The assessment of ongoing community-based interventions to prevent obesity: lessons learned

Abstract

BackgroundThe assessment of real-life, community-based interventions to tackle obesity is an important step in the development of effective policies. Especially multi-level interventions have a high likely effectiveness and potential reach in counteracting the obesity epidemic. Although much can be learned from these initiatives, performing an evaluation of such interventions is challenging. The aim of the current article is to provide a descriptive overview of the data collection process and general results of an assessment of ongoing multi-level obesity prevention community interventions for adults in Europe, and the lessons learned from this effort.MethodsThe data collection was divided into two main phases: a) finding the ongoing obesity prevention interventions by contacting key informants in each of the European Union countries and the European Economic Area, and searching existing databases; and b) collecting detailed information (including the reach, effectiveness, adoption, implementation and maintenance (RE-AIM)) of the selected interventions using questionnaires for informants in each of the interventions.ResultsA total of 78 interventions from 24 European countries were included in the final sample. The number of identified interventions varied greatly per country. The interventions covered various implementation levels (national, regional or local) and determinants (physical, sociocultural, economic, political), mostly addressing both nutrition and physical activity behaviours.ConclusionsWe found that many multi-level obesity prevention interventions among adults are currently active in Europe, although we found relatively few in Southern and Eastern Europe. Identifying interventions and obtaining detailed information proved to be a difficult, time consuming and painstaking process. We discuss some of the reasons why this might be the case and present recommendations based on our experiences. We suggest that future research uses a step-wise approach, keeping participant burden to a minimum. The use of personalised and tailored strategies is recommended, led by researchers who exercise flexibility, tact and patience during the data collection process.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1563-2) contains supplementary material, which is available to authorized users.

Recommendations and Improvements for the Evaluation of Integrated Community-Wide Interventions Approaches

“…However, overweight and obesity develop within a sociocultural and physical environment in which these behaviours are made possible and sometimes even stimulated [8, 9]. So far obesity prevention efforts targeting individual behaviour [10] (e.g., education, treatment, and improving skills) have unfortunately had limited effects [11, 12]. Therefore, interventions at a higher level are needed [13–15].…”

“…Furthermore, it can increase accountability, as well as strategic and financial support, and enhance the sustainability of resources [30]. Moreover, programme evaluation may assist in the dissemination of knowledge of the programme and of elements that are proving successful to other areas and professionals [11, 30]. Although important for programme success, the evaluation of ICIAs is challenging.…”

UWALK: the development of a multi-strategy, community-wide physical activity program

“…Strategies targeted multiple levels and sectors to promote physical activity and establish the UWALK brand. Previous research has suggested a lack of information surrounding the development, implementation, and dissemination of health promotion programs [13,46]. The current paper attempts to address this gap and provide information in terms of knowledge translation relevant to both researchers and professionals.…”

“…Though positive physical activity-related outcomes are associated with programs, such as those previously mentioned, there remains a lack of research systematically describing and evaluating real-world programs that bridge the gap between research and applied community settings [12,13]. The RE-AIM framework provides an effective model to assist in developing and evaluating dissemination efforts and potential public health impact of health promotion programs [14].…”

Protocol for an economic evaluation of WHO STOPS childhood obesity stepped-wedge cluster randomised controlled trial

“…While not unique to this intervention, this research is part of a much larger research effort and there is a genuine risk of overburdening community members with data collection at the risk of undermining community support. 34 The costing method applied requires achievement of a balance between data comprehensiveness, feasibility and community sensitivity.…”