Community-based Obesity Prevention Research Articles

A systematic review of recruitment and retention of ethnic minorities and migrants in obesity prevention randomised controlled trials.

Participants' recruitment and retention into community-based interventions can be challenging, especially in research involving ethnic minorities and migrants. Despite known challenges, there are limited reviews that probe recruitment and retention strategies involving ethnic minorities and migrants in the Organisation for Economic Cooperation and Development (OECD) countries. This systematic review aimed to measure recruitment and retention rates and identify the barriers and facilitators to effective recruitment and retention of ethnic minorities and migrants in community-based obesity prevention Randomised Control Trials (RCTs) in OECD countries. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five databases (CINAHL, Cochrane, Embase, Medline and PsychInfo) were searched from January 2000 to March 2022, in addition to Google and Google Scholar. Methodological quality and risk of bias were assessed, and pooled analysis and meta-ethnographic analysis were conducted on the included studies. Twenty-five studies were included in the review. The pooled analysis found a 64% rate of recruitment of ethnic minorities in RCTs, with a retention rate of 71%. Key facilitators identified were-use of multiple communication channels, incentives, recruiting community champions, participant convenience and employing culturally sensitive strategies. Key barriers to participation were limited access to study sites, time constraints, limited trust, perceived fear, and anxiety. Findings suggest the importance of undertaking culturally appropriate recruitment and retention strategies to minimise barriers and facilitate effective recruitment and retention of low-income ethnic minorities and migrants in community-based research.

Are climate-change actions present in community-based obesity prevention interventions? Development and application of the DoublE-duty actions in CommunIty-baSed obesity InterVEntions (DECISIVE) framework

Abstract Aim Community-based obesity prevention interventions (CBOPIs) target the causes of obesity. Actions implemented in CBOPIs could simultaneously impact both climate change and obesity, making them a potentially important approach. To date, limited work has been undertaken to identify and categorise double-duty actions (those that simultaneously influence obesity and climate change) in CBOPIs. The prevalence of double-duty actions in CBOPIs is currently unknown. This paper outlines the development and application of the DoublE-duty actions in CommunIty-baSed obesity InterVEntions (DECISIVE) framework to address this gap. Subjects and methods A scoping review focusing on obesity and climate change was performed, and the results informed the development of DECISIVE. DECISIVE was applied to studies included in the Cochrane review of obesity prevention interventions in children, and both the published and unpublished data of a completed intervention. Results The scoping review identified one study and one systematic review which contributed to the development of DECISIVE. The framework lists nine double-duty actions, plus an ‘Other’ action. Each action’s potential impact on both obesity and climate change is summarised and example strategies are provided. Reduce the availability and consumption of ultra-processed foods was the most prevalent double-duty action when applying DECISIVE to published studies. Conclusion DECISIVE is the first framework to recognise double-duty actions on obesity and climate change in CBOPIs. The development of DECISIVE holds important implications for community stakeholders who may be able to better identify, incorporate, and promote double-duty actions. This may enhance stakeholder acceptability, feasibility, and value-for-money of interventions.

Using Human-Centered Design and Cocreation to Create the Live 5-2-1-0 Mobile App to Promote Healthy Behaviors in Children: App Design and Development

The prevalence of obesity among Canadian children is rising, partly because of increasingly obesogenic environments that limit opportunities for physical activity and healthy nutrition. Live 5-2-1-0 is a community-based multisectoral childhood obesity prevention initiative that engages stakeholders to promote and support the message of consuming ≥5 servings of vegetables and fruits, having <2 hours of recreational screen time, participating in ≥1 hour of active play, and consuming 0 sugary drinks every day. A Live 5-2-1-0 Toolkit for health care providers (HCPs) was previously developed and piloted in 2 pediatric clinics at British Columbia Children's Hospital. This study aimed to co-create, in partnership with children, parents, and HCPs, a Live 5-2-1-0 mobile app that supports healthy behavior change and could be used as part of the Live 5-2-1-0 Toolkit for HCPs. Three focus groups (FGs) were conducted using human-centered design and participatory approaches. In FG 1, children (separately) and parents and HCPs (together) participated in sessions on app conceptualization and design. Researchers and app developers analyzed and interpreted qualitative data from FG 1 in an ideation session, and key themes were subsequently presented separately to parents, children, and HCPs in FG-2 (co-creation) sessions to identify desired app features. Parents and children tested a prototype in FG 3, provided feedback on usability and content, and completed questionnaires. Thematic analysis and descriptive statistics were used for the qualitative and quantitative data, respectively. In total, 14 children (mean age 10.2, SD 1.3 years; 5/14, 36% male; 5/14, 36% White), 12 parents (9/12, 75% aged 40-49 years; 2/12, 17% male; 7/12, 58% White), and 18 HCPs participated; most parents and children (20/26, 77%) participated in ≥2 FGs. Parents wanted an app that empowered children to adopt healthy behaviors using internal motivation and accountability, whereas children described challenge-oriented goals and family-based activities as motivating. Parents and children identified gamification, goal setting, daily steps, family-based rewards, and daily notifications as desired features; HCPs wanted baseline behavior assessments and to track users' behavior change progress. Following prototype testing, parents and children reported ease in completing tasks, with a median score of 7 (IQR 6-7) on a 7-point Likert scale (1=very difficult; 7=very easy). Children liked most suggested rewards (28/37, 76%) and found 79% (76/96) of suggested daily challenges (healthy behavior activities that users complete to achieve their goal) realistic to achieve. Participant suggestions included strategies to maintain users' interest and content that further motivates healthy behavior change. Co-creating a mobile health app with children, parents, and HCPs was feasible. Stakeholders desired an app that facilitated shared decision-making with children as active agents in behavior change. Future research will involve clinical implementation and assessment of the usability and effectiveness of the Live 5-2-1-0 app.

Practical Strategies for Improving Sustainability and Scale-up of Noncommunicable Disease-related Public Health Interventions: Lessons from the Better Health Program in Southeast Asia.

The Better Health Program has been addressing key health system issues in the prevention and control of noncommunicable diseases (NCDs) in Malaysia, Thailand, Vietnam, and the Philippines. As the program comes to an end, the sustainability and scaling-up of issues have assumed importance. The objective is to assess how well sustainability and scale-up strategies have been integrated into the design and implementation of a 3-year multicountry technical program; to explore enablers and barriers of sustainability and scaling up; and to identify practical strategies that can improve sustainability and scale-up of Better Health Program interventions. We applied a staged approach to explore barriers and enablers and to identify practical strategies to improve sustainability and scale-up of four NCD interventions: community-based obesity prevention, front-of-pack labeling, local learning networks (LLNs), and NCD surveillance. We extracted evidence from peer-reviewed literature and local documents. We also conducted in-depth interviews with the implementation teams and key stakeholders. We conducted a thematic synthesis of the resulting information to identify practical strategies that improve sustainability and scale-up of the four interventions. Strong engagement of stakeholders at higher levels of the health system was identified as the main enabler, while limited funding and commitment from local governments were identified as a key barrier to sustainability and scale-up. Strengthening the social and institutional anchors of community health volunteers, enhancing evidence-based advocacy for front-of-pack labeling, trailblazing the LLN innovation, and securing the commitment of local governments in the implementation of NCD surveillance were among the key strategies for improving sustainability and scale-up of Better Health Program interventions in Malaysia, Thailand, Philippines, and Vietnam, respectively. This study identified practical strategies for improving sustainability and scale-up of NCD-related interventions. Implementation of the strategies that had high priority and feasibility will improve the sustainability of critical elements of the program in the respective countries.

Using Mixed Methods to Identify Community Needs/Challenges, Assets, and Opportunities for Promoting Healthy Weight in Preschool-Aged Children in Two Rural Communities

ObjectivesChild obesity is a serious public health concern in rural areas. Some multi-level child obesity prevention interventions have been conducted in the U.S., but none have targeted rural areas. This formative study assesses needs/challenges, assets, and opportunities to promote healthy weight in preschool-aged children in two rural communities that will guide the development of a multi-level community-based intervention. MethodsMixed methods were used in two rural communities in Indiana and North Carolina. Parents of children aged 2–5 years participated in focus groups (27 parents) or interviews (14 parents). Childcare providers (n = 13) and stakeholders from 23 community organizations participated in interviews. Observational audits of grocery stores and physical activity resources were conducted using CX3 and the Physical Activity Resource Assessment tools, respectively. ResultsFamily barriers included limited nutrition knowledge, cooking skills, and financial resources. Childcare providers cited a disconnect between childcare and home practices, lack of funding and training in health, and limited childcare options to meet family demands. Community level challenges centered on lack of transportation, limited infrastructure in the built environment to support healthy lifestyles, and limited community activities/opportunities to be physically active. Reported community challenges were supported by audits- 38% of stores carried high-quality fruits/vegetables; 25% met recommended standards for other healthy foods, and the average physical activity environment score was 0.6 (out of 3). Assets included community organizations (food pantries, farmers markets, childcare) that provided access to low-cost healthy meals and avenues for families to connect/learn about healthy lifestyles. Participants recommended that interventions involve community partnerships, target the entire family, improve resource dissemination to the community, leverage existing resources, and explore avenues to improve existing infrastructure. ConclusionsBarriers to healthy weight exist in rural areas, but there are assets that can be leveraged. These findings will guide the development of a rural community-based child obesity prevention intervention. Funding SourcesNIH award (5R03HD097393) and UNC Chapel Hill.

Evaluation proposal of a national community-based obesity prevention programme: a novel approach considering the complexity perspective

Community-based obesity prevention programmes are considered an important strategy to curb the obesity epidemic. The JOGG (Youth At a Healthy Weight) approach is a large-scale community-based programme for childhood obesity prevention in the Netherlands that has been implemented over the past ten years. Practice-based development of the programme, both at the national and local level, increasingly poses challenges for its evaluation. One considerable challenge is the increasing acknowledgement of the complexity in the JOGG-approach, characterized by (a) objectives that vary locally, (b) adaptions to the programme over time in response to a community’s shifting needs, challenges and opportunities, and (c) emergent outcomes and non-linear causality.We propose an evaluation framework that highlights elements of the complex local practice, including the local programme theory, implementation, adaption, the influence of context and feedback loops and intended as well as emergent and unintended outcomes. By studying each of these elements in practice, we hope to learn about principles that guide effective obesity prevention across contexts. The results of the proposed evaluation will inform both practice and research.Considering complexity in evaluation is a relatively new challenge in public health and therefore an emergent research area. The proposed framework for complex evaluations allows to retrospectively evaluate a programme that was implemented and developed in practice, and enables us to learn from practice-based experiences. Following the ISBNPA Dare2Share initiative, we kindly invite other researchers in the field to share their ideas and experiences regarding integration of complexity in evaluation.

A Theory of Change for Community-Based Systems Interventions to Prevent Obesity

Applying systems science in public health trials is a recent innovation in childhood obesity prevention. This paper aims to use systems science conventions to propose a theory of change for community-based interventions aiming to build capacity and use exemplars from systems science for obesity prevention to describe how this approach works. Participants were community-based researchers. A dynamic hypothesis was created in workshops conducted in 2020 and 2021 by identifying variables critical to building community capacity for systems thinking. These were used to develop stock and flow diagrams representing individual causal relationships, feedback loops, and the overall theory of change. The resultant model identified 9 stocks and 4 pairs of central balancing and reinforcing feedback loops. These represented building commitment through relationships, mutual learning, strengthening collaboration, and embedding capacity. The model is described using examples from 3 trials involving 25 communities across Victoria, Australia. This nonlinear and practice-based model illustrates the process of community-based obesity prevention. The model integrates >20 years of community-based intervention implementation experience, providing an overarching theory of how such interventions work to create change and prevent obesity.

Rethinking sustainability in childhood obesity prevention interventions: learning from South Australia's Obesity Prevention and Lifestyle (OPAL) Programme.

Increases in childhood obesity have occurred across a relatively short time-period, yet childhood obesity prevention is a longer-term game. Programmes have only identified population-level changes after 12 years of on-the-ground activity [Romon et al.]. Community stakeholders can impact the success of public health interventions [Ganter et al.; Lee et al.] and they have been identified as a critical success factor for programme sustainability [Schell et al.]. Qualitative research with stakeholders (n = 59) provides their insights and understandings of the sustainability of OPAL, a South Australian childhood obesity prevention programme. Stakeholders identified activities that they thought contributed to improved sustainability of action such as embedding obesity prevention into organizational policy and plans; and installation of infrastructure within communities to modify physical environments. In contrast, there was little appetite for sustaining OPAL or other formulations of a childhood obesity prevention programme. This research has implications for planning and implementation of community-based childhood obesity prevention initiatives when considering the balance of the portfolio of activities for implementation.

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

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.

Contamination within trials of community-based public health interventions: lessons from the HENRY feasibility study

IntroductionContamination occurs when participants allocated to trial control arms receive elements of the active intervention. Randomisation at cluster level, rather than individual level, may reduce or eliminate contamination, avoiding the dilution of intervention effectiveness that it may cause. However, cluster randomisation can result in selection bias and may not be feasible to deliver. We explored the extent of contamination in a qualitative study nested within a feasibility study of HENRY (Health, Exercise and Nutrition for the Really Young); a UK community-based child obesity prevention programme. We aimed to determine the nature and impact of contamination to inform a larger planned trial and other trials in community based public health settings.MethodWe invited participants to take part in the nested qualitative study who were already involved in the HENRY feasibility study. Semi-structured interviews/focus groups were conducted with children’s centre managers (n=7), children’s centre staff (n=15), and parents (n=29). Data were transcribed and analysed using an integrative approach. First, deductively organised using a framework guided by the topic guide and then organised using inductive thematic analysis.ResultsPotential for contamination between treatment arms was recognised by all stakeholder groups. Staff within the intervention centres presented the greatest risk of contamination, predominantly because they were often asked to work in other children centre’s (including control group centres). ‘Sharing of best practice’ by staff was reported to be a common and desirable phenomenon within community based settings. Parental sharing of HENRY messages was reported inconsistently; though some parents indicated a high degree of knowledge transfer within their immediate circles.ConclusionsThe extent of contamination identified has influenced the design of a future effectiveness trial of HENRY which will be clustered at the centre level (with geographically distinct clusters). The common practice of knowledge sharing amongst community teams means that this clustering approach is also likely to be most suitable for other trials based within these settings. We provide recommendations (e.g. cluster randomisation, training intervention facilitators on implications of contamination) to help reduce the impact of contamination in public health intervention trials with or without clustering, whilst enabling transfer of knowledge where appropriate.Trial registrationClinicalTrials.gov Identifier NCT03333733 registered 6th November 2017

Evaluating the Impact of the Healthy Kids Community Challenge (HKCC) on Physical Activity of Older Youth.

(1) Background: The Healthy Kids Community Challenge (HKCC) was a community-based obesity prevention intervention funded by the Government of Ontario (Canada). (2) Methods: A quasi-experimental design was used to examine the impact of the HKCC on physical activity (PA) outcomes using both repeat cross-sectional (T1 2014–2015, n = 31,548; T2 2015–2016, n = 31,457; and T3 2016–2017, n = 30,454) and longitudinal data (n = 3906) from the COMPASS study. Grade 9–12 students in HKCC communities were placed into one of three intervention groups [T2 data collection post-HKCC finishing (IG1), T2 data collection during HKCC (IG2), and T2 data collection pre-HKCC starting (IG3)], Ontario students in non-HKCC communities were Control Group 1 (CG1) and Alberta students were Control Group 2 (CG2). (3) Results: Repeat cross-sectional results show over time the HKCC had no significant impact on PA outcomes in any of the intervention groups. Longitudinal results show a significant decrease in time spent in moderate-to-vigorous PA (IG2: −3.15 min/day) between T1 and T3 in IG2. (4) Conclusions: These results suggest the HKCC did not have an impact on improving PA outcomes among older youth in HKCC communities. Moving forward, there is a need to provide effective and sustainable interventions to promote PA among older youth.

Facilitators and Barriers to Implementation of Community-Based Socio-Ecological Approaches to Obesity Prevention Among Cooperative Extension Agents

Perceptions, knowledge, and attitudes of Cooperative Extension Service (CES) Family and Consumer Science (FCS) agents related to the planning and implementation of community-based multi-level ecological obesity prevention strategies were identified through qualitative, exploratory research. Focus group discussions (FGD) were conducted in the five regions of the Louisiana State University CES (LSU AgCenter). Participants included CES FCS Extension agents (n = 35; 97% of agents). Participants were female and responsible for conducting programming in parishes (counties). Thematic analysis of data found principal factors that influenced FCS Extension agents’ perceived ability to plan and implement community-based multi-level obesity prevention approaches to include knowledge of the socio-ecological model, beliefs about roles of CES, funding, human resources, community connectedness, community buy-in, guidance, and internal support. Assessing what FCS agents perceived as barriers and facilitators to implementing community-based obesity prevention approaches provided valuable direction to the state FCS office. Understanding gaps in knowledge, professional development needs, and existing strengths will help make the transition to community-based obesity prevention initiatives more effective. These findings may be beneficial to other CES and public health agencies implementing multi-level, community-based obesity prevention programs in partnership with community coalitions.

The Development of a Multilevel Intervention to Optimise Participant Engagement with an Obesity Prevention Programme Delivered in UK children\u2019s Centres

Poor participant engagement threatens the potential impact and cost-effectiveness of public health programmes preventing meaningful evaluation and wider application. Although barriers and levers to engagement with public health programmes are well documented, there is a lack of proven strategies in the literature addressing these. This paper details the development of a participant engagement intervention aimed at promoting enrolment and attendance to a community-based pre-school obesity prevention programme delivered in UK children’s centres; HENRY (Health, Exercise, Nutrition for the Really Young). The Behaviour Change Wheel framework was used to guide the development of the intervention. The findings of a coinciding focused ethnography study identified barriers and levers to engagement with HENRY that informed which behaviours should be targeted within the intervention to promote engagement. A COM-B behavioural analysis was undertaken to identify whether capability, opportunity or motivation would need to be influenced for the target behaviours to occur. APEASE criteria were used to agree on appropriate intervention functions and behaviour change techniques. A multi-level participant engagement intervention was developed to promote adoption of target behaviours that were proposed to promote engagement with HENRY, e.g. ensuring the programme is accurately portrayed when approaching individuals to attend and providing ‘taster’ sessions prior to each programme. At the local authority level, the intervention aimed to increase buy-in with HENRY to increase the level of resource dedicated to engagement efforts. At the centre level, managers were encouraged to widen promotion of the programme and ensure that staff promoted the programme accurately. HENRY facilitators received training to increase engagement during sessions, and parents that had attended HENRY were encouraged to recruit their peers. This paper describes one of the first attempts to develop a theory-based multi-level participant engagement intervention specifically designed to promote recruitment and retention to a community-based obesity prevention programme. Given the challenges to implementing public health programmes with sufficient reach, the process used to develop the intervention serves as an example of how programmes that are already widely commissioned could be optimised to enable greater impact.

Community-based sugar-sweetened beverage intervention associated with short-term improvements in self-rated oral health.

To assess the efficacy of a community-based childhood obesity prevention intervention targeting Sugar-sweetened beverage (SSB) consumption on self-rated oral health among children and their parents/caregivers. This study is a secondary analysis of data from a pilot site-randomized intervention (H2 GO!) targeting SSB consumption and obesity risk among children. The 6-week SSB behavioural intervention was implemented in two Massachusetts Boys and Girls Club sites that were matched for size and racial/ethnic composition. Children ages 9-12years and their parents/caregivers were eligible to participate. Data on self-rated oral health and sociodemographics were obtained via self-report surveys at baseline, 2 and 6months. Generalized linear mixed regression models were used to estimate 2- and 6-month change in oral health associated with the intervention. Data are from 100 child participants (46% female; 38% Black, 20% Hispanic, 13% White, 12% Multiracial, 11% Asian) and 87 parent participants (78.2% female; 37.9% Hispanic, 29.9% Black, 14.9% Asian, 10.3% White). At baseline, 47% of child participants rated their oral health as good, followed by very good (32%), fair (11%) and excellent (10%). Among parents, 46.3% rated their oral health as good, followed by very good (29.3%), excellent (9.8%), fair (9.7%) and poor (4.9%). The intervention was associated with 2- and 6-month improvements in child participants' mean self-rated oral health scores (β=0.78; 95% CI: 0.48, 1.087; P<.001; β=0.98; 95% CI: 0.61, 1.34; P<.001, respectively) and with 2-month improvements in parent participants' mean self-rated oral health (β=0.42; 95% CI: 0.016, 0.82; P=.042). Short-term improvements in oral health among children and their parents/caregivers were observed among those participating in a SSB behavioural intervention. Community-based behavioural programmes targeting SSB consumption may be a promising approach to promote oral health as well as prevent childhood obesity.

Three-Year Changes in Low-Income Children's Physical Activity: Prospective Influence of Neighborhood Environment and Parent Supportive Behavior

To prospectively evaluate parent supportive behaviors (PSB) for child physical activity (PA) and neighborhood environment variables on changes in child PA over 3years. Secondary data analysis of the Now Everybody Together for Amazing and Healthful Kids-Worksstudy with 534 parent-child (age 2-4years) dyads randomized to a community-based pediatric obesity prevention intervention for 3years (92% retention). PSB and neighborhood environmental variables were examined in relation to changes in child moderate-to-vigorous PA (MVPA), light and sedentary activity, and screen time. Child and parent accelerometry data were collected at visit 0, 12, 24, and 36months. Mixed multivariate models were used to examine independent and interactive effects of parent-level and neighborhood-level variables on changes in child PA outcomes. PSB significantly interacted with visit on change in child MVPA (β=0.12) and sedentary behaviors (β= -0.18). Over 3years, a 1-unit increase in PSB was associated with an average increase of 4.3minutes/day of MVPA and an average decrease of 6.5minutes/day of sedentary time. Significant main effects were observed for PSB and 3-year change in child screen time (β=-0.05). The children of parents with higher PSB at baseline watched an average of 1.8 fewer minutes/day of screen time compared with parents with lower baseline PSB. Neighborhood-level variables were not significantly associated with changes in child PA outcomes. Parents who increase their supportive behaviors for their child's PA have children who are more physically active and less sedentary over time. Interventions to increase preschool-age children's PA may enhance their effectiveness by targeting parents' supportive behaviors for their child's PA.

Measuring commissioners\u2019 willingness-to-pay for community based childhood obesity prevention programmes using a discrete choice experiment

BackgroundIn the UK, rates of childhood obesity remain high. Community based programmes for child obesity prevention are available to be commissioned by local authorities. However, there is a lack of evidence regarding how programmes are commissioned and which attributes of programmes are valued most by commissioners. The aim of this study was to determine the factors that decision-makers prioritise when commissioning programmes that target childhood obesity prevention.MethodsAn online discrete choice experiment (DCE) was used to survey commissioners and decision makers in the UK to assess their willingness-to-pay for childhood obesity programmes.ResultsA total of 64 commissioners and other decision makers completed the DCE. The impact of programmes on behavioural outcomes was prioritised, with participants willing to pay an extra £16,600/year if average daily fruit and vegetable intake increased for each child by one additional portion. Participants also prioritised programmes that had greater number of parents fully completing them, and were willing to pay an extra £4810/year for every additional parent completing a programme. The number of parents enrolling in a programme (holding the number completing fixed) and hours of staff time required did not significantly influence choices.ConclusionsEmphasis on high programme completion rates and success increasing children’s fruit and vegetable intake has potential to increase commissioning of community based obesity prevention programmes.

Evaluation outcomes of a knowledge translation platform: a structure for support and exchange in prevention

Obesity prevention is an urgent public health priority that requires action at multiple levels. Collaboration between academics, policy and practice is necessary to ensure best-practice implementation. A national knowledge translation and exchange (KT) platform, the Collaboration of Community-based Obesity Prevention Sites (CO-OPS), was delivered and evaluated over three years (2013–15). A mixed-methods evaluation used communications and website data, knowledge-brokering data, event evaluations, interviews and tracer searches to assess process (reach, delivery, quality, cost, uptake) and impact (use of tools/resources, networking, improvements in practice). Results included: 1) average 27% yearly membership growth (330 new members per year) in response to KT activities including tailored communications, stakeholder engagement, knowledge brokering and networking opportunities; 2) sustained website use with approximately 1200 visits/month and 73% unique visitors; and high access to networking and professional development information (120 hits/month), and best practice guidelines (60 hits/month); 3) higher uptake of face-to-face interactive strategies (for example, workshops) than online interactive strategies (for example, knowledge broker service) and higher uptake of passive KT (for example, website resources) than interactive KT strategies (for example, workshops); 4) the KT function of CO-OPS was clearly valued, and appeared to address a gap in implementation. A central coordinating KT platform provided support for best practice and exchange opportunities to a broad network of practice, policy and academic professionals. Simple KT strategies such as tailored, targeted online resources were useful for practice, whilst more intensive KT strategies were important for network engagement. Findings are applicable to other information-sharing networks where professionals address complex public health problems.

The ‘GROW Social Network’ datasets

Abstract The GROW Social Network datasets were compiled as part of a 3-year community-based family-based pediatric obesity prevention intervention (N = 610). The datasets include (i) multiplex edges between adult study participants at four timepoints (baseline, 3, 12, and 36 mon), and (ii) multiplex edges within small intervention-only subgroups (30 groups of approximately 10 adult intervention participants) and a previously validated self-report measure of perceived cohesion at three timepoints (3, 6, and 12 wk). Actor attributes are richly characterized in a linkable dataset.

Community Based Obesity Prevention and Treatment Programme "6-10-14 for Health"

Community Based Obesity Prevention and Treatment Programme "6-10-14 for Health"

Changes in weight status, quality of life and behaviours of South Australian primary school children: results from the Obesity Prevention and Lifestyle (OPAL) community intervention program

BackgroundChildhood obesity is a serious public health concern worldwide. Community-based obesity prevention interventions offer promise due to their focus on the broader social, cultural and environmental contexts rather than individual behaviour change and their potential for sustainability and scalability. This paper aims to determine the effectiveness of a South Australian community-based, multi-setting, multi-strategy intervention, OPAL (Obesity Prevention and Lifestyle), in increasing healthy weight prevalence in 9 to 11-year-olds.MethodsA quasi-experimental repeated cross-sectional design was employed. This paper reports on the anthropometric, health-related quality of life (HRQoL) and behaviour outcomes of primary school children (9–11 years) after 2–3 years of intervention delivery. Consenting children from primary schools (20 intervention communities, INT; 20 matched comparison communities, COMP) completed self-report questionnaires on diet, activity and screen time behaviours. HRQoL was measured using the Child Health Utility 9D. Body Mass Index (BMI) z-score and weight status were determined from children’s measured height and weight. A multilevel mixed-effects model, accounting for clustering in schools, was implemented to determine intervention effect. Sequential Bonferroni adjustment was used to allow for multiple comparisons of the secondary outcomes.ResultsAt baseline and final, respectively, 2611 and 1873 children completed questionnaires and 2353 and 1760 had anthropometric measures taken. The prevalence of children with healthy weight did not significantly change over time in INT (OR 1.11, 95%CI 0.92–1.35, p = 0.27) or COMP (OR 0.85, 95%CI 0.68–1.06, p = 0.14). Although changes in the likelihood of obesity, BMI z-score and HRQoL favoured the INT group, the differences were not significant after Bonferroni adjustment. There were also no significant differences between groups at final for behavioural outcomes.ConclusionsOPAL did not have a significant impact on the proportion of 9 to 11-year-olds in the healthy weight range, nor children’s BMI z-score, HRQoL and behaviours. Long-term, flexible community-based program evaluation approaches are required .Trial registrationACTRN12616000477426 (12th April 2016, retrospectively registered).