Introduction
In the recent decades, the issue of childhood obesity in the US has been increasingly coming to the forefront in the public view and in academia as a major health problem. Currently, the obesity rate in the States is some of the highest in the world, with a significant percentage of children being either simply overweight or outright obese as well.
Background and Significance of the Problem
One of three children in the US has excess weight issues, with obese children making up about 17 percent of the total population between the ages of 2 to 19 (Ogden, Carroll, Kit, & Flegal, 2014). It has been estimated that the numbers have grown to be seen as propagating unhealthy eating habits, coupled with lack of physical activity and other detrimental factors. These include uninhibited advertising of unhealthy (junk) foods in schools, high in calories, salt, sugar and fat, while healthier foods, high in nutrients, have a negligible presence in the advertisement scene. Communities are not equipped to educate children about the dangers of less healthy foods and the importance of a healthy lifestyle. They are often not equipped for active physical activity, and actively discourage it through absence of parks or safe roots for walking or biking. Similarly, community centers and child centers do not have unifying federal regulations and guidelines for healthy food promotion, and many community shops and retailers focus on unhealthy foods, decreasing the availability and affordability of healthy foods.

Obesity is strongly connected with a number of severe short and long-term health risks. These risks include increased cholesterol and blood pressure, which leads to higher risks of cardiovascular maladies, development of type 2 diabetes, breathing problems, and obesity later in life. There are also numerous problems related to the quality of living, which include low-esteem, negative perception of the quality of life, problems with social integration, all leading to psychological stress and depression (Childhood Obesity Causes & Consequences, 2015).

Statement of the Problem and Purpose of the Study
Despite the fact that reduction of childhood obesity is the target of many public health initiatives, with the Centers for Disease Control and Prevention, the Institute of Medicine, the US Surgeon General, and the government actively funding interventions at both state- and community levels, the effects have been minor. No significant changes have been recorded in both children and adults in the years 2003 to 2012, with obesity rates remaining high (Ogden et al., 2014).

However, several states have shown some measure of success at fighting obesity, with Oregon showing a 32 percent decline in obesity in the years 2003-2007, currently holding the last place among other states for childhood obesity (Singh, Kogan, & Dyck, 2010). Notably, according to a 2010 assessment, almost half of the schools did not sell less healthy food altogether and prohibited promotion of sweets and junk foods and 11 percent always offered healthy options first, and

This research will aim to study the childhood obesity-reducing interventions implemented in different states, how effective they are compared to those implemented in Oregon, and can similar interventions be recreated in other states to address the issue.

Research Questions, Hypothesis, and Variables with Operational Definitions
Research Question
What kinds of community nursing interventions support effective reductions in childhood obesity rates?
Hypothesis: Research and Null
This paper will test the hypothesis that the community interventions used in Oregon can be replicated in other states to achieve the same results. The research hypothesis is that application of these interventions and regulations in schools and communities in other states will be followed by gradual reduction of obesity prevalence. The null hypothesis would be that these interventions do not influence the obesity rates in significant ways, and that other local conditions and factors need to be studied to determine the causes of weight reduction among children in Oregon, in order to develop best practices.

Identifying and Defining Study Variables
The independent variable in this experimental study is the community nursing intervention, aimed at the removal of the unhealthy food promotion in communities and schools in particular, and active promotion of healthier, more nutritious foods. The dependent variables are the childhood obesity rates in the studied states. To achieve the most efficient comparison, the researchers would need to replicate the level of implementation of these interventions in Oregon, the controlled variables. This will allow the researchers to assess the differences in intervention effectiveness under the same conditions, and thus potentially find other factors affecting the differences in results.

Operationalize Variables
To successfully aggregate data in a coherent and reliable manner, the researchers would need to operationalize their variables. The experiment will assess the dependent variable childhood obesity levels, which will be determined by calculating what percentage of children with the amount of extra weight more than 10 percent higher than their body weight. The independent variable will be based on the total percentage of schools and communities to have fully integrated the same initiatives as Oregon. Finally, the passage of time will be estimated in years, following the same methodology as other studies. This should provide the research with a reliable way of interpreting the effectiveness of the experiment.

Literature Review
The United States continues to have a high prevalence level of childhood obesity. As Ogden, Carroll, Curtin, Lamb, and Flegal (2010) posit, a “in 2007-08, obesity prevalence (with body mass index (BMI) greater than or equal to the 95th percentile of the CDC growth chart) was 19.6% for children between 6 to 11 years of age and 18.1% for adolescents aged 12 to 19 years” (p.242). Alongside the increased incidence rates of childhood obesity, the consumption of energy intake obtained from take-away foods from home and at restaurants that deal with fast foods has been increasing rapidly (Bauer, Larson, Nelson, Story, & Neumark-Sztainer, 2009).

Fast foods are closely associated with higher calorific intake, fats, poor nutrient intake, higher sodium intake, and higher BMI. Hence, they correlate positively to the witnessed cases of childhood obesity. For example, Niemeier, Raynor, Lloyd-Richardson, Rogers, and Wing (2006) attribute a higher weight gain to the increased fast food intake during the transition age from adolescent to adulthood. Therefore, childhood obesity in the US is attributed to poor eating habits and meager food choices among children. These factors are modifiable through contextual and environmental factors such as making healthy foods available, ensuring that only convenient and appealing healthy foods are promoted, and/or adjusting prices. These approaches replicate Oregon’s childhood obesity interventions, which have significantly contributed to a reduction of the health problem.

Food prices form an important factor that determines the degree of consumption of unhealthy foods, which are associated with high childhood obesity. Indeed, the prevalence of childhood obesity varies according to household income. In case of Oregon, low-income earners (those earning $15,000 or less) with obesity stands at 29.4% compared to 25.1% of those who earn more than $15,000 (Oregon Health Authority, 2015). Consequently, successful childhood obesity intervention programs in Oregon incorporate parents whereby they (programs) are moderated to reflect their household incomes.

Benchmarking from the case of Oregon, other states intervention programs should focus on increasing the affordability of healthy food alternatives. When dealing with the problem of childhood obesity, most states recognize the value of school and family-based treatment approaches as two important facets of community-centered intervention for childhood obesity. For example, Kothandan (2014) reviews the effectiveness of the two aspects of interventions for childhood obesity. Cases of childhood obesity in the US have been increasing within the last ten years. Currently, childhood obesity is now considered a major public health issue. Consequently, an effective intervention program is inevitable if the problem must be dealt with in an amicable manner. However, amid this important proposition, Kothandan (2014) reviews articles published between 2001 and 2010. The author does not report the confidence intervals that are necessary in specifying the most effective community-based intervention approach.