Community-based interventions for obesity prevention: lessons learned by Australian policy-makers.

Michelle M Haby,Rebecca Doherty,Vicky Mason,Nicky Welch

doi:10.1186/1756-0500-5-20

Abstract

BackgroundInterest in community-based interventions (CBIs) for health promotion is increasing, with a lot of recent activity in the field. This paper aims, from a state government perspective, to examine the experience of funding and managing six obesity prevention CBIs, to identify lessons learned and to consider the implications for future investment. Specifically, we focus on the planning, government support, evaluation, research and workforce development required.MethodsThe lessons presented in this paper come from analysis of key project documents, the experience of the authors in managing the projects and from feedback obtained from key program stakeholders.ResultsCBIs require careful management, including sufficient planning time and clear governance structures. Selection of interventions should be based on evidence and tailored to local needs to ensure adequate penetration in the community. Workforce and community capacity must be assessed and addressed when selecting communities. Supporting the health promotion workforce to become adequately skilled and experienced in evaluation and research is also necessary before implementation.Comprehensive evaluation of future projects is challenging on both technical and affordability grounds. Greater emphasis may be needed on process evaluation complemented by organisation-level measures of impact and monitoring of nutrition and physical activity behaviours.ConclusionsCBIs offer potential as one of a mix of approaches to obesity prevention. If successful approaches are to be expanded, care must be taken to incorporate lessons from existing and past projects. To do this, government must show strong leadership and work in partnership with the research community and local practitioners.

Highlights

Interest in community-based interventions (CBIs) for health promotion is increasing, with a lot of recent activity in the field
And in Australia, there has been a shift from individually-focused interventions to a socio-ecological approach that looks beyond the individual to the environmental factors that impact on health and wellbeing [1,2]
Results from HPC:BAEW and similar CBIs will provide valuable information about the effectiveness of awareness raising and interventions targeted to the individual, when compared with broader strategies such as changes to organisational policies, creation of strong partnerships and changes to the environment

Summary

Introduction

Interest in community-based interventions (CBIs) for health promotion is increasing, with a lot of recent activity in the field. Recent trends in health promotion emphasise community-based (or whole-of-community) programs as an important strategy for achieving population-level change in risk factors and health. And in Australia, there has been a shift from individually-focused interventions to a socio-ecological approach that looks beyond the individual to the environmental factors that impact on health and wellbeing [1,2]. The impact of CBIs has been modest (with reduction in risk factors of between 5 and 15% at most) [4,5,6,7,8,9], with the exception of a number of HIV prevention programs that have shown larger impacts [1]

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