Community-based interventions provide a promising approach for the prevention of obesity, particularly among children. These interventions are hampered by the challenges of good quality data to support implementation, evaluation and continual improvement. The Global Obesity Centre (GLOBE) has a program of research at the intersection of evaluation, systems and implementation science and this paper describes our use of measurement within this approach to supporting obesity prevention in community settings.
Childhood obesity monitoring and use of routine data have shown to be very effective in supporting community engagement in childhood obesity prevention initiatives. Our current large-scale interventions have demonstrated comprehensive and low-cost data collection across a number of levels, including anthropometry, behavior, networks, systems and environmental and contextual data. The creation of monitoring within schools (collecting anthropometric and survey data from >18,000 Victorian school children in >250 primary and secondary schools) in several trials has demonstrated the feasibility of opt out consent. This approach provides high quality, high participation (>80% student participation rate) data which can support ongoing community efforts to mobilise and sustain interventions.
These data in turn are supported by measures of ‘systems’ characteristics including systems maps, social networks and community readiness to change. Systems maps help to capture the shared mental models of participants, making explicit their assumptions about how childhood obesity works in their community. Repeating systems mapping with participants over time can help qualitatively capture how participants’ understanding of childhood obesity evolves, which can then inform improved action based on ongoing learning.
Social networks in public health are critical for program development, implementation and community engagement. Analysis of community leadership networks gives us insight and understanding of the role that different network structures and composition influence obesity prevention efforts and outcomes over time.
Community-readiness to change is a tool to capture dimensions of the community’s readiness, willingness and resources available to address the issue of childhood obesity in their community.
This presentation will discuss the use of measurement at the intersection of systems, implementation and evaluation science and the many questions this work poses for measurement in community settings. The model describes represents the next iteration in moves towards evidence-based, community owned childhood obesity prevention. Efforts are needed to formalize, embed and scale high quality, standardized methods for measurement, implementation, evaluation and constant adaptation of community change efforts.