Department of Applied Health Science, Indiana University Bloomington, Bloomington, IN, United States.
Department of Health Behavior, North Carolina Translational and Clinical Sciences Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Front Public Health. 2024 May 31;12:1372890. doi: 10.3389/fpubh.2024.1372890. eCollection 2024.
Multi-level interventions promoting healthy weight in rural preschool children aged 2-5 years are limited. With the goal of developing a community-informed obesity prevention intervention for rural preschool-aged children, the purpose of this descriptive study was to identify: (1) community settings and intervention strategies to prioritize for an intervention; (2) potential implementation challenges and solutions; and (3) immediate interventions the study team and community partners could collaboratively implement. Workshops occurred in two rural communities in Indiana (2 workshops) and North Carolina (2 workshops), with high obesity rates. A guide was developed to moderate discussions and participants voted to rank community settings and intervention strategies. There were 9-15 participants per workshop, including parents, childcare providers, and representatives of community organizations. Community settings identified as priorities for child obesity prevention included the home, educational settings (preschools), food outlets, recreational facilities, and social media. Priority intervention strategies included providing nutrition and physical activity education, increasing access to healthy foods and physical activity in the built environment, and enhancing food security. Potential intervention implementation challenges centered on poor parental engagement; using personalized invitations and providing transportation support to families were proffered solutions. Immediate interventions to collaboratively implement focused on making playgrounds esthetically pleasing for physical activity using game stencils, and nutrition education for families via quarterly newsletters. This participatory approach with community partners provided insight into two rural communities' needs for child obesity prevention, community assets (settings) to leverage, and potential intervention strategies to prioritize. Findings will guide the development of a multi-level community-based intervention.
多层面干预措施可促进农村 2-5 岁学龄前儿童的健康体重，但此类干预措施有限。本研究旨在为农村学龄前儿童制定社区参与式肥胖预防干预措施，目的是确定：（1）干预措施需要优先考虑的社区环境和干预策略；（2）潜在的实施挑战和解决方案；（3）研究团队和社区合作伙伴可以共同实施的即时干预措施。该研究在印第安纳州和北卡罗来纳州两个肥胖率较高的农村社区（每个州各开展 2 次研讨会）开展了工作坊。工作坊制定了一份指南来引导讨论，参与者投票对社区环境和干预策略进行了排名。每次工作坊的参与者有 9-15 人，包括家长、儿童保育提供者以及社区组织的代表。被确定为儿童肥胖预防的重点社区环境包括家庭、教育环境（幼儿园）、食品店、娱乐设施和社交媒体。优先干预策略包括提供营养和体育教育、增加社区环境中健康食品和体育活动的可及性以及增强粮食安全。潜在的干预实施挑战集中在家长参与度差；提出的解决方案包括使用个性化邀请函和为家庭提供交通支持。立即开展的合作干预措施侧重于使用游戏模板使操场更具吸引力以促进体育活动，并通过季度通讯向家庭提供营养教育。这种与社区合作伙伴的参与式方法提供了对两个农村社区儿童肥胖预防需求、可利用的社区资产（环境）以及需要优先考虑的潜在干预策略的深入了解。研究结果将指导多层面基于社区的干预措施的制定。
