Substantial variation across states in the prevalence and trends in childhood overweight and obesity indicate a need for state-specific surveillance to make state comparisons to national estimates and identify high-risk populations. The purpose of this study was to examine body mass index (BMI) trends among third-grade children in Ohio between the 2004–2005 and 2009–2010 school years and examine changes in prevalence of obesity by specific demographic subgroups. Third-grade children (n = 33,672) were directly weighed and measured throughout the school years by trained health care professionals. Trends in overweight/obesity (≥85th percentile of BMI by age/sex), obesity (≥95th percentile), and obesity level 2 (≥97th percentile) over five time periods (2004–2005, 2006–2007, 2007–2008, 2008–2009, 2009–2010) were modeled using logistic regression, accounting for the survey design and adjusting for sex, race/ethnicity, National School Lunch Program (NSLP) participation, and age. Differences in these BMI categories were also examined by these subgroups. BMI estimates did not demonstrate a statistically significant trend over the five time periods for overweight/obesity (34% to 36%), obesity (18% to 20%), or obesity level 2 (12% to 14%). However, increases in overweight/obesity prevalence were found in Hispanic children (37.8% vs 53.1%; P<0.01). Decreases in obesity (16.6% vs 14.1%; P=0.02) and obesity level 2 (11.3% vs 9.3%; P=0.02) were found among children not participating in NSLP and residing in suburban counties (obesity [17.3% vs 14.7%; P=0.03] and obesity level 2 [11.8% vs 9.8%; P=0.05]). Finally, decreases in overweight/obesity and obesity level 2 among boys were observed (15% vs 12.9%; P=0.02). Despite no significant overall trends in overweight/obesity, obesity, or obesity level 2 between 2004 and 2010, prevalence changed among specific subgroups. Obesity prevention efforts should be widespread and include special emphasis on groups experiencing increases or no change in prevalence.

We determined the efficacy of a Southwest Ohio state‐sponsored intervention to promote nutrition (Nu) and physical activity (PA) in preschool child care. We conducted baseline (7/08–4/09) and follow‐up (9/09–12/09) phone interviews with child care center directors on Nu and PA environments of centers in an intervention (I, N=108 centers, Dayton area) and a demographically similar control (C, N=162 centers, Cincinnati area) county. A self‐assessment was sent to the 108 I centers; 28 [active intervention (AI)] returned the application and received a Targeted Action Plan to address self identified deficiencies in Nu and PA environments. The 6mo (mean±SD) in global Nu (eg, meal environment, milk, juice, snacks, etc) and PA (eg, TV, outdoor play & muscle room features, etc) scores trended higher in AI than inactive intervention (II, N=80 centers) for Nu (0.86±1.71 v 0.10±2.74 p=0.21) and PA (0.96±3.74 v 0.00±3.35 p=0.18), but not C (Nu: 0.45±2.60, p=0.4; PA: 0.80±3.78, p=0.8). The trend in differences between AI and II remained after adjustment for race (25% and 27% primarily black in AI and II respectively) or % of children receiving meal subsidy (>75% of children for 39% of AI and 32% of II). These pilot data suggest the intervention could be effective as an annual state‐wide public health initiative, but a larger study is needed.RWJF‐supported