Preventing Childhood Obesity - Evidence Policy and Practice.pdf

Chapter 26
Victoria, Australia. The projects were based on health
promotion principles taking a community capacity
23 – 25
building approach and aimed to build actions,
community skills and contribute to the evidence for
obesity prevention.
Each project aimed to strengthen their community
’ s capacity to promote healthy eating and physical
activity, and to prevent unhealthy weight gain in children.
26 All action plans had three objectives around
community capacity building, communications and
evaluation, with a further 4 – 6 behavioral objectives
and 1 – 2 innovative or pilot project objectives. All
projects used quasi - experimental evaluation designs
with parallel comparison groups and >1,000 children
in each arm. 26 Funding came from multiple government
and public research funding sources.
Sentinel s ite p rojects
“Romp & Chomp ” targeted preschool children and
their families within the City of Greater Geelong from
2005 to 2008 ( ∼ 12,000 children under 5 years of age).
Nineteen long day care facilities, 44 family day care
centers and 38 kindergartens consented to being
involved in the evaluation of the project. The project
had a strong focus on developing sustainable changes
in areas of policy, socio - cultural, physical and economic
environments. 27
“ Be Active Eat Well ” ( BAEW ) targeted children
aged 4 – 12 years and their families in the rural town of
Colac. Primary schools ( n = 6) were the major setting
for action but other settings such as kindergartens,
neighborhoods and fast - food outlets were involved. 28
Positive anthropometric changes have been reported
in this project. 29
“ It ’ s your Move! ” focused on secondary school students
aged 13 – 17 years. All secondary schools ( n = 5)
from the East Geelong/Bellarine Peninsula area of
Geelong were selected. Student ambassadors worked
throughout the project as advocates and implementers.
This project was part of the four - country
Pacific intervention study: Obesity Prevention In
Communities ( OPIC ).
30,31
A research team for the Sentinel Site, based at
Deakin University, supported the interventions, provided
training, assisted with building capacity and, in
particular, was responsible for the evaluation component
of each project. The full logic model for the
way the interventions were assumed to influence the
outcomes and their associated measured and modeled
components is shown in Figure 26.2 .
Community e ngagement and e stablishing
s tructures and r oles
The projects began by engaging key stakeholders in
the target settings and relevant government and non -
government agencies. Champions (people visible and
influential in the community) helped cement the
engagement process.
Program management, organizational structures,
coordination and strategic alliances were established
to support implementation. An interim steering committee
with membership from stakeholders established
the project and employed a project coordinator.
After 6 – 9 months this committee was structured
into a two - tiered management system (Reference
Committee and Local Steering Committee) to coincide
with the implementation phase. The Reference
Committee ’ s role was to provide higher - level strategic
input and support and the Local Steering Committee
was empowered to implement the project, including
budgetary decisions. Members included project staff
and those at the grass roots in the project ’ s key settings
and terms of reference were established for each
committee.
Developing an a ction p lan
The ANGELO process was used to assist each community
set priorities for action, culminating in
an action plan. 14 This was achieved mainly through
a facilitated workshop with key stakeholders and, in
the case of It ’ s Your Move!, with members of the
target group (adolescents). The “ elements ” in the
framework refer to a list of potential target behaviors,
knowledge and skill gaps, and environmental barriers
developed from the literature, local evidence and
experience, and specific analyses or targeted
research.
32,33
The ANGELO process had five stages as outlined in
Figure 26.3 , with steps 2 – 5 occurring within a two - day
workshop. 14
At the workshop, the situational analysis (stage 1)
was presented including evidence from the literature
on obesity and obesity prevention and other technical
assessments, as well as information from the community
engagement process (e.g. existing programs).
A potential list of elements were scanned/altered by
228