Notes From the Field: Creating a Typology of Childhood Obesity Intervention Strategies

Abstract

Classification systems can be useful for evaluating and communicating the impact of interventions. We describe how a typology was created to inform the development of a community intervention dose index (CIDI) intended to measure the strength of impacts attributed to multiple childhood obesity intervention strategies implemented in a large, diverse urban jurisdiction in the United States during 2000–2016. The categorization system was constructed via a three-stage process: (Stage 1) identify relevant constructs for categorizing intervention strategies; (Stage 2) review peer-reviewed literature and program requests for proposals to identify and integrate common attributes of intervention strategies based on Stage 1 constructs; and (Stage 3) vet the results from prior stages to develop a final version of the typology, slated for research application and for use in program improvement. The final system grouped strategies into four macrolevel and five microlevel categories. Macrolevel strategies included government/public institutional policies, infrastructure investments, and business practices. Microlevel strategies included group education, counseling, health communication and social marketing, home visitation, and screening and referral. Grouping intervention strategies in a purposeful, classified manner facilitated communications among researchers and practitioners during the gathering and quantifying of intervention data for the CIDI project and may be used to guide scarce public health resource allocation decisions.

Provider–Patient Interactions as Predictors of Lifestyle Behaviors Related to the Prevention and Management of Diabetes

“…In this regard, investing in individual (micro-level) approaches to combat T2DM remains a critical action. These individual-level interventions should complement, rather than compete with, the sometimes more popular policy/system (macro-level) interventions that have been implemented by federal and state public health agencies during the past two decades, including those focused on childhood obesity prevention [40][41][42] and other chronic disease control targets for the general population [43][44][45].…”

Provider-Patient Interactions as Predictors of Lifestyle Behaviors Related to the Prevention and Management of Diabetes

“…In this regard, investing in individual (microlevel) approaches to combat T2DM remains a critical action. These individual-level interventions should complement, instead of compete with, the sometimes more popular policy/system (macro-level) interventions that have been implemented by federal and state public health agencies during the past two decades, including those focused on childhood obesity prevention [40][41][42] and other health promotion in the general population [43][44][45].…”

Learning More from What We Already Know About Childhood Obesity Prevention

“…One that relates directly to childhood obesity interventions used a taxonomic approach to develop a nine-component typology (a broad conceptual classification) of community intervention approaches-both macrolevel (e.g., policy and environmental change) and microlevel (directly targeting changes in individual behavior)-based on studies conducted in Los Angeles County in 2000-2016. 21 This typology was used to develop a quantitative Community Intervention Dose Index by coding each strategy for strength (expert judgments of effectiveness), estimated percentage of the target population reached (information from program grantees or, if necessary, expert judgment), and fidelity (evidence as to whether the intervention was implemented as intended). 22 Typology of Interventions in Proximal Physical Micro-Environments focuses on classifying strategies based on behavioral economics theory (''nudge'' approaches, or interventions on ''choice architecture'').…”