Assessing community readiness for overweight and obesity prevention in pre-adolescent girls: a case study

BMC Public Health

Paula Louise Griffiths¹  Noel Cameron¹  Joanna May Kesten¹ 

[1] Centre for Global Health and Human Development, Loughborough University, LE11 3TU, Loughborough, UK

关键词: Pre-adolescent girls;    Obesity prevention;    Community readiness;   

Others  :  1161419
DOI  :  10.1186/1471-2458-13-1205

 received in 2013-04-22, accepted in 2013-12-13,  发布年份 2013

【 摘 要 】

Background

Childhood overweight and obesity is a global public health concern. For girls in particular, being overweight or obese during pre-adolescence (aged 7–11 years) has intergenerational implications for both the mother and her future offspring. In the United Kingdom (UK) there is increasing interest in community targeted interventions but less is known about how to tailor these approaches to the needs of the community. This study applied the Community Readiness Model (CRM), for the first time in the UK, to demonstrate its applicability in designing tailored interventions.

Methods

Community readiness assessment was conducted using semi-structured key informant interviews. The community’s key informants were identified through focus groups with pre-adolescent girls. The interviews addressed the community’s efforts; community knowledge of the efforts; leadership; community climate; community knowledge of the issue and resources available to support the issue. Interviews were conducted until the point of theoretical saturation and questions were asked separately regarding physical activity (PA) and healthy eating and drinking (HED) behaviours. The interviews were transcribed verbatim and were firstly analysed thematically and then scored using the assessment guidelines produced by the CRM authors.

Results

Readiness in this community was higher for PA than for HED behaviours. The lowest scores related to the community’s ’resources’ and the ’community knowledge of the issue’; affirming these two issues as the most appropriate initial targets for intervention. In terms of resources, there is also a need for resources to support the development of HED efforts beyond the school. Investment in greater physical education training for primary school teachers was also identified as an intervention priority. To address the community’s knowledge of the issue, raising the awareness of the prevalence of pre-adolescent girls’ health behaviours is a priority at the local community level. Inconsistent school approaches contributed to tensions between schools and parents regarding school food policies.

Conclusions

This study has identified the readiness level within a UK community to address the behaviours related to overweight and obesity prevention in pre-adolescent girls. The focus of an intervention in this community should initially be resources and raising awareness of the issue within the community.

【 授权许可】

   
2013 Kesten et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Ebbeling CB, Pawlak DB, Ludwig DS: Childhood obesity: public-health crisis, common sense cure. Lancet 2002, 360(9331):473-482.
• [2]National Child Measurement Programme: England 2010/2011 school year. Leeds: The Health and Social Care Information Centre, Lifestyles Statistics; 2011. http://www.hscic.gov.uk/searchcatalogue?productid=10135&q=title%3a%22national webcite+child+measurement+programme%22&sort=Relevance&size=10&page=1#top
• [3]Rokholm B, Baker JL, Sorensen TI: The levelling off of the obesity epidemic since the year 1999–a review of evidence and perspectives. Obes Rev 2010, 11(12):835-846.
• [4]Olds T, Maher C, Zumin S, Peneau S, Lioret S, Castetbon K, Bellisle , de Wilde J, Hohepa M, Maddison R, Lissner L, Sjoberg A, Zimmermann M, Aeberli I, Ogden C, Flegal K, Summerbell C: Evidence that the prevalence of childhood overweight is plateauing: data from nine countries. Int J Pediatr Obes 2011, 6:342-360.
• [5]Cuttini M, Barreto ML: Prevention of childhood obesity: issues on the evaluation of interventions. J Epidemiol Community Health 2010, 64(11):939.
• [6]Daniels SR: Complications of obesity in children and adolescents. Int J Obes (Lond) 2009, 33(Suppl 1):S60-S65.
• [7]Hypponen E, Power C, Smith GD: Parental growth at different life stages and offspring birthweight: an intergenerational cohort study. Paediatr Perinat Epidemiol 2004, 18(3):168-177.
• [8]Martin RM, Smith GD, Frankel S, Gunnell D: Parents’ growth in childhood and the birth weight of their offspring. Epidemiology 2004, 15(3):308-316.
• [9]Li L, Law C, Lo Conte R, Power C: Intergenerational influences on childhood body mass index: the effect of parental body mass index trajectories. Am J Clin Nutr 2009, 89(2):551-557.
• [10]Power C, Pouliou T, Li L, Cooper R, Hypponen E: Parental and offspring adiposity associations: insights from the 1958 British birth cohort. Ann Hum Biol 2011, 38(4):390-399.
• [11]Kesten J, Griffiths PL, Cameron N: A systematic review to determine the effectiveness of interventions designed to prevent overweight and obesity in pre-adolescent girls. Obes Rev 2011, 12(12):997-1021.
• [12]McLeroy KR, Bibeau D, Steckler A, Glanz K: An ecological perspective on health promotion programs. Health Educ Q 1988, 15(4):351-377.
• [13]Healthy lives, healthy people: a call to action on obesity in England. London: Department of Health; 2011. https://www.gov.uk/government/publications/healthy-lives-healthy-people-a-call-to-action-on-obesity-in-england webcite
• [14]Plested B, Edwards R, Jumper-Thurman P: Community readiness: a handbook for successful change. Fort Collins (CO): Tri-Ethnic Center for Prevention Research; 2006. http://triethniccenter.colostate.edu/CRhandbookcopy.htm webcite
• [15]Edwards RW, Jumper-Thurman P, Plested BA, Oetting ER, Swanson L: Community readiness: research to practice. J Community Psychol 2000, 28(3):291-307.
• [16]Obesity: working with local communities. London: National Institute for Health and Clinical Excellence; 2012. http://publications.nice.org.uk/obesity-working-with-local-communities-ph42/recommendations webcite
• [17]Oetting ER, Donnermeyer JF, Plested BA, Edwards RW, Kelly K, Beauvais F: Assessing community readiness for prevention. Int J Addict 1995, 30(6):659-683.
• [18]Thurman PJ: Community readiness: a promising model for community healing, (Native American topic specific monograph series). U.S. Department of Justice: The University of Oklahoma Health Sciences Center; 2000.
• [19]Findholt N: Application of the community readiness model for childhood obesity prevention. Public Health Nurs 2007, 24(6):565-570.
• [20]Sliwa S, Goldberg JP, Clark V, Collins J, Edwards R, Hyatt RR, Junot B, Nahar E, Nelson ME, Tovar A, Economos CD: Using the community readiness model to select communities for a community-wide obesity prevention intervention. Prev Chronic Dis 2011, 8(6):A150.
• [21]Millar L, Robertson N, Allender S, Nichols M, Bennett C, Swinburn B: Increasing community capacity and decreasing prevalence of overweight and obesity in a community based intervention among Australian adolescents. Prev Med 2013, 56(6):379-384.
• [22]Ehlers DK, Huberty JL, Beseler CL: Is school community readiness related to physical activity before and after the Ready for Recess intervention? Health Educ Res 2013, 28(2):192-204.
• [23]Office for national statistics: Census: population and household estimates for England and Wales. Children & Society 2011, 2012(10):90-105.
• [24]National Obesity Observatory: Childhood obesity and its determinants. BMI classification population monitoring. (85th/95th) Centiles. Children aged 10–11 years% overweight and obese. 2011/2012. http://www.sepho.org.uk/noo/NCMP/single/atlas.html webcite
• [25]Thurman PJ, Plested BA, Edwards RW, Foley R, Burnside M: Community readiness: the journey to community healing. J Psychoactive Drugs 2003, 35(1):27-31.
• [26]Kesten J: The role of community readiness in the prevention of overweight and obesity in pre-adolescent girls. Loughborough University, Institutional repository; 2013. http://www.lboro.ac.uk/services/library/online/repository/ webcite
• [27]Communities and Local Government: Indices of Deprivation. https://www.gov.uk/government/collections/english-indices-of-deprivation webcite
• [28]Office of National Statistics: The national statistics socio economic classification (NS-SEC rebased on the SOC2010). http://www.ons.gov.uk/ons/guide-method/classifications/current-standard-classifications/soc2010/soc2010-volume-3-ns-sec--rebased-on-soc2010--user-manual/index.html#14 webcite
• [29]Glaser B, Strauss A: The discovery of grounded theory: strategies for qualitative research. New Jersey: Aldine Transaction; 1967.
• [30]Braun V, Clarke V: Using thematic analysis in psychology. Qual Res Psychol 2006, 3(2):77-101.
• [31]Healthy Schools: Healthy schools. http://healthyschools.org.uk webcite
• [32]Leicestershire Healthy Schools: Healthy weight and obesity prevention. Interventions and activities. http://www.leicspart.nhs.uk/_OurServicesAZ-FamilyLifestyleClubs.aspx webcite
• [33]Coram Life Education: About us- what we do. http://www.lifeeducation.org.uk/newsletter/newsindex.php?action=publicarticle&id=389 webcite
• [34]Israel BA, Parker EA, Rowe Z, Salvatore A, Minkler M, Lopez J, Butz A, Mosley A, Coates L, Lambert G, Potito PA, Brenner B, Rivera M, Romero H, Thompson B, Coronado G, Halstead S: Community-based participatory research: lessons learned from the centers for Children’s environmental health and disease prevention research. Environ Health Perspect 2005, 113(10):1463-1471.
• [35]Sloan S: The continuing development of primary sector physical education: working together to raise quality of provision. Eur Phys Educ Rev 2010, 16(3):267-281.
• [36]Harris J, Cale L, Musson H: The predicament of primary physical education: a consequence of’insufficient’ ITT and’ineffective’ CPD? Physical Education & Sport Pedagogy 2012, 17(4):367-381.
• [37]Beyond 2012: outstanding physical education for all : physical education in schools 2008–12. Manchester: Office for Standards in Education, Children’s Services and Skills (Ofsted); 2013. http://www.ofsted.gov.uk/resources/120367 webcite
• [38]Leisure centre food and drink survey – 2008. Department of Health West Midlands. West Bromwich: Department of Health West Midlands 2008 Naomi Jones and Catherine Goodridge; 2008. http://webcache.googleusercontent.com/search?q=cache:fCMg2aGPeKoJ:nhfshare.heartforum.org.uk/RMAssets/OLC_Resources/West_Midlands/Food/2423_WM.pdf webcite+&cd=1&hl=en&ct=clnk&gl=uk
• [39]Healthier catering in leisure centres: evaluation of a pilot initiative. Wales: Wavehill Consulting; 2008. http://www.physicalactivityandnutritionwales.org.uk/Documents/740/Healthy_Catering_Report_-_11.pdf webcite
• [40]Bruss MB: Childhood obesity prevention: an intervention targeting primary caregivers of school children. OBESITY 2010, 18(1):99-107.
• [41]Jones AR, Parkinson KN, Drewett RF, Hyland RM, Pearce MS, Adamson AJ: Parental perceptions of weight status in children: the Gateshead Millennium Study. Int J Obes (Lond) 2011, 35(7):953-962.
• [42]Jeffery AN, Voss LD, Metcalf BS, Alba S, Wilkin TJ: Parents’ awareness of overweight in themselves and their children: cross sectional study within a cohort (EarlyBird 21). BMJ 2005, 330(7481):23-24.
• [43]Corder K, van Sluijs EMF, McMinn AM, Ekelund U, Cassidy A, Griffin SJ: Perception versus reality awareness of physical activity levels of British children. Am J Prev Med 2010, 38(1):1-8.
• [44]Evans B, Colls R, Horschelmann K: ‘Change4Life for your kids’: embodied collectives and public health pedagogy. Sport, Education and Society 2011, 16(3):323-341.
• [45]Della Torre Swiss SB, Akre C, Suris JC: Obesity prevention opinions of school stakeholders: a qualitative study. J Sch Health 2010, 80(5):233-239.
• [46]Haroun D, Harper C, Pearce J, Wood L, Sharp L, Poulter J, Hall L, Smyth S, Huckle C, Nelson M: Primary school food survey 2009. Sheffield. 2010. http://www.childrensfoodtrust.org.uk/assets/research-reports/primary_school_food_survey_2009_full_technical_report_revised2012.pdf webcite
• [47]Hesketh K, Waters E, Green J, Salmon L, Williams J: Healthy eating, activity and obesity prevention: a qualitative study of parent and child perceptions in Australia. Health Promot Int 2005, 20(1):19-26.
• [48]Zenzen W, Kridli S: Integrative review of school-based childhood obesity prevention programs. J Pediatr Health Care 2009, 23(4):242-258.
• [49]Kipping RR, Jago R, Lawlor DA: Developing parent involvement in a school-based child obesity prevention intervention: a qualitative study and process evaluation. J Public Health (Oxf) 2012, 34(2):236-244.
• [50]Borrayo EA: Using a community readiness model to help overcome breast health disparities among US Latinas. Subst Use Misuse 2007, 42(4):603-619.
• [51]Brackley M, Davila Y, Thornton J, Leal C, Mudd G, Shafer J, Castillo P, Spears W: Community readiness to prevent intimate partner violence in Bexar County, Texas. J Transcult Nurs 2003, 14(3):227-236.
• [52]Plested B, Smitham DM, Jumper-Thurman P, Oetting ER, Edwards RW: Readiness for drug use prevention in rural minority communities. Subst Use Misuse 1999, 34(4–5):521-544.
• [53]Office for National Statistics: Neighbourhood statistics. http://neighbourhood.statistics.gov.uk/dissemination/LeadAreaSearch.do?a=3&i=1001&m=0&s=1238600655117&enc=1&areaSearchText=charnwood&areaSearchType=141&extendedList=false&searchAreas=Search webcite