Preventing Childhood Obesity - Evidence Policy and Practice.pdf

CHAPTER 7
Evidence of m ulti - s etting a pproaches for o besity
p revention: t ranslation to b est p ractice
Andrea M. de Silva - Sanigorski 1,2 and Christina Economos 3,4
1 WHO Collaborating Centre for Obesity Prevention, Deakin University, Geelong, Australia
2 Jack Brockoff Child Health and Wellbeing Program, McCaughey Centre, Melbourne
School of Population Health, The University of Melbourne, Melbourne, Australia
3 Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA,
USA
4 John Hancock Center for Physical Activity and Nutrition, Tufts University, Boston, MA,
USA
Summary and recommendations
for practice
• Childhood obesity is a complex issue and both individual
efforts and societal changes are needed.
• Multi - setting, community - wide strategies directed
at all ages and groups offer a comprehensive, equitable
and intergenerational response to the problem.
• Interventions should be developed within an integrated
chronic disease prevention model and with a
community - based participatory research framework
to maximize funding and health impact.
• Interventions that attempt to alter health behaviors
must not be developed in isolation from the broader
social and environmental context.
• Obesity prevention programs must include rigorous
evaluation involving multiple levels and various settings
to guide improvements to childhood obesity
efforts in a range of contexts.
Method
For this chapter we scanned and reviewed the published
literature (e.g., PubMed and CINAHL ® , The
Cumulative Index to Nursing and Allied Health
Literature) to select studies that were effective and
Preventing Childhood Obesity. Edited by
E. Waters, B.A. Swinburn, J.C. Seidell and R. Uauy.
© 2010 Blackwell Publishing.
examined the key elements that were consistent across
the studies. With input from both authors, the evidence
was synthesized and integrated into recommendations.
There was no restriction on studies outside
the developed countries. However, there is no large
representation of studies outside developed countries,
which may limit the applicability of the recommendations
developed.
Social c hange m odels:
w hat c an w e l earn?
Population behavior is influenced by several societal
subsystems, including the economy, the political
system, social institutions, and culture. To influence
behavior on a broad societal level, multiple subsystems
must be targeted. To that end, understanding how to
prevent a further rise in obesity can been informed
through lessons from a range of successful attempts at
social change that include increasing breastfeeding
rates, seat - belt use, smoking cessation and recycling. 1
Key elements identified as essential from these past
successes include: recognition that there was a crisis;
major economic implications associated with the
crisis; a science base including research, data and evidence;
sparkplugs, or leaders who can work for their
cause through their knowledge, competence, talents,
skills, and even charisma; coalitions to move the
agenda forward and a strategic, integrated media
advocacy campaign; involvement of the government
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