Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Missouri.
Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, 610 E 22nd St, Kansas City, MO 64108. Email:
Prev Chronic Dis. 2018 Feb 22;15:E24. doi: 10.5888/pcd15.170306.
Policy, systems, and environmental approaches are recommended for preventing childhood obesity. The objective of our study was to evaluate the Healthy Lifestyles Initiative, which aimed to strengthen community capacity for policy, systems, and environmental approaches to healthy eating and active living among children and families.
The Healthy Lifestyles Initiative was developed through a collaborative process and facilitated by community organizers at a local children's hospital. The initiative supported 218 partners from 170 community organizations through training, action planning, coalition support, one-on-one support, and the dissemination of materials and sharing of resources.
Eighty initiative partners completed a brief online survey on implementation strategies engaged in, materials used, and policy, systems, and environmental activities implemented. In accordance with frameworks for implementation science, we assessed associations among the constructs by using linear regression to identify whether and which of the implementation strategies were associated with materials used and implementation of policy, systems, and environmental activities targeted by the initiative.
Each implementation strategy was engaged in by 30% to 35% of the 80 survey respondents. The most frequently used materials were educational handouts (76.3%) and posters (66.3%). The most frequently implemented activities were developing or continuing partnerships (57.5%) and reviewing organizational wellness policies (46.3%). Completing an action plan and the number of implementation strategies engaged in were positively associated with implementation of targeted activities (action plan, effect size = 0.82; number of strategies, effect size = 0.51) and materials use (action plan, effect size = 0.59; number of strategies, effect size = 0.52). Materials use was positively associated with implementation of targeted activities (effect size = 0.35).
Community-capacity-building efforts can be effective in supporting community organizations to engage in policy, systems, and environmental activities for healthy eating and active living. Multiple implementation strategies are likely needed, particularly strategies that involve a high level of engagement, such as training community organizations and working with them on structured action plans.
政策、制度和环境方法被推荐用于预防儿童肥胖。我们研究的目的是评估健康生活倡议，该倡议旨在加强社区能力，以采取政策、制度和环境方法，促进儿童和家庭健康饮食和积极生活。
健康生活倡议是通过一个协作过程制定的，并由当地儿童医院的社区组织者提供便利。该倡议通过培训、行动计划、联盟支持、一对一支持以及材料的传播和资源的共享，支持了 218 名来自 170 个社区组织的合作伙伴。
80 名倡议合作伙伴完成了一份简短的在线调查，内容涉及所采用的实施策略、使用的材料以及倡议所针对的政策、制度和环境活动的实施情况。根据实施科学框架，我们使用线性回归来评估各结构之间的关联，以确定实施策略中哪些与所使用的材料和倡议所针对的政策、制度和环境活动的实施有关。
80 名调查受访者中，有 30%至 35%的人采用了每项实施策略。使用最多的材料是教育传单（76.3%）和海报（66.3%）。实施最频繁的活动是发展或继续伙伴关系（57.5%）和审查组织健康政策（46.3%）。完成行动计划和采用的实施策略数量与目标活动的实施（行动计划，效应大小=0.82；策略数量，效应大小=0.51）和材料使用（行动计划，效应大小=0.59；策略数量，效应大小=0.52）呈正相关。材料使用与目标活动的实施呈正相关（效应大小=0.35）。
社区能力建设工作可以有效地支持社区组织参与健康饮食和积极生活的政策、制度和环境活动。可能需要多种实施策略，特别是需要涉及高度参与的策略，例如培训社区组织并与他们一起制定结构化的行动计划。
