Cyril Sheila, Polonsky Michael, Green Julie, Agho Kingsley, Renzaho Andre
School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
Department of Marketing, Deakin Business School, Deakin University, 221 Burwood Highway, Burwood, Vic. 3125, Australia. Email.
Aust Health Rev. 2017 Jul;41(3):297-307. doi: 10.1071/AH16069.
Objective Disadvantaged communities bear a disproportionate burden of childhood obesity and show low participation in childhood obesity prevention initiatives. This study aims to examine the level of readiness of disadvantaged communities to engage with childhood obesity prevention initiatives. Methods Using the community readiness model, 95 semi-structured interviews were conducted among communities in four disadvantaged areas of Victoria, Australia. Community readiness analysis and paired t-tests were performed to assess the readiness levels of disadvantaged communities to engage with childhood obesity prevention initiatives. Results The results showed that disadvantaged communities demonstrated low levels of readiness (readiness score=4/9, 44%) to engage with the existing childhood obesity prevention initiatives, lacked knowledge of childhood obesity and its prevention, and reported facing challenges in initiating and sustaining participation in obesity prevention initiatives. Conclusion This study highlights the need to improve community readiness by addressing low obesity-related literacy levels among disadvantaged communities and by facilitating the capacity-building of bicultural workers to deliver obesity prevention messages to these communities. Integrating these needs into existing Australian health policy and practice is of paramount importance for reducing obesity-related disparities currently prevailing in Australia. What is known about the topic? Childhood obesity prevalence is plateauing in developed countries including Australia; however, obesity-related inequalities continue to exist in Australia especially among communities living in disadvantaged areas, which experience poor engagement in childhood obesity prevention initiatives. Studies in the USA have found that assessing disadvantaged communities' readiness to participate in health programs is a critical initial step in reducing the disproportionate obesity burden among these communities. However, no studies in Australia have assessed disadvantaged communities' readiness to engage in obesity prevention initiatives. What does this paper add? This paper addresses the current gap in the knowledge of disadvantaged communities' level of readiness to engage in childhood obesity prevention initiatives in Australia. The study also identified the key factors responsible for low readiness of disadvantaged communities to participate in current childhood obesity prevention services. By using the Community Readiness model this study shows the readiness levels specific to the various dimensions of the model; Understanding dimension-specific readiness allows us to identify strategies that are tailored to each dimension, as guided by the model. What are the implications for practitioners? With the increasing burden of childhood obesity on disadvantaged communities, policymakers and health practitioners are facing a crisis in obesity prevention and management. Almost every year, new interventions are being planned and implemented. However if the target communities are not ready to participate in the available interventions these efforts are futile. This study exposes the key factors responsible for low readiness to participate in current obesity prevention services by disadvantaged communities. Addressing these key factors and improving readiness before designing new interventions will improve the participation of disadvantaged communities in those interventions. The study findings ultimately have the potential of reducing obesity-related disparities in Australia.
目的 处境不利社区承受着儿童肥胖的不成比例的负担,且在儿童肥胖预防倡议中的参与度较低。本研究旨在考察处境不利社区参与儿童肥胖预防倡议的准备程度。方法 采用社区准备度模型,对澳大利亚维多利亚州四个处境不利地区的社区进行了95次半结构化访谈。进行了社区准备度分析和配对t检验,以评估处境不利社区参与儿童肥胖预防倡议的准备水平。结果 结果显示,处境不利社区参与现有儿童肥胖预防倡议的准备程度较低(准备度得分=4/9,44%),缺乏对儿童肥胖及其预防的知识,并且报告在启动和持续参与肥胖预防倡议方面面临挑战。结论 本研究强调需要通过解决处境不利社区中与肥胖相关的低文化水平问题,以及促进双语工作者向这些社区传递肥胖预防信息的能力建设,来提高社区准备度。将这些需求纳入澳大利亚现有的卫生政策和实践对于减少目前澳大利亚普遍存在的与肥胖相关的差异至关重要。关于该主题已知的情况是什么?在包括澳大利亚在内的发达国家,儿童肥胖患病率趋于平稳;然而,澳大利亚与肥胖相关的不平等现象仍然存在,尤其是在处境不利地区的社区,这些社区在儿童肥胖预防倡议中的参与度较低。美国的研究发现,评估处境不利社区参与健康项目的准备程度是减轻这些社区不成比例的肥胖负担的关键第一步。然而,澳大利亚尚未有研究评估处境不利社区参与肥胖预防倡议的准备程度。本文补充了什么?本文填补了澳大利亚在处境不利社区参与儿童肥胖预防倡议准备程度知识方面的当前空白。该研究还确定了导致处境不利社区参与当前儿童肥胖预防服务准备程度低的关键因素。通过使用社区准备度模型,本研究展示了该模型各维度特有的准备水平;了解各维度特有的准备度使我们能够在该模型的指导下确定针对每个维度量身定制的策略。对从业者有何启示?随着儿童肥胖给处境不利社区带来的负担日益加重,政策制定者和卫生从业者在肥胖预防和管理方面面临危机。几乎每年都在规划和实施新的干预措施。然而,如果目标社区没有准备好参与现有的干预措施,这些努力将是徒劳的。本研究揭示了导致处境不利社区参与当前肥胖预防服务准备程度低的关键因素。在设计新的干预措施之前解决这些关键因素并提高准备度,将提高处境不利社区对这些干预措施的参与度。该研究结果最终有可能减少澳大利亚与肥胖相关的差异。