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在澳大利亚悉尼西南部采用社区主导的全系统方法解决儿童超重和肥胖问题的过程中进行跟踪实施。

Tracking implementation within a community-led whole of system approach to address childhood overweight and obesity in south west Sydney, Australia.

作者信息

Maitland Nicola, Wardle Karen, Whelan Jill, Jalaludin Bin, Creighton Doug, Johnstone Michael, Hayward Josh, Allender Steven

机构信息

Health Promotion Service, Population Health, South Western Sydney Local Health District, Liverpool, New South Wales, Australia.

Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Australia.

出版信息

BMC Public Health. 2021 Jun 26;21(1):1233. doi: 10.1186/s12889-021-11288-5.

Abstract

BACKGROUND

Obesity is a chronic disease that contributes to additional comorbidities including diabetes, kidney disease and several cancers. Change4Campbelltown implemented a 'whole of system' approach to address childhood overweight and obesity. We present methods to track implementation and stakeholder engagement in Change4Campbelltown.

METHODS

Change4Campbelltown aimed to build capacity among key leaders and the broader community to apply techniques from systems thinking to develop community-led actions that address childhood obesity. Change4Campbelltown comprised development of a stakeholder-informed Causal Loop Diagram (CLD) and locally-tailored action plan, formation of key stakeholder and community working groups to prioritise and implement actions, and continuous monitoring of intervention actions. Implementation data included an action register, stakeholder engagement database and key engagement activities and were collected quarterly by the project management team over 2 years of reporting.

RESULTS

Engagement activities increased level of community engagement amongst key leaders, the school-sector and community members. Community-led action increased as engagement increased and this action is mapped directly to the primary point of influence on the CLD. As action spread diversified across the CLD, the geographical spread of action within the community increased.

CONCLUSIONS

This paper provides a pragmatic example of the methods used to track implementation of complex interventions that are addressing childhood overweight and obesity.

摘要

背景

肥胖是一种慢性疾病,会引发包括糖尿病、肾病和几种癌症在内的其他合并症。坎贝尔敦变革行动采取了一种“全系统”方法来解决儿童超重和肥胖问题。我们介绍了在坎贝尔敦变革行动中跟踪实施情况和利益相关者参与度的方法。

方法

坎贝尔敦变革行动旨在增强关键领导者和更广泛社区运用系统思维技巧的能力,以制定由社区主导的解决儿童肥胖问题的行动。坎贝尔敦变革行动包括制定一份由利益相关者提供信息的因果循环图(CLD)和因地制宜的行动计划,组建关键利益相关者和社区工作组以确定行动的优先级并加以实施,以及持续监测干预行动。实施数据包括一份行动登记册、利益相关者参与度数据库以及关键参与活动,由项目管理团队在两年的报告期内每季度收集一次。

结果

参与活动提高了关键领导者、学校部门和社区成员的社区参与程度。随着参与度的提高,由社区主导的行动也有所增加,且这种行动直接对应于因果循环图上的主要影响点。随着行动在因果循环图上的分布日益多样化,社区内行动的地理分布范围也扩大了。

结论

本文提供了一个实用范例,展示了用于跟踪解决儿童超重和肥胖问题的复杂干预措施实施情况的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1d9/8236147/48293d23fe1d/12889_2021_11288_Fig1_HTML.jpg

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