a series of participant-engaged GMB activities, including actions ideas for each jurisdiction. Jurisdiction-specific CLDs were then synthesized into a regional CLD.

Results: The regional CLD showed that key factors related to healthy diets for children were community and family programs, nutritional knowledge and cultural norms, local food production, schools and early child education, policies and regulations, child food preference and healthy eating habits, food cost, social media, household resources, land use, funding, availability of quality time, food storage and distribution, physical activity and exercise, environment climate change and weather, mental health, resource extraction based economy, access to local foods, and quality of preventive healthcare. These key factors, and the relationships between them, are the focus of local community actions and simulation modeling that are now in process.

Conclusions: The regional CLD with action ideas, developed by the CHL team, identified the variables that are being operationalized with local actions and allows for simulation modeling of relative impact of selected interventions on diet quality and weight status of children.

Funding Sources: USDA NIFA AFRI, NIH NHLBI, NIH NCI