Whole of Systems Trial Of Prevention Strategies for childhood obesity: WHO STOPS childhood obesity

Allender, Steven; Millar, Lynne; Hovmand, Peter S.; Bell, Colin; Moodie, Marj; Carter, Rob; Swinburn, Boyd; Lowe, Janette; Morgan, Sue; Orellana, Liliana; Strugnell, Claudia

doi:10.1016/j.orcp.2016.10.201

Cited by 30 publications

(65 citation statements)

References 11 publications

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“…A further apparent strength of this approach is the emphasis on rigorous process and application of best evidence in obesity prevention with the fundamental aim of community ownership. This process represents the current cutting edge of implementation and evaluation in community‐based intervention by providing a process to apply best evidence alongside a cluster randomized controlled trial and opt out consent outcomes measurement . Writing in the New England Journal of Medicine, Bleich argues the next step in prevention of chronic disease is a deliberate focus on population‐level approaches that make the healthy choice the easy choice rather than relying on individuals to purposefully change their own behaviour .…”

Section: Discussionmentioning

confidence: 99%

“…The Whole of Systems Trial of Prevention Strategies for Childhood Obesity (WHOSTOPS) is a cluster‐randomized trial of a systems approach to mobilizing community action for childhood obesity prevention in 10 communities from the Great South Coast region of Victoria, Australia. The design is reported in detail elsewhere but includes a pilot community Sustainable Eating Activity Change Portland (SEA Change Portland), five communities in the initial 2‐year period, and the remaining five joining after the second year. The intervention approach was to build and support capacity within intervention communities to apply methods inspired by community‐based system dynamics in the design, implementation, evaluation, and constant improvement of efforts to prevent childhood obesity.…”

Section: Methodsmentioning

confidence: 99%

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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%

Section: Methodsmentioning

confidence: 99%

Translating systems thinking into practice for community action on childhood obesity

et al. 2019

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“…Environments need to support and encourage physical activity and healthy diets and this needs to be across areas of higher and lower socio‐economic disadvantage. Indeed, the focus of recent obesity prevention work has shifted to trying to apply techniques from systems science, notably using techniques with entire communities to recognize the complexity of causes and use these in the design and implementation of efforts to prevent obesity . These efforts naturally include environmental changes to support healthy choices in a way that may promote equitable health outcomes.…”

Section: Discussionmentioning

confidence: 99%

Variation in the physical activity environment according to area‐level socio‐economic position—A systematic review

et al. 2019

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Summary Physical inactivity is a major contributing factor to obesity, and both follow a socio‐economic gradient. This systematic review aims to identify whether the physical activity environment varies by socio‐economic position (SEP), which may contribute to socio‐economic patterning of physical activity behaviours, and in turn, obesity levels. Six databases were searched. Studies were included if they compared an objectively measured aspect of the physical activity environment between areas of differing SEP in a high‐income country. Two independent reviewers screened all papers. Results were classified according to the physical activity environment analysed: walkability/bikeability, green space, and recreational facilities. Fifty‐nine studies met the inclusion criteria. A greater number of positive compared with negative associations were found between SEP and green space, whereas there were marginally more negative than positive associations between SEP and walkability/bikeability and recreational facilities. A high number of mixed and null results were found across all categories. With a high number of mixed and null results, clear socio‐economic patterning in the presence of physical activity environments in high‐income countries was not evident in this systematic review. Heterogeneity across studies in the measures used for both SEP and physical activity environments may have contributed to this result.

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“…It is also highly extensible: having used it to gain intuition about our central hypothesis as well as diffusion mechanics and community contexts, we can now begin applying it prospectively to provide useful input into the design and deployment of future interventions, such as whom to recruit into a steering committee and to what degree meetings need to increase their knowledge, engagement, and connections to one another. Whole‐of‐community interventions have continued to form an important plank in global efforts to prevent obesity , and tools such as the ABM described here, which may prospectively provide insight to create more effective coalitions and diffusion of knowledge, represent a critical next step in whole‐of‐community childhood obesity prevention.…”

Section: Discussionmentioning

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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Whole of Systems Trial Of Prevention Strategies for childhood obesity: WHO STOPS childhood obesity

Cited by 30 publications

References 11 publications

Translating systems thinking into practice for community action on childhood obesity

Translating systems thinking into practice for community action on childhood obesity

Variation in the physical activity environment according to area‐level socio‐economic position—A systematic review

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

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