Department of Public Health, East Carolina University, Greenville, North Carolina (Dr Jilcott Pitts); and Department of Nutrition, Gillings School of Global Public Health and UNC Center for Health Promotion and Disease Prevention (Mss Smith, Thayer, Drobka, and Miller and Dr Ammerman), and Department of Medicine, School of Medicine (Dr Keyserling), University of North Carolina at Chapel Hill.
J Public Health Manag Pract. 2013 Nov-Dec;19(6):503-10. doi: 10.1097/PHH.0b013e3182893bbb.
Obesity-prevention policies are needed, particularly in low-income rural areas of the southern United States, where obesity and chronic disease prevalence are high. In 2009, the Centers for Disease Control and Prevention issued the "Common Community Measures for Obesity Prevention" (COCOMO), a set of 24 recommended community-level obesity-prevention strategies.
A variety of stakeholders in Lenoir County, North Carolina, were surveyed and interviewed, ranking the winnability, defined as feasibility and acceptability, of each of the 24 COCOMO-recommended strategies based on local culture, infrastructure, funding, and community support.
Mixed-methods.
This study was part of the Heart Healthy Lenoir project, a community-based project to reduce cardiovascular disease risk and disparities in risk in Lenoir County, North Carolina.
COCOMO assessments were conducted with 19 Community Advisory Council members and in-depth interviews were conducted with 11 community stakeholders. Heart Healthy Lenoir lifestyle intervention participants (n = 366) completed surveys wherein they ranked their support for 7 obesity-prevention strategies (based on the COCOMO strategies).
Ranking of obesity-prevention strategies.
Policies to improve physical activity opportunities were deemed the most winnable, whereas policies that would limit advertisement of unhealthy food and beverages were deemed the least winnable. The most winnable food-related strategy was improving mechanisms to procure food from local farms. Stakeholders perceived the public as unfavorably disposed toward government mandates, taxes, and incentives. Among Heart Healthy Lenoir participants, males indicated lower levels of support for COCOMO-related strategies than females, and African Americans indicated higher levels of support than white participants.
The formative work presented here provides insight into the winnability of proposed obesity-prevention policy change strategies in Lenoir County, North Carolina.
需要采取肥胖预防政策，尤其是在美国南部的低收入农村地区，这些地区肥胖症和慢性病的发病率很高。2009 年，美国疾病控制与预防中心发布了《肥胖预防共同社区措施》（COCOMO），这是一套 24 项推荐的社区层面肥胖预防策略。
北卡罗来纳州莱诺尔县的各种利益相关者接受了调查和访谈，根据当地文化、基础设施、资金和社区支持，对 COCOMO 推荐的 24 项策略中的每一项进行了可赢性（即可行性和可接受性）的排名。
混合方法。
本研究是“心脏健康莱诺尔”项目的一部分，这是一个在北卡罗来纳州莱诺尔县开展的以社区为基础的项目，旨在降低心血管疾病风险和风险差异。
19 名社区咨询委员会成员进行了 COCOMO 评估，11 名社区利益相关者进行了深入访谈。“心脏健康莱诺尔”生活方式干预参与者（n=366）完成了调查，他们对 7 项肥胖预防策略（基于 COCOMO 策略）表示支持。
肥胖预防策略排名。
提高体育活动机会的政策被认为是最可行的，而限制不健康食品和饮料广告的政策则被认为是最不可行的。最可行的与食品相关的策略是改善从当地农场采购食品的机制。利益相关者认为公众对政府强制命令、税收和激励措施持不利态度。在“心脏健康莱诺尔”参与者中，男性对 COCOMO 相关策略的支持程度低于女性，非裔美国人的支持程度高于白人参与者。
这里提出的形成性工作为了解北卡罗来纳州莱诺尔县拟议的肥胖预防政策变化策略的可赢性提供了深入的见解。
