Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Velenjak St., Shahid Chamran Highway, Tehran, Iran.
Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI), Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran.
BMC Public Health. 2023 Feb 15;23(1):344. doi: 10.1186/s12889-023-15163-3.
Community Readiness Intervention for Tackling Childhood Obesity (CRITCO) is a theory-based intervention being developed to improve the readiness of an Iranian urban population to engage in childhood obesity prevention programs. This study aimed to explore changes in readiness of intervention and control local communities from diverse socio-economic areas of Tehran.
This study was a seven-month quasi-experimental intervention implemented in four intervention communities and compared with four controls. Aligned strategies and action plans were developed around the six dimensions of community readiness. The Food and Nutrition Committee was established in each intervention community to make collaborative efforts among different sectors and assess the fidelity of the intervention. The pre-and post- readiness change was explored through interviews with 46 community key informants.
The total readiness of intervention sites increased by 0.48 units (p < 0.001) and shifted to the next higher level, from preplanning to the preparation stage. At the same time, the readiness of control communities decreased by 0.39 units (p < 0.001), although their readiness stage remained unchanged, reflecting the fourth stage. Also, a sex-dependent CR change was observed, such that the girls' schools showed a more remarkable improvement in interventions and less decline in controls. The readiness stages of interventions significantly improved for four dimensions related to community efforts, knowledge of the efforts, knowledge of childhood obesity issue, and leadership. Furthermore, the readiness of control communities significantly decreased on three of six dimensions related to community effort, knowledge of efforts, and resources.
The CRITCO successfully improved the readiness of intervention sites for addressing childhood obesity. It is hoped that the present study can be a spark for developing readiness-based childhood obesity prevention programs in Middle Eastern and other developing countries.
The CRITCO intervention was registered at Iran Registry for Clinical Trials ( http://irct.ir ; IRCT20191006044997N1) on 11/11/2019.
社区准备度干预以解决儿童肥胖问题（CRITCO）是一种基于理论的干预措施，旨在提高伊朗城市人口参与儿童肥胖预防计划的准备度。本研究旨在探讨来自德黑兰不同社会经济地区的干预和对照当地社区准备度的变化。
这是一项为期七个月的准实验干预研究，在四个干预社区实施，并与四个对照社区进行比较。围绕社区准备度的六个维度制定了一致的策略和行动计划。在每个干预社区都成立了食品和营养委员会，以促进不同部门之间的合作，并评估干预措施的保真度。通过对 46 名社区关键信息提供者的访谈，探讨了干预前后准备度的变化。
干预社区的总准备度增加了 0.48 个单位（p<0.001），从预规划阶段进入准备阶段。与此同时，对照社区的准备度下降了 0.39 个单位（p<0.001），尽管其准备度阶段保持不变，反映了第四阶段。此外，还观察到 CR 变化存在性别依赖性，即女孩学校在干预措施方面表现出更显著的改善，而在对照措施方面的下降幅度较小。与社区努力、对努力的了解、对儿童肥胖问题的了解以及领导力相关的四个维度的干预准备度显著提高。此外，与社区努力、对努力的了解和资源相关的六个维度中的三个，对照社区的准备度显著下降。
CRITCO 成功提高了干预社区解决儿童肥胖问题的准备度。希望本研究能够为中东和其他发展中国家制定基于准备度的儿童肥胖预防计划提供启示。
CRITCO 干预措施于 2019 年 11 月 11 日在伊朗临床试验注册中心（http://irct.ir；IRCT20191006044997N1）注册。
