Abstract
Purpose and ObjectivesPolicy, systems, and environmental approaches are recommended for preventing childhood obesity. The objective of our study was to evaluate the Healthy Lifestyles Initiative, which aimed to strengthen community capacity for policy, systems, and environmental approaches to healthy eating and active living among children and families.Intervention ApproachThe Healthy Lifestyles Initiative was developed through a collaborative process and facilitated by community organizers at a local children’s hospital. The initiative supported 218 partners from 170 community organizations through training, action planning, coalition support, one-on-one support, and the dissemination of materials and sharing of resources.Evaluation MethodsEighty initiative partners completed a brief online survey on implementation strategies engaged in, materials used, and policy, systems, and environmental activities implemented. In accordance with frameworks for implementation science, we assessed associations among the constructs by using linear regression to identify whether and which of the implementation strategies were associated with materials used and implementation of policy, systems, and environmental activities targeted by the initiative.ResultsEach implementation strategy was engaged in by 30% to 35% of the 80 survey respondents. The most frequently used materials were educational handouts (76.3%) and posters (66.3%). The most frequently implemented activities were developing or continuing partnerships (57.5%) and reviewing organizational wellness policies (46.3%). Completing an action plan and the number of implementation strategies engaged in were positively associated with implementation of targeted activities (action plan, effect size = 0.82; number of strategies, effect size = 0.51) and materials use (action plan, effect size = 0.59; number of strategies, effect size = 0.52). Materials use was positively associated with implementation of targeted activities (effect size = 0.35).Implications for Public HealthCommunity-capacity–building efforts can be effective in supporting community organizations to engage in policy, systems, and environmental activities for healthy eating and active living. Multiple implementation strategies are likely needed, particularly strategies that involve a high level of engagement, such as training community organizations and working with them on structured action plans.
Highlights
Childhood obesity is a major public health concern in the United States and the world
Implications for Public Health Community-capacity–building efforts can be effective in supporting community organizations to engage in policy, systems, and environmental activities for healthy eating and active living
The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors’ affiliated institutions
Summary
Of the 218 surveys sent, 12 were returned because of an invalid email address, 126 had no response, and 80 were completed (39% response rate [80 of 206]). Partners who attended training sessions, completed an action plan, and engaged in more Healthy Lifestyles Initiative implementation strategies were more likely to use 12345 Fit-Tastic! The training sessions and action plan involved a higher level of engagement than other implementation strategies, suggesting that this higher level of engagement may be needed to support organizations to use healthy messaging materials. Disseminating messaging materials may increase organizations’ engagement in childhood obesity prevention, but messaging materials alone are not likely to be strong drivers of organization or behavior change and should be paired with policy, systems, and environmental supports such as training and action planning. Findings suggest that community-capacity–building efforts can support community organizations in implementing policy, systems, and environmental activities but that multiple implementation strategies are likely needed, activities that require a relatively high level of engagement, such as educational training and creating action plans
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