The goals of the Central California Regional Obesity Prevention Program (CCROPP) are to promote safe places for physical activity, increase access to fresh fruits and vegetables, and support community and youth engagement in local and regional efforts to change nutrition and physical activity environments for obesity prevention. CCROPP has created a community-driven policy and environmental change model for obesity prevention with local and regional elements in low-income, disadvantaged ethnic and rural communities in a climate of poor resources and inadequate infrastructure. Evaluation data collected from 2005-2009 demonstrate that CCROPP has made progress in changing nutrition and physical activity environments by mobilizing community members, engaging and influencing policymakers, and forming organizational partnerships.

Public health leadership development programs have proliferated since the release of the Institute of Medicine's call for strengthened public health leadership. Little has been documented, however, about the impact of these programs. This article presents results of an eight-year retrospective evaluation of the Centers for Disease Control and Prevention/University of California Public Health Leadership Institute, the nation's first year-long leadership development program serving senior public health leaders. Results show that this program has had a positive impact on participants' leadership effectiveness at the personal, organizational, and community levels as well as on the field of public health.

IntroductionFew studies have examined how joint-use agreements between schools and communities affect use of school facilities after hours for physical activity in under-resourced communities. The objective of this study was to assess whether these agreements can increase community member use of these opened spaces outside of school hours.MethodsTrained observers conducted school site observations after joint-use agreements were implemented in 7 Los Angeles County school districts. All 7 districts had disproportionately high adult and child obesity rates, and all had executed a joint-use agreement between schools and community or government entities from January 2010 through December 2012. To assess use, we adapted the System for Observing Play and Recreation in Communities (SOPARC) instrument to record the number, demographic characteristics, and physical activity levels of community members who used the joint-use school sites. To supplement observations, we collected contextual information for each location, including the existence of physical activity programs at the site and the condition of exercise equipment.ResultsWe completed 172 SOPARC observations and related environmental assessments for 12 school sites. Observations made on 1,669 site users showed that most of them were Hispanic and nearly half were adults; three-quarters engaged in moderate to vigorous physical activity. Community member use of school sites was 16 times higher in joint-use schools that had physical activity programs than in schools without such programs.ConclusionJoint-use agreements are a promising strategy for increasing moderate to vigorous physical activity among adults and children in under-resourced communities. Providing physical activity programs may substantially increase after-hours use of school facilities by community members.

BACKGROUND. The California Endowment's Healthy Eating, Active Communities program was designed to reduce disparities in the incidence of obesity by improving food and physical-activity environments for low-income children. It was recognized at the outset that to succeed, the program needed support from community advocates. Health care providers can be effective advocates to mobilize community members and influence policy makers. OBJECTIVE. This study was conducted to describe how health care providers address obesity prevention in clinical practice and to assess health care providers' level of readiness to advocate for policies to prevent childhood obesity. METHODS. The study included two data-collection methods, (1) a self-administered survey of health care providers (physicians, dietitians, nurses, nurse practitioners, medical assistants, and community health workers) and (2) stakeholder interviews with health care facility administrators, health department staff, and health insurance organization representatives. Two-hundred and forty-eight health care providers participated in the provider survey and the health care stakeholder interviews were conducted with 56 respondents. RESULTS. The majority (65%) of health care providers usually or always discussed the importance of physical-activity, reducing soda consumption, and breastfeeding (as appropriate) during clinical pediatric visits. More than 90% of the providers perceived home or neighborhood environments and parental resistance as barriers to their efforts to prevent childhood obesity in clinical practice. More than 75% of providers reported not having engaged in any policy/advocacy activities related to obesity-prevention. Most (88%) of the stakeholders surveyed thought that health care professionals should advocate for policies to reduce obesity, especially around insurance coverage for obesity-prevention. CONCLUSIONS. Providers perceived that changing the food and physical-activity environments in neighborhoods and schools was likely to be the most effective way to support their clinical obesity-prevention efforts. Health care providers need time, training, resources, and institutional support to improve their ability to communicate obesity-prevention messages in both clinical practice and as community policy advocates.

The purpose of this research was to assess California public health departments capacity, practices, and resources for changing nutrition and physical activity environments for obesity prevention. The researchers surveyed key public health department personnel representing all 61 health departments in California using a Web-based survey tool. The response rate for the survey was 62 percent. This represented a 93 percent health department response rate. Analysis was conducted on the individual respondent and public health department levels and stratified by metropolitan statistical area and foundation-funded versus not foundation-funded. Public health departments are engaged in obesity prevention including environmental and policy change approaches. The majority of respondents stated that monitoring obesity rates and providing leadership for obesity prevention are important roles for public health. Health departments are involved in advocacy for healthier eating and/or physical activity in school environments and the development and monitoring of city/county policies to improve the food and/or physical activity environments. Funding and staff skill may influence the degree of public health department engagement in obesity prevention. A majority of respondents rate their staffing capacity for improving nutrition and physical activity environments as inadequate. Access to flexible foundation funding may influence how public health departments engage in obesity prevention.