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Wayfinding the Live 5-2-1-0 Initiative-At the Intersection between Systems Thinking and Community-Based Childhood Obesity Prevention.

ABSTRACT: Childhood obesity is complex and requires a 'systems approach' that collectively engages across multiple community settings. Sustainable Childhood Obesity Prevention through Community Engagement (SCOPE) has implemented Live 5-2-1-0-a multi-sector, multi-component childhood obesity prevention initiative informed by systems thinking and participatory research via an innovative knowledge translation (KT) model (RE-FRAME). This paper describes the protocol for implementing and evaluating RE-FRAME in two 'existing' (>2 years of implementation) and two 'new' Live 5-2-1-0 communities to understand how to facilitate and sustain systems/community-level change. In this mixed-methods study, RE-FRAME was implemented via online resources, webinars, a backbone organization (SCOPE) coordinating the initiative, and a linking system supporting KT. Qualitative and quantitative data were collected using surveys and stakeholder interviews, analyzed using thematic analysis and descriptive statistics, respectively. Existing communities described the consistency of Live 5-2-1-0 and extensive local partnerships/champions as catalysts for synergistic community-wide action; new communities felt that the simplicity of the message combined with the transfer of experiential learning would inform their own strategies and policies/programs to broadly disseminate Live 5-2-1-0. RE-FRAME effectively guided the refinement of the initiative and provided a framework upon which evaluation results described how to implement a community-based systems approach to childhood obesity prevention.

SUBMITTER: Amed S

PROVIDER: S-EPMC4924071 | biostudies-literature | 2016 Jun

REPOSITORIES: biostudies-literature

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Wayfinding the Live 5-2-1-0 Initiative-At the Intersection between Systems Thinking and Community-Based Childhood Obesity Prevention.

Amed Shazhan S Shea Stephanie S Pinkney Susan S Wharf Higgins Joan J Naylor Patti-Jean PJ

International journal of environmental research and public health 20160621 6

Childhood obesity is complex and requires a 'systems approach' that collectively engages across multiple community settings. Sustainable Childhood Obesity Prevention through Community Engagement (SCOPE) has implemented Live 5-2-1-0-a multi-sector, multi-component childhood obesity prevention initiative informed by systems thinking and participatory research via an innovative knowledge translation (KT) model (RE-FRAME). This paper describes the protocol for implementing and evaluating RE-FRAME in ...[more]

PMID: 27338432

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Project description:BackgroundHealthy Together Victoria (HTV) was a Victorian Government initiative that sought to reduce the prevalence of overweight and obesity through targeting chronic disease risk factors including physical activity, poor diet quality, smoking, and harmful alcohol use. The intervention involved a boosted workforce of > 170 local-level staff in 12 communities; employed to deliver system activation around health and wellbeing for individuals, families and communities. A cluster randomised trial (CRT) of a systems thinking approach to obesity prevention was embedded within HTV. We present the two-year changes in overweight and obesity and associated behaviours among secondary school students across Victoria, Australia.MethodsTwenty-three geographically bounded areas were randomised to intervention (12 communities) or comparison (11 communities). Randomly selected secondary schools within each community were invited to participate in the trial in 2014 and 2016. Students in Grade 8 (aged approximately 13-15 years) and Grade 10 (aged approximately 15-16 years) at participating schools were recruited using an opt-out approach across July-September 2014 and 2016. Primary outcomes were body mass index (BMI) and waist circumference. Secondary outcomes were physical activity, sedentary behaviour, diet quality, health-related quality of life, and depressive symptoms. Linear mixed models were fit to estimate the intervention effect adjusting for child/school characteristics.ResultsThere were 4242 intervention children and 2999 control children in the final analysis. For boys, the two-year change showed improvement in intervention versus control for waist circumference (difference in change: - 2.5 cm; 95% confidence interval [CI]: - 4.6, - 0.5) and consumption of sugar-sweetened beverages per day (< 1 serve: 8.5 percentage points; 95% CI: 0.6, 16.5). For girls, there were no statistically significant differences between conditions.ConclusionsHTV seemed to produce favourable changes in waist circumference and sugar-sweetened beverage consumption for boys, however, no effect on BMI was observed. Although the HTV intervention was cut short, and the period between data collection points was relatively short, the changes observed in HTV contribute to the growing evidence of whole-of-community interventions targeting childhood obesity.Trial registrationThis trial is unregistered. The intervention itself was a policy setting delivered by government and our role was the collection of data to evaluate the effect of this natural experiment. That is, this study was not a trial from the classical point of view and we were not responsible for the intervention.

Project description:BackgroundAnyone who has ever found themselves lost while driving in an unfamiliar neighborhood or forgotten where they parked their car can appreciate the importance of being able to navigate their environment. Navigation, or wayfinding, is a large-scale spatial ability that involves keeping track of the relative positions of objects and features in space, which allows for determining the path to a goal location. Early experiences shape spatial skill development, and research finds sex differences in spatial behaviors from preschool through adulthood, with males consistently outperforming females. The basis for sex differences in spatial aptitude is still debated, but explanations include differences in childhood spatial experience, the use of strategies for solving large-scale spatial problems, and spatial anxiety. The current study seeks to understand childhood wayfinding factors that may influence sex and individual differences in wayfinding strategies and wayfinding anxiety in adulthood.MethodOne hundred fifty-nine undergraduate psychology students reported their childhood wayfinding experience (i.e., time spent outside, distance traveled), current use of wayfinding strategies (i.e., route strategy, orientation strategy), and current wayfinding anxiety and general anxiety levels.ResultsIndependent samples t tests revealed that, compared with females, males reported spending more time outside and traveling farther distances as children, having less current wayfinding anxiety and route strategy use, and having more current orientation strategy use. Mediation analyses found that distance traveled, but not time spent outdoors, during childhood mediated sex differences in route strategy use and wayfinding anxiety in adults, even when controlling for general anxiety. Furthermore, when controlling for participant sex and general anxiety, current wayfinding anxiety mediated the relationship between distance traveled during childhood and route strategy use in adults.ConclusionThe current findings provide potential environmental explanations for sex and individual differences in large-scale spatial behaviors, including wayfinding. Specifically, sex differences in early wayfinding experience may explain why males and females develop different strategies for navigating and different levels of wayfinding anxiety. Furthermore, regardless of sex, allowing children to explore and navigate their outdoor environments away from home may help lessen their fears about navigating and, in turn, improve the strategies they choose to traverse unfamiliar territories.

Project description:BackgroundCommunity-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.AimTo 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.MethodsThree 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.ResultsThe 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.ConclusionGenR8 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.

Dataset Information

Wayfinding the Live 5-2-1-0 Initiative-At the Intersection between Systems Thinking and Community-Based Childhood Obesity Prevention.

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Wayfinding the Live 5-2-1-0 Initiative-At the Intersection between Systems Thinking and Community-Based Childhood Obesity Prevention.

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