Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.
Southern Grampians Glenelg Primary Care Partnership, Hamilton, Victoria, Australia.
PLoS One. 2022 May 11;17(5):e0266654. doi: 10.1371/journal.pone.0266654. eCollection 2022.
Community-based interventions have shown promise in reducing childhood overweight and obesity. However, they have been critiqued for using linear logic models. Participatory community-based systems approaches are posited as addressing the complexity of non-linear relationships in a local context. Community members are empowered to understand and describe obesity causation, identify and prioritise possible solutions. The application of such approaches to childhood obesity is in its infancy.
To describe the first 12 months of a participatory whole-of-community systems approach to creating collective action to tackle childhood obesity, called GenR8 Change, in a local government area of Victoria, Australia.
Three group model building (GMB) sessions focused on the development of a causal loop diagram (CLD), prioritised evidence-informed actions, and developed implementation strategies. The collective impact framework underpinned the approach, with a local backbone group supporting community members to implement prioritised actions.
The first two GMB sessions included 20 key community leaders where a CLD examining the factors contributing to childhood obesity in the community was constructed and refined (22 variables GMB1, 53 variables GMB2). In the third session, 171 members of the wider community further refined the CLD, identified priorities for childhood obesity prevention (72 variables in final CLD). One-hundred and thirteen individuals signed up across 13 working groups to plan and implement 53 prioritised actions. Agreed community actions included creating sugar free zones; developing healthy policies; increasing breastfeeding rates; improving drinking water access; and increasing physical activity options. Twelve months post-GMB3, 115 actions had been implemented.
GenR8 Change is one of the first communities to apply systems thinking to childhood obesity prevention. Knowledge on how to collectively identify relevant leverage points to tackle childhood obesity can now be shared with other communities.
基于社区的干预措施已被证明在减少儿童超重和肥胖方面具有潜力。然而,它们因使用线性逻辑模型而受到批评。参与式基于社区的系统方法被认为可以解决当地非线 性关系的复杂性。社区成员有能力理解和描述肥胖的成因,确定和优先考虑可能的解决方案。这种方法在儿童肥胖领域的应用还处于起步阶段。
描述澳大利亚维多利亚州一个地方政府区域采用参与式全社区系统方法来开展集体行动以解决儿童肥胖问题的前 12 个月的情况,该方法称为 GenR8 Change。
三次小组模型构建 (GMB) 会议重点是制定因果关系图 (CLD)、确定循证行动的优先次序以及制定实施策略。该方法以集体影响框架为基础,由一个当地骨干小组支持社区成员实施优先行动。
前两次 GMB 会议包括 20 名主要社区领导人,他们构建并完善了一个考察社区中导致儿童肥胖的因素的 CLD(GMB1 有 22 个变量,GMB2 有 53 个变量)。在第三次会议上,更广泛的社区的 171 名成员进一步完善了 CLD,确定了儿童肥胖预防的优先事项(最终 CLD 中有 72 个变量)。有 113 人在 13 个工作组中报名,计划和实施 53 项优先行动。达成的社区行动包括创建无糖区;制定健康政策;提高母乳喂养率;改善饮用水供应;以及增加体育活动选择。在 GMB3 之后的 12 个月,已经实施了 115 项行动。
GenR8 Change 是首批将系统思维应用于儿童肥胖预防的社区之一。现在可以与其他社区分享如何共同确定解决儿童肥胖问题的相关杠杆点的知识。