Department of Health Sciences, VU University of Amsterdam, De Boelelaan 1085, 1081HV, Amsterdam, The Netherlands.
EPODE International Network, 109-111 Rue Royale, 1000, Brussels, Belgium.
BMC Public Health. 2018 Jan 29;18(1):189. doi: 10.1186/s12889-018-5042-4.
Evaluation and monitoring methods are often unable to identify crucial elements of success or failure of integrated community-wide approaches aiming to tackle childhood overweight and obesity, yet difficult to determine in complex programmes. Therefore, we aimed to systematically appraise strengths and weaknesses of such programmes and to assess the usefulness of the appraisal tools used.
To identify strengths and weaknesses of the integrated community-based approaches two tools were used: the Good Practice Appraisal tool for obesity prevention programmes, projects, initiatives and intervention (GPAT), a self-administered questionnaire developed by the WHO; and the OPEN tool, a structured list of questions based on the EPODE theory, to assist face-to-face interviews with the principle programme coordinators. The strengths and weaknesses of these tools were assessed with regard to practicalities, quality of acquired data and the appraisal process, criteria and scoring.
Several strengths and weaknesses were identified in all the assessed integrated community-based approaches, different for each of them. The GPAT provided information mostly on intervention elements whereas through the OPEN tool information on both the programme and intervention levels were acquired.
Large variability between integrated community-wide approaches preventing childhood obesity in the European region was identified and therefore each of them has different needs. Both tools used in combination seem to facilitate comprehensive assessment of integrated community-wide approaches in a systematic manner, which is rarely conducted. Nonetheless, the tools should be improved in line to their limitations as recommended in this manuscript.
评估和监测方法通常无法确定旨在解决儿童超重和肥胖问题的综合性社区方法成功或失败的关键因素,但在复杂的项目中很难确定。因此,我们旨在系统地评估这些项目的优缺点,并评估所用评估工具的有用性。
为了确定综合社区方法的优缺点,我们使用了两种工具:世卫组织制定的肥胖预防计划、项目、倡议和干预措施良好实践评估工具 (GPAT),这是一个自我管理的问卷;以及基于 EPODE 理论的结构化问题清单 OPEN 工具,用于协助与主要项目协调员进行面对面访谈。这些工具的优缺点是根据实用性、获取数据的质量以及评估过程、标准和评分来评估的。
在所有评估的综合社区方法中,都发现了几个优缺点,每个方法都有不同的优缺点。GPAT 主要提供干预要素的信息,而通过 OPEN 工具,可以获取项目和干预层面的信息。
在欧洲地区,预防儿童肥胖的综合性社区方法存在很大的差异,因此它们各自都有不同的需求。本研究建议结合使用这两种工具,以系统的方式促进对综合性社区方法的全面评估,而这在实践中很少进行。尽管如此,这些工具应根据其局限性进行改进,正如本文所建议的那样。