Application of the Community Readiness Model for childhood obesity prevention: a scoping review

Abstract

Summary The Community Readiness Model (CRM) provides an approach to determine community readiness (CR), which is the degree of a community’s preparedness to address a health issue. This scoping review aims to characterize internationally existing applications of the CRM for childhood obesity prevention. Therefore, a systematic literature research was conducted in PubMed, Cochrane Library, LIVIVO and Google Scholar. Of 285 identified records, 17 studies met the eligibility criteria and were included in the scoping review. The CRM has already been applied to childhood obesity prevention in the USA (n = 10), Australia (n = 4), UK (n = 1), Iran (n = 1) and South Africa (n = 1). Mainly geographically defined communities (n = 12) like counties and cities were analysed but also schools (n = 4) and churches (n = 1). The scoping review revealed various methodological changes to the standard protocol of which some are particularly relevant for the application to childhood obesity prevention. The identified studies reported readiness scores in the low to mid-range of the nine-point readiness scale. To increase CR, strategies were proposed that addressed raising awareness and knowledge of childhood obesity, but also supporting connectivity in and between settings. This scoping review provides researchers and health promoters with an overview of international CR measurements and setting-specific strategies to increase CR. It highlights the potential of targeted interventions to increase readiness and shows tentative support for the assumption of a possible link between CR level and changes in obesity prevalence.

Community Readiness Assessment of the “Take TIME for Your Child’s Health” Intervention

“…A scoping review conducted in 2022 found 17 studies worldwide that used the community readiness model for childhood obesity prevention. The average community readiness scores from studies without an intervention ranged from 1.6 to 6.08 [4]. These studies demonstrate the effective use of the community readiness model for assessing community preparedness to prevent childhood obesity.…”

“…These studies demonstrate the effective use of the community readiness model for assessing community preparedness to prevent childhood obesity. The review also identified five studies comparing the results of community readiness before and after an intervention [4]. Readiness scores increased after an intervention period of 2 to 5 years following "It's Your Move!"…”

“…Intervention success was attributed to providing financial support and technical assistance as part of a collaborative grant strategy [8], social marketing and social media techniques to shift community knowledge, values, and norms around obesity [7], and increasing a community's capacity to identify, mobilize, and address public health problems by the development of knowledge, skills, structures, and resources [5]. Schroder and colleagues suggested the need to investigate whether there is a minimum threshold for intervention duration before an increase in readiness can be seen [4]. Furthermore, previous studies were conducted in the United States and Australia, leaving a gap in knowledge for Canadian communities.…”

Strategies to improve the implementation of intensive lifestyle interventions for obesity

“…The Community Readiness Model (CRM), developed to guide the creation of community-level behavior change interventions, has been applied to a wide range of public health topics, including alcohol abuse, cardiovascular disease, and children's social-emotional development ( 19 – 22 ). A community's readiness varies by issue; for obesity, community readiness is often low or middling, in part because people may discount negative consquences of obesity that will accrue in the distant future ( 23 – 25 ). In this context, ILIs that target weight-related behaviors (e.g., diet or physical activity) may fail if they are not aligned with the community's highest priorities.…”

Contextual effects of community capacity as a predictor for adolescent alcohol, tobacco, and illicit drug use: A multi-level analysis

“…Among these dimensions, the community's commitment in our study holds particular relevance to the concept of community readiness for prevention. Extensive research has highlighted the positive associations between community readiness and health outcomes ( Gansefort, Brand, Princk, & Zeeb, 2018 ; Kostadinov, Daniel, Stanley, Gancia, & Cargo, 2015 ; Schröder, Schnabel, Hassel, & Babitsch, 2022 ). Community readiness, as introduced by the Tri-Ethnic Center for Prevention Research ( Stith et al, 2006 ; Tri-Ethnic Center for Prevention Research, 2014 ), is closely related to community capacity as it reflects a community's preparedness and receptivity to address specific issues.…”