Preventing Childhood Obesity - Evidence Policy and Practice.pdf

Community capacity building
Facilitating a ccess to
a dditional r esources
Additional resources are the catalyst for building the
capacity of a community to create change. The
resources required at the start include funding from
various sources and technical expertise on obesity
prevention and evaluation. Initial funding for community
- based health promotion should ideally be
provided by government health departments because
they have the mandate to promote community health
and they are the first to become aware of emerging
health risks. Achieving this, however, usually requires
advocacy to ensure that funding is put towards prevention
rather than treatment. In addition, the
funding needs to be locally rather than centrally controlled
because the concepts of community empowerment
and capacity building are easily lost in health
department contract requirements, politics and
bureaucracy. Health departments can also provide the
technical expertise on obesity prevention and evaluation
that communities need to take action, although
universities can also fill this role, particularly where
they are closely linked with the community.
The Sentinel Site for Obesity Prevention was a demonstration
site in the Barwon - South West region of
Victoria, Australia, that aimed to build the programs,
skills and evidence necessary to attenuate and eventually
reverse the obesity epidemic in children and adolescents.
30 It was based on a partnership between the
region ’ s university (Deakin University) and its health,
education and local government agencies. For each of
the three community - based childhood obesity prevention
projects supported by the Sentinel Site, the government
health department provided initial funding
for the projects and the university provided technical
expertise (training) and evaluated the projects.
Once the capacity building process has begun, facilitating
access to additional resources becomes a
process of supporting communities to reorientate
existing resources towards obesity prevention. For
example, in the Be Active Eat Well project which targeted
children aged 4 to 12 years of age, the local
government agency saw synergies between the
project ’ s goal of increasing physical activity and their
own goal of supporting local sports clubs. In order to
maximize these, they contributed the time and
resources of their Sport and Recreation Officer to reg-
istering children ’ s participation in an after - school
activity program. It also involved supporting the community
to build up core internal funding streams and
to access external resources such as grants and/or
sponsorship.
Most community - based programs do not seek to
involve the private sector in obesity prevention, in part
because of “ strings ” that often come with the resources
they provide. However, to stay true to the idea that
obesity prevention requires multiple strategies in multiple
settings, and that the private sector needs to be
involved, Good for Kids Good for Life has a strategy
to attract sponsors to the program not only to expand
the resources available but also to engage and reorientate
businesses and the private sector towards creating
healthier environments for children. A policy has
been developed to minimize the risks associated with
such commercial sponsorship (see Box 27.4 ).
Shape up Sommerville was a successful obesity
intervention aimed at children in Massachusetts
that used a community - based participatory research
(CBPR ) approach. 17 As part of this approach, researchers
successfully helped intervention communities
secure over $1.5 million from other funding sources
for the interventions. In the pilot phase of a community
- based obesity prevention initiative in France
(Ensemble, prévenons l ’obésité des enfants [EPODE ]
translated as “ Together we can prevent obesity in children
” ), 38 most of their funds were received from the
private sector (including the food industry) and less
than a quarter from public sources such as regional
councils, education, research and health departments.
Currently, the mix is closer to 50:50 from the private
sector (including food industry 18%, but also insurance
agencies, distributors, foundations) and from
public sector, mainly from the local government. The
private funds are dedicated to central coordination —
organizing, training, coaching, social marketing
development and communications. The public funds
are for the local communities to pay local project
managers and for tools (personal communication,
Borys JM 2008).
Developing s tructures for
c ommunity d ecision m aking
There is a tremendous amount of creativity, innovation
and know - how in communities. With adequate
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