Propagating Change: Using RE-FRAME to Scale and Sustain A Community-Based Childhood Obesity Prevention Initiative

Abstract

Sustainable Childhood Obesity Prevention through Community Engagement (SCOPE) has developed Live 5-2-1-0, a multi-sectoral, multi-component community-based childhood obesity prevention initiative grounded in systems thinking and participatory research principles. Building on previous work, this study continued implementation of an innovative knowledge exchange model, RE-FRAME, in two ‘new’ and two ‘existing’ Live 5-2-1-0 communities. This mixed-methods study examined follow-up data to determine the nature and extent of the model’s ability to build and sustain community capacity and facilitate the scale-up and sustainability of systems- and community-level change. Qualitative and quantitative data were collected using stakeholder interviews, and quantitative process tracking (PTT) and capacity building tools (CCBT), and were analyzed using thematic analysis and descriptive statistics, respectively. Results from three communities with baseline and follow-up CCBT data showed capacity domain scores increased (15/27; 56%) or remained constant (10/27; 37%) over the study period. PTT data showed over 50 multi-sectoral community partnerships formed in Community D (new) and 108 actions implemented. Stakeholder interviews identified having a common cause, co-ownership, champion networks and consistency of the Live 5-2-1-0 message as essential to sustainability of the initiative. RE-FRAME supports knowledge exchange and community capacity-building that is integral to initiating and sustaining a community-based childhood obesity prevention initiative.

Theoretical Mediators of Diabetes Risk and Quality of Life Following a Diabetes Prevention Program for Latino Youth With Obesity

“…10 Health disparities research has shown that individual-level strategies may not be efficacious within vulnerable communities where there is a clear need to leverage social and familial connectedness for health promotion and disease prevention. 45 In fact, the most effective strategies for vulnerable, minority populations recognize that health behaviors occur in the context of relationships with family and friends. 46 Thus, interventions grounded in the SCT may need to be adapted to account for social and familial factors in order to maximize intervention effectiveness.…”

Aligning healthcare, public health and social services: A scoping review of the role of purpose, governance, finance and data

“…Websites and frequent meetings were also recommended (Heo et al., 2018 ). Others recommended transparent agendas, budgets and role definitions (van Duijn et al., 2018 ; Eckart et al., 2019 ; Green et al., 2014 ; Hedberg et al., 2019 ; Ho et al., 2019 ; Kennedy et al., 2019 ; Walker et al., 2012 ).…”

“…Perhaps most importantly, financing often comes with restrictions (Fisher & Elnitsky, 2012 ). In some cases, cuts in funding brought focus to collaboratives (Kennedy et al., 2019 ; Zahner et al., 2014 ) or were themselves a catalyst for collaboration (Cantor et al., 2015a ).…”

“…The literature suggests that current approaches to accountability could be both more realistic and idealistic: realistic in that challenges with effective accountability are more difficult to overcome than many anticipate and idealistic in that the lack of funding seems often to be considered nearly fatal even while organisations with limited resources continue to do impressive work. Certainly, budget shortfalls are very real, and communities often suffer because of this, but much good can also be accomplished with creative use of available funds, even when they are not as plentiful as they could be (Cantor et al., 2015a ; Kennedy et al., 2019 ; Zahner et al., 2014 ).…”

Engpassvermeidung in der Patientenversorgung

“…Jedoch können laut einer Studie 70 % der Veränderungsprojekte in Krankenhäusern nicht nachhaltig implementiert werden. Die größte Herausforderung liegt nicht im Start eines Verbesserungsprojektes, sondern in der Weiterführung der Veränderungsprozesse,nachdemderersteEnthusiasmusverflogenist [19].Für eine nachhaltige Prozessverbesserung bedarf es daher Beständigkeit, Akzeptanz und Zusammenführung [20].…”