Study: Communities must be ready for obesity advocacy to be successful

Feb. 02, 2013, The Nation's Health

By Kim Krisberg

Youth advocates can play a role in addressing childhood obesity, but communities must first be ready to embrace the issue, a recent study finds.

Using a community readiness assessment tool developed by Colorado State University, researchers gauged the potential for youth advocacy to shift norms in a south Omaha, Neb., Hispanic community. The research, published in December in the journal Preventing Chronic Disease, found that the community was at a low stage of readiness for change. But using the tool provided a framework for building a tailored youth-led obesity prevention movement, according to the study.

Today, the youth-led movement, known as SaludableOmaha, continues to work toward healthy change, attract new community partners and embedding obesity prevention in already-existing programs.

According to the study, 31 percent of adolescents in south Omaha are overweight or obese, compared to 20 percent of adolescents in the primarily white communities of northwest and southwest Omaha.

“We’re trying to mobilize the community, from individuals to families to institutions, to come together around the concept of healthy living,” said study co-author Terry Huang, PhD, MPH, CPH, professor and chair of the Department of Health Promotion, Social and Behavioral Health at the University of Nebraska Medical Center College of Public Health [and senior advisor to the National Collaborative on Childhood Obesity]. “We wanted to increase the level of readiness so in the future, if someone came in and wanted to implement a specific obesity intervention, this community would be ready to partner with you.”

The south Omaha project was one of two projects funded in 2011 via the Robert Wood Johnson Foundation’s Active Living Research program, which was looking for innovative ways to put youth in the driver’s seat in designing and implementing a youth advocacy-based intervention, said Huang, an APHA member. He noted that the Omaha effort is “not your traditional research project — it’s really a grassroots initiative with evaluation wrapped around it.”

The goal of the project was to assess the potential of empowering the community’s Hispanic youth to create a social movement to bring about change. The project had two phases: Phase one focused on training a group of youth advocates. In phase two, youth created and launched SaludableOmaha based on the community readiness model.

“The study looked at the capacity and readiness of the community to take on this social movement,” Huang told The Nation’s Health. “Right now, there’s little research on how youth can make a difference in obesity prevention.”

Using the community readiness model, researchers found that the south Omaha community was home to low levels of readiness to address childhood obesity. For example, parents said that while they felt some people might think childhood obesity is a problem, the community as a whole did not consider it a major concern. Such data was key to tailoring an obesity prevention effort that fit the community’s needs and increased the chances of long-term sustainability.

“(The community readiness model) is an important tool for addressing issues such as childhood obesity in underserved communities because it provides a framework for matching interventions to the community,” study authors wrote. “Thus, efforts that do not consider readiness for change and tailor strategies to stage or readiness will likely neglect communities with lower readiness but higher need.”

Since the launch of SaludableOmaha, Huang said the movement has “grown to a much more sophisticated place.” For example, SaludableOmaha has partnered with a local high school to engage students in improving school meals. SaludableOmaha has also partnered with the local health department to persuade local restaurants to display healthy eating tips. Huang said youth advocates will test health messages to see what resonates with local restaurant owners and then develop a set of tools that participating restaurants can use.

“This problem affects children, so why shouldn’t children be in control of how to solve the problem?” Huang said. “They can’t do it alone, but they certainly deserve to be at the table. I would love to see more activities in the future in which children’s voices are not only incorporated, but they are also part of the decision making process in any solution package.”

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