Preventing Childhood Obesity - Evidence Policy and Practice.pdf

Chapter 27
Table 27.1 Capacity building domains from the
Capacity Building Index.
Network
partnerships
Knowledge
transfer
Problem
solving
Infrastructure
The relationships between groups and
organizations within the project ' s network.
This includes both the comprehensiveness
and the quality of the relationships, i.e. are
all of the significant groups and
organizations involved and what is the
nature of their involvement.
The development, exchange and use of
information within and between the groups
and organizations within the project ' s
network.
The ability to use well - recognized methods
to identify and solve problems arising in the
development and implementation of the
project.
The level of investment in the project by
the groups and organizations that make up
the project ' s network. Infrastructure
includes both tangible and non - tangible
investments such as investment in the
development of protocols and policy, social
capital, human capital and financial capital.
of consensus on measuring indicators of capacity
building.
The Community Capacity Index (CCI ), 4 however,
is a useful evaluation tool and was administered for
the Be Active Eat Well Project to assist in identifying
baseline capacity to implement the project and
increases in capacity over time. Capacity was mapped
against a set of indicators within four domains (see
Table 27.1 ).
Within the first three domains, three levels of
capacity are identified, with each level measured by a
set of indicators. The fourth domain, infrastructure,
has four levels or sub - domains (policy, financial,
human/intellectual, and social investments), also with
sets of indicators. The indicators within the CCI represent
the abilities, behaviors or characteristics of the
project ’ s network. At baseline, basic capacity was
evident in network partnerships, knowledge transfer
and problem solving. Financial infrastructure was low
but social infrastructure was high. Over the three years
of the project, capacity demonstrably increased in all
four domains. At follow - up, similar levels of increase
in capacity were observed across the first three
domains. Financial infrastructure remained relatively
low while policy infrastructure made the highest gain
from baseline to follow - up.
Measuring community capacity is not only important
for helping us explain why an intervention did or
did not work. It also reminds evaluators of the need
to balance scientific evidence with community relevance,
29 to understand the value of communities being
able to make use of their own data, and to contribute
to the vital role of effective knowledge translation. 46
Conclusions
Obesity in a child predicts a lifetime risk of chronic
disease. Obese children have a 70 – 80% chance of still
being obese at age 20. 47 This makes prevention paramount.
The evidence suggests that the optimal
approach is to have multiple strategies occurring in
multiple settings to prevent childhood obesity, 19 but
this cannot be achieved in a sustainable way unless
communities are recognized as part of the solution.
To date there are no best - practice models of community
capacity building for childhood obesity prevention
to help communities do this. Fortunately,
however, community - based interventions are emerging
that can serve as demonstration models and we
have cited several examples. The next step is for these
intervention programs to form networks that bring
greater social and political support to community
programs and foster knowledge sharing so that the
obesity epidemic can be addressed more efficiently
and on a progressively larger scale. In Brazil, networks
of local community initiatives to promote healthy
diets and active lifestyles have been described as fundamental
for achieving sustainable behavior change. 48
Similar networks have been a key feature of the
EPODE program which now involves almost 200
towns in France, is also running in Spain (21 communities),
Belgium (18 communities) and is starting
in Canada, Greece and Australia.
A community - based approach encourages creativity
within communities, harnesses local passion to
provide healthy environments for children, and
empowers them to provide local solutions for their
own contexts. For these reasons, we should be optimistic
that significant and sustainable reductions in
childhood obesity are possible.
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