Higher CE also has been found to be associated with spending fewer hours watching television, playing computer games, and engaging in social media (known as recreational screen time), and screen time has been positively associated with overweight and obesity. For example, communities with higher CE have lower prevalence of obesity, depression, and risk-taking behaviors and lower rates of morbidity and mortality when compared with similar communities with lower CE. Improving CE shows promise for improving health outcomes. This method of estimating an intervention’s CE dose and examining change over time and effect of CE and its building blocks on intervention outcomes shows promise.
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Significantly more activities facilitating empowerment and civic engagement were conducted in high-dose communities, which were more likely to show improvements in screen time, than in low-dose communities. The correlation between change in screen time and CE dose was significant ( r s = 0.83, p =. Next, communities were categorized as having a high CE dose or a low CE dose, and differences between four high-dose and five low-dose communities were compared using a two-tailed t-test. CE dose at each time interval and change in screen time was correlated using Spearman’s rho. Monthly reports from nine intervention communities were quantified, and CE dose was calculated for each community overall, at 4 time intervals (6, 12, 18, and 24 months), and for each CE building block-social bonding, social bridging, social leveraging, empowerment, and civic engagement.
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We used data from CHL to estimate CE dose and examine its association with a successful outcome from CHL-reduction in children’s recreational screen time. The 2 year Children’s Healthy Living (CHL) intervention aimed to improve child behaviors known to affect obesity. However, processes to increase CE and estimate its dose within an intervention are not well understood. Increased community collective efficacy (CE), defined as social cohesion among neighbors and their willingness to intervene for common good, is associated with improved community health outcomes.