Ganter Claudia, Aftosmes-Tobio Alyssa, Chuang Emmeline, Blaine Rachel E, Land Thomas, Davison Kirsten K
Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 2, 3rd Floor, Boston, MA, 02115, USA.
Department of Health Care Management, Technical University Berlin, Strasse des 17. Juni 135, Berlin, 10623, Germany.
J Community Health. 2016 Apr;41(2):305-14. doi: 10.1007/s10900-015-0097-y.
Prior research has identified numerous factors contributing to increased rates of childhood obesity. However, few studies have focused explicitly on the experience of community stakeholders in low-income communities. This study sought to capture the perspectives of these on-the-ground experts regarding major factors contributing to childhood obesity as well as gaps in current prevention and control efforts. We conducted semi-structured interviews with 39 stakeholders from different community sectors (e.g., healthcare providers, childcare providers, teachers). Data were drawn from the Massachusetts Childhood Obesity Research Demonstration project, a multi-level, multi-sector intervention designed to reduce childhood obesity being implemented in two low-income communities in Massachusetts. Interviews were conducted at baseline, transcribed, coded using grounded theory approach, and analyzed in NVivo 10.0. The vast majority of stakeholders had recently participated in obesity prevention strategies, and nearly all of them identified gaps in prevention efforts either within their organizations or in the broader community. In addition to factors previously identified in the literature, several themes emerged including the need to change policies to increase physical activity during school, offer healthier snacks in schools and afterschool programs, and increase communication and collaboration within the community in prevention efforts. Community stakeholders can impact the success of interventions by bridging the gap between science and lived experience. The results of this study can guide future research by highlighting the importance of including stakeholders' frontline experiences with target populations, and using information on identified gaps to augment intervention planning efforts.
先前的研究已经确定了许多导致儿童肥胖率上升的因素。然而，很少有研究明确关注低收入社区中社区利益相关者的经历。本研究旨在了解这些一线专家对导致儿童肥胖的主要因素以及当前预防和控制工作中的差距的看法。我们对来自不同社区部门（如医疗保健提供者、儿童保育提供者、教师）的39名利益相关者进行了半结构化访谈。数据来自马萨诸塞州儿童肥胖研究示范项目，这是一项旨在降低儿童肥胖率的多层次、多部门干预措施，正在马萨诸塞州的两个低收入社区实施。访谈在基线时进行，转录后，采用扎根理论方法进行编码，并在NVivo 10.0中进行分析。绝大多数利益相关者最近都参与了肥胖预防策略，几乎所有人都指出了其所在组织内部或更广泛社区在预防工作中的差距。除了文献中先前确定的因素外，还出现了几个主题，包括需要改变政策以增加在校期间的体育活动、在学校和课后项目中提供更健康的零食，以及在预防工作中加强社区内部的沟通与合作。社区利益相关者可以通过弥合科学与实际经验之间的差距来影响干预措施的成功。本研究的结果可以通过强调纳入利益相关者与目标人群的一线经验的重要性，并利用已确定差距的信息来加强干预计划工作，从而指导未来的研究。
