Wayfinding the Live 5-2-1-0 Initiative—At the Intersection between Systems Thinking and Community-Based Childhood Obesity Prevention

Abstract

Childhood obesity is complex and requires a ‘systems approach’ that collectively engages across multiple community settings. Sustainable Childhood Obesity Prevention through Community Engagement (SCOPE) has implemented Live 5-2-1-0—a multi-sector, multi-component childhood obesity prevention initiative informed by systems thinking and participatory research via an innovative knowledge translation (KT) model (RE-FRAME). This paper describes the protocol for implementing and evaluating RE-FRAME in two ‘existing’ (>2 years of implementation) and two ‘new’ Live 5-2-1-0 communities to understand how to facilitate and sustain systems/community-level change. In this mixed-methods study, RE-FRAME was implemented via online resources, webinars, a backbone organization (SCOPE) coordinating the initiative, and a linking system supporting KT. Qualitative and quantitative data were collected using surveys and stakeholder interviews, analyzed using thematic analysis and descriptive statistics, respectively. Existing communities described the consistency of Live 5-2-1-0 and extensive local partnerships/champions as catalysts for synergistic community-wide action; new communities felt that the simplicity of the message combined with the transfer of experiential learning would inform their own strategies and policies/programs to broadly disseminate Live 5-2-1-0. RE-FRAME effectively guided the refinement of the initiative and provided a framework upon which evaluation results described how to implement a community-based systems approach to childhood obesity prevention.

Collective Impact Partnership and Backbone Organizations as Enablers of Children’s Well-Being

“…Examples from Three Thematic CI Areas Thematically, most of the reviewed articles consisted of CI initiatives related to (1) children's nutrition, food, and obesity. For example, enhancing healthy eating and breastfeeding, healthy food consumption, obesity reduction, and assessing the impacts of nutrition-related CI initiatives provided the primary focus for the majority of the reviewed CI initiatives (Amed et al 2015(Amed et al , 2016Blake-Lamb et al 2018;Bonnevie et al 2020;Grumbach et al 2017;Leruth et al 2017;Hermann et al 2017;Meinen et al 2016). All CI initiatives related to food and nutrition, except for one which dealt with breastfeeding promotion (Leruth et al 2017), covered multiple regions, and included local partners.…”

Missing in Action: Indigenous Knowledge Systems in Evaluation of Comprehensive Community Initiatives

“…Generalizable methodologies focus on scientifically rigorous evaluation of complex community change initiatives that enhance their relevance for policy makers and/or funders to extend to other contexts (Amed et al, 2016;Komro et al, 2016;Lee & Chavis, 2012;Peters et al, 2016). Stepped Wedge Cluster Ran dom Control Trials, longitudinal studies with standardized continuous measure ment, interrupted time-series designs, multiple baseline designs, and cost-benefi t analysis were all identified as scientifically rigorous evaluation strategies for CCIs utilizing a range of quantitative data from cluster detection to socio-economic in dicators, asset mapping, and spatial patterning, as well as qualitative data through questionnaires and semi-structured interviews (Kingsley et al, 2014;Komro et al, 2016).…”

“…Who determines relevance and credibility, and what are the appropriate crite ria for such determinations? ( Abboud & Claussen, 2016;Amed, Shea, Pinkney, Wharf Higgins, & Naylor, 2016;Cabaj, 2014;Cook, 2015;Coombe, 2012;Fiester, 2011;Kania & Kramer, 2011) A related debate concerned scientific rigour. Developmental methodologies view internal validity as key to enabling contextual learning, connecting eff orts to outcomes within specific contexts (Bradford & Chouinard, 2009).…”

“…Some viewed these contextual aspects as critical components in evaluation (Kingsley, Coulton, & Pettit, 2014). Other perspectives viewed contextual issues as impediments to generalizability and focused on control over, as opposed to understanding of, such issues (Amed et al, 2016;Farrow & Schorr, 2011).…”

What are the elements of a whole system approach to community-centred public health? A qualitative study with public health leaders in England’s local authority areas

“…The literature also found that community involvement in research was an effective element. [33][34][35] The existence of active communities was a key element of local systems, enabled where needed by community development, social action and support for grassroots approaches and community asset transfer (ii. Active communities).…”