Haby Michelle M, Doherty Rebecca, Welch Nicky, Mason Vicky
Prevention & Population Health Branch, Victorian Government Department of Health, 50 Lonsdale St, Melbourne, Victoria 3000, Australia.
BMC Res Notes. 2012 Jan 10;5:20. doi: 10.1186/1756-0500-5-20.
Interest in community-based interventions (CBIs) for health promotion is increasing, with a lot of recent activity in the field. This paper aims, from a state government perspective, to examine the experience of funding and managing six obesity prevention CBIs, to identify lessons learned and to consider the implications for future investment. Specifically, we focus on the planning, government support, evaluation, research and workforce development required.
The lessons presented in this paper come from analysis of key project documents, the experience of the authors in managing the projects and from feedback obtained from key program stakeholders.
CBIs require careful management, including sufficient planning time and clear governance structures. Selection of interventions should be based on evidence and tailored to local needs to ensure adequate penetration in the community. Workforce and community capacity must be assessed and addressed when selecting communities. Supporting the health promotion workforce to become adequately skilled and experienced in evaluation and research is also necessary before implementation.Comprehensive evaluation of future projects is challenging on both technical and affordability grounds. Greater emphasis may be needed on process evaluation complemented by organisation-level measures of impact and monitoring of nutrition and physical activity behaviours.
CBIs offer potential as one of a mix of approaches to obesity prevention. If successful approaches are to be expanded, care must be taken to incorporate lessons from existing and past projects. To do this, government must show strong leadership and work in partnership with the research community and local practitioners.
对基于社区的健康促进干预措施（CBIs）的兴趣日益浓厚，该领域近期开展了大量活动。本文旨在从州政府的角度审视资助和管理六项预防肥胖的社区干预措施的经验，找出经验教训，并思考对未来投资的影响。具体而言，我们关注所需的规划、政府支持、评估、研究和劳动力发展。
本文介绍的经验教训来自对关键项目文件的分析、作者管理项目的经验以及从关键项目利益相关者那里获得的反馈。
社区干预措施需要精心管理，包括足够的规划时间和明确的治理结构。干预措施的选择应基于证据，并根据当地需求进行调整，以确保在社区中有足够的覆盖面。在选择社区时，必须评估并解决劳动力和社区能力问题。在实施之前，还需要支持健康促进劳动力在评估和研究方面具备足够的技能和经验。对未来项目进行全面评估在技术和可承受性方面都具有挑战性。可能需要更加强调过程评估，并辅以组织层面的影响措施以及对营养和身体活动行为的监测。
社区干预措施作为预防肥胖的多种方法之一具有潜力。如果要扩大成功的方法，必须注意吸取现有和过去项目的经验教训。为此，政府必须发挥强有力的领导作用，并与研究界和当地从业者合作。
