OPREVENT2 Community Action Component to Promote Healthy Policy, Systems, and Environments With Native American Communities: Process Evaluation and Lessons Learned

Abstract

Abstract Objectives To assess the implementation of the Community Action Component (CAC) of OPREVENT2, which aimed to promote healthy food and physical activity policies, systems, and environments (PSE) with six Native American communities. Methods OPREVENT2 examined the impact of a multi-level, multi-component obesity prevention intervention in six tribal communities in the Southwest and Midwest regions of the US (Three randomly selected to receive the intervention first, three to receive second). The CAC was designed to identify and develop PSE changes in partnership with community partners. We developed the following implementation standards prior to the intervention: we aimed to hold monthly meetings that were ≥1 hour and recruited ≥10 participants representing different stakeholder groups (health staff, store employee, tribal leader, school teachers/staff, and community members). We used measures of frequency to evaluate the extent that we met established reach, dose delivered, and fidelity standards. Results CAC meetings used participatory approaches to discuss ways to use PSE changes to encourage healthy eating and physical activity in stores, schools, worksites, and communities. Overall, we achieved high dose delivered; we held one monthly meeting on average that ranged 60–120 minutes. Reach varied by community; on average we attained 64%, 101%, 479% of the participants. Meetings were attended most often by community members, health staff, and tribal leaders, with low participation from store employees or school teachers/staff. Whenever possible, CAC meetings were planned with existing meetings to enhance reach to encourage sustainability and enable collaboration with community partners. Future interventions could develop a tribal council resolution to encourage other stakeholder groups to attend and promote sustainability of intersectoral work at an earlier stage. Assessing community readiness could assist in developing strategies to promote PSE changes that are tailored to each community. Conclusions The inclusion of CAC complements community-based obesity prevention strategies in Native American communities and can achieve moderate to high reach, dose-delivered, and fidelity. Funding Sources National Heart, Lung, and Blood Institute.