Sustaining obesity prevention in communities: a systematic narrative synthesis review

Whelan, Jillian; Love, Patrick; Millar, Lynne; Allender, Steven; Bell, Colin

doi:10.1111/obr.12675

Cited by 44 publications

(75 citation statements)

References 94 publications

(281 reference statements)

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“…Further in‐depth empirical studies, such as key informant interviews, document analysis, and environmental audits would deepen the understanding of the key elements of success in whole of community efforts to prevent childhood obesity. Preliminary success raises questions about how sustainable these efforts will be and Whelan's systematic review of sustainability in community efforts to prevent obesity gives cause for optimism that sustainability is possible though rarely studied thoroughly nor adequately considered in intervention design. Similarly, the full evaluation of systems thinking in community‐based intervention is in its infancy, and real effort is required to establish the tools and resources to undertake thorough evaluation that serves both the community committed to acting and the broader need for other communities to learn what works and what does not.…”

Section: Discussionmentioning

confidence: 99%

Translating systems thinking into practice for community action on childhood obesity

et al. 2019

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SummaryWe report on the first 18 months of two communities' efforts using methods inspired by community‐based participatory system dynamics for the development, implementation, and evaluation of whole of community efforts to improve the health of children. We apply Foster‐Fishman's theoretical framework for characterizing systems change to describe the initiatives. Bounding the system began with defining leaders more broadly than standard health interventions to be those who had the ability to change environments to improve health, including food retailers, government, and business, and using high‐quality childhood monitoring data to define the problem. Widespread access to junk food, barriers to physical activity, and efforts to promote health predominantly through programmatic approaches were identified as potential root causes. System interactions existed in the form of relationships between stakeholder groups and organizations. The approach described built new relationships and strengthened existing relationships. Willingness in taking risks, changing existing practice, and redesigning health promotion work to have a community development focus, were levers for change. This approach has resulted in hundreds of community‐led actions focused on changing norms and environments. Insights from this approach may be useful to support other communities in translating systems theory into systems practice. Further empirical research is recommended to explore the observations in this paper.

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Section: Discussionmentioning

confidence: 99%

Translating systems thinking into practice for community action on childhood obesity

et al. 2019

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“…In a second workplace, the CEO chose to survey their staff prior to action which resulted in a sign being placed on the refrigerator to provide information about sugar content of the drinks. Effective leadership has been linked elsewhere to sustainable obesity prevention [31] and the capacity to implement health promoting strategies through community diffusion [32].…”

Section: Discussionmentioning

confidence: 99%

A rural community moves closer to sustainable obesity prevention - an exploration of community readiness pre and post a community-based participatory intervention

et al. 2019

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BackgroundUnderstanding levels of community readiness can result in prevention efforts that align with communities’ ability and capacity for change and, therefore, be more effective and sustainable. Our study aimed to use baseline (pre-intervention) community readiness scores to assist with the development of obesity prevention strategies, and to assess changes in community readiness over time (pre/post- intervention), to provide evidence of intervention impact.MethodOur study was located in a rural and remote area of Victoria, Australia. Community readiness was part of a broader obesity prevention intervention designed to create healthier food and physical activity environments through the combination of systems thinking and collaborative community-led solutions. Interviews were conducted using the community readiness to change tool in 2016 (pre) and 2018 (post) with a community representative sample. Baseline data informed the development of community relevant strategies and the pre/post results formed part of the overall evaluation.ResultsThe tool generated both quantitative and qualitative (quotes) data. A final readiness score was calculated that corresponded to one of the nine stages of readiness. Four of the five domains of the community readiness to change tool showed statistically significant improvements over time (p < 0.05): knowledge of effort, knowledge of issue, community climate, and leadership. The resources domain that did not improve pre/post intervention.ConclusionCommunity readiness to change interviews, pre- and post- intervention, provided essential information related to the appropriate targeting and pitch of the prevention strategies, as well as providing an overall evaluation of the positive movement in the community’s readiness to implement change.

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“…Any future community-led systems-based obesity prevention efforts should consider these recommendations in addition to documenting and publishing their learnings to build the evidence base for the implementation process of these initiatives. Future research should capture the view of those who do not engage in the approach and consider learnings from a systems lens in other community-based interventions, such as thinking about feedback loops and delays regarding factors influencing project implementation [18], how to apply this approach in policy making processes [19], and how to strengthen using a sustainability framework in planning, implementation and reporting stages to help communities maintain a healthy weight [20]. In utilising a combination of systems thinking, ABCD and collective impact across all four process stages, additional recommendations were identified from responses that are applicable throughout the entire process of implementation.…”

Section: Implications For Future Practicementioning

confidence: 99%

Process evaluation of a whole-of-community systems approach to address childhood obesity in western Victoria, Australia

Jenkins¹,

Lowe²,

Allender

et al. 2020

BMC Public Health

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Background: SEA Change Portland is a systems-based approach implemented in Portland, Victoria that utilises local community resources to sustainably prevent and reduce the prevalence of childhood obesity. Action is implemented by community-led task teams with differing priority areas, and supported by a steering committee representative of four collaborating organisations. This study examines the SEA Change Portland process to identify significant events, enablers and barriers of its development and implementation to date as reported by key stakeholders involved in implementation during the first 12 months. Methods: Semi-structured interviews were conducted with eight steering group members and three community task team members. Data was collected utilising open ended interview questions to gather in-depth information regarding program implementation, and the individual attitudes, beliefs and experiences of key stakeholders. Results: Data were analysed under three key themes: collective impact, systems thinking and asset based community development (ABCD). Participants gave perceptions of significant events; factors positively and negatively affecting the process; reasons for becoming involved in the process; perceived efficacy of task teams, principles of diversity and areas of concern. Themes emerged from participant responses allowing were categorisation of their responses into four key process stages: initial lead up; process development; establishing community ownership of the obesity system; and community action. Conclusion: Collective impact was a crucial element in applying the systems thinking. Strong and equitable relationships between steering organisations and topic experts provided the initiative with a sustainable foundation, and ABCD promotes community ownership and future sustainability. Understanding the process of implementing a new whole-of-community systems approach to childhood obesity prevention such as SEA Change Portland has provided vital knowledge for other communities regarding enablers and barriers of this promising approach.

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Sustaining obesity prevention in communities: a systematic narrative synthesis review

Cited by 44 publications

References 94 publications

Translating systems thinking into practice for community action on childhood obesity

Translating systems thinking into practice for community action on childhood obesity

A rural community moves closer to sustainable obesity prevention - an exploration of community readiness pre and post a community-based participatory intervention

Process evaluation of a whole-of-community systems approach to address childhood obesity in western Victoria, Australia

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