Preventing Childhood Obesity - Evidence Policy and Practice.pdf

Chapter 26
participants for appropriateness (stage 2) then prioritized
according to importance and changeability
(stage 3). Within settings relevant to the community
(e.g. homes, early child care settings, schools, neighborhoods),
environmental barriers were prioritized. A
scoring and ranking process determined priorities.
The merge (stage 4) integrated the highest five to
seven ranked behavioral, knowledge, skill and environmental
elements as targets for action. These were
discussed, and in the final step, the agreed priority
elements were molded into a structured action plan
(stage 5). The behaviors were generally used to create
the objectives with the associated knowledge gaps and
environmental barriers being used to identify strategies.
It was important that objectives were written in
Specific, Measurable, Achievable, Relevant, Time -
bound (SMART ) format. 34 The action plans were
further refined with the community and timelines,
processes and accountability added. The action plan
became a “ living ” document, which guided implementation
and evolved through several versions
during the life of the project.
Sustainability
A community capacity building approach was chosen
to maximize sustainability and this was an objective
on its own as well as being built into all other objectives.
The extent to which this was achieved varied
across the programs. Projects with champions in high
places, engaged organizations with strong partnerships,
experience in securing funding, and a skilled
workforce were more likely to be sustainable. Where
possible, integration of strategies into the organizational
development domain was striven for. For
example, obtaining management support from an
organization to link with their strategic plan and then
integrating roles and responsibilities of workers to
align with the goals/objectives of the project would
assist with longevity. Additionally, ensuring actions
were integrated into existing policy and maximizing
actions for environmental change also contributed to
sustainability.
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