Understanding a successful obesity prevention initiative in children under 5 from a systems perspective

Owen, Brynle; Brown, Andrew; Kuhlberg, Jill; Millar, Lynne; Nichols, Melanie; Economos, Christina D.; Allender, Steven

doi:10.1371/journal.pone.0195141

Cited by 55 publications

(63 citation statements)

References 40 publications

(46 reference statements)

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“…This work represents a novel combination of two robust bodies of literature: whole-of-community interventions and diffusion of social phenomena through networks (5,(15)(16)(17)(18)(19)(20). This combination allowed us to build upon the powerful insights of each.…”

Section: Comparison To the Literaturementioning

confidence: 99%

Activating a Community: An Agent‐Based Model of Romp & Chomp, a Whole‐of‐Community Childhood Obesity Intervention

Kasman

Hammond

Heuberger

et al. 2019

Obesity

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Objective Successful whole‐of‐community childhood obesity prevention interventions tend to involve community stakeholders in spreading knowledge about and engagement with obesity prevention efforts through the community. This process is referred to by the authors as stakeholder‐driven community diffusion (SDCD). This study uses an agent‐based model in conjunction with intervention data to increase understanding of how SDCD operates. Methods This agent‐based model retrospectively simulated SDCD during Romp & Chomp, a 4‐year whole‐of‐community childhood obesity prevention intervention in Victoria, Australia. Stakeholder survey data, intervention records, and expert estimates were used to parameterize the model. Model output was evaluated against criteria derived from empirical data and experts’ estimates of the magnitude and timing of community knowledge and engagement change. Results The model was able to produce outputs that met the evaluation criteria: increases in simulated community knowledge and engagement driven by SDCD closely matched expert estimates of magnitude and timing. Conclusions Strong suggestive evidence was found in support of a hypothesis that SDCD was a key driver of the success of the Romp & Chomp intervention. Model exploration also provided additional insights about these processes (including where additional data collection might prove most beneficial), as well as implications for the design and implementation of future interventions.

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Section: Comparison To the Literaturementioning

confidence: 99%

Activating a Community: An Agent‐Based Model of Romp & Chomp, a Whole‐of‐Community Childhood Obesity Intervention

Kasman

Hammond

Heuberger

et al. 2019

Obesity

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“…CLDs are a tool that helps to understand the problem in the healthcare settings [26]. It is a tool which is widely used in the field of public health and health policy decision making: participant retention in HIV prevention programs, [29] exploring trust building in vaccination [28] or understanding obesity prevention programs [39]. To our knowledge, our CLDs are the first example of how to model TH adoption in the field of COPD by different HCPs.…”

Section: Discussionmentioning

confidence: 99%

Developing a strategic understanding of telehealth service adoption for COPD care management: A causal loop analysis of healthcare professionals

et al. 2020

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Background Telehealth services can improve the quality of health services for chronic obstructive pulmonary disease (COPD) management, but the clinical benefits for patients yet not clear. It is crucial to develop a strategy that supports the engagement of healthcare professionals to promote the sustainable adoption of telehealth services further. The aim of the study was to show how variables related to the perception of telehealth services for COPD by different healthcare professionals interact to influence its adoption and to generate advice for future telehealth service implementation. Methods Data was thematically synthesized from published qualitative studies to create causal loop diagrams, further validated by expert interviews. These diagrams visualize dependencies and their polarity between different variables. Results Adoption of telehealth services from the nurse's perspective is directly affected by change management and autonomous decision making. From the physician's perspective, perceived value is the most important variable. Physical activity management and positive user experience are considered affecting perceived value for physiotherapists. There is no consensus where self-management services should be positioned in the COPD care pathway.

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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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Understanding a successful obesity prevention initiative in children under 5 from a systems perspective

Cited by 55 publications

References 40 publications

Activating a Community: An Agent‐Based Model of Romp & Chomp, a Whole‐of‐Community Childhood Obesity Intervention

Activating a Community: An Agent‐Based Model of Romp & Chomp, a Whole‐of‐Community Childhood Obesity Intervention

Developing a strategic understanding of telehealth service adoption for COPD care management: A causal loop analysis of healthcare professionals

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

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