Abstract
Prior research has identified numerous factors contributing to increased rates of childhood obesity. However, few studies have focused explicitly on the experience of community stakeholders in low-income communities. This study sought to capture the perspectives of these on-the-ground experts regarding major factors contributing to childhood obesity as well as gaps in current prevention and control efforts. We conducted semi-structured interviews with 39 stakeholders from different community sectors (e.g., healthcare providers, childcare providers, teachers). Data were drawn from the Massachusetts Childhood Obesity Research Demonstration project, a multi-level, multi-sector intervention designed to reduce childhood obesity being implemented in two low-income communities in Massachusetts. Interviews were conducted at baseline, transcribed, coded using grounded theory approach, and analyzed in NVivo 10.0. The vast majority of stakeholders had recently participated in obesity prevention strategies, and nearly all of them identified gaps in prevention efforts either within their organizations or in the broader community. In addition to factors previously identified in the literature, several themes emerged including the need to change policies to increase physical activity during school, offer healthier snacks in schools and afterschool programs, and increase communication and collaboration within the community in prevention efforts. Community stakeholders can impact the success of interventions by bridging the gap between science and lived experience. The results of this study can guide future research by highlighting the importance of including stakeholders’ frontline experiences with target populations, and using information on identified gaps to augment intervention planning efforts.
Similar content being viewed by others
References
Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2014). Prevalence of childhood and adult obesity in the United States, 2011–2012. Journal of American Medical Association, 311(8), 806–814.
Shrewsbury, V., & Wardle, J. (2008). Socioeconomic status and adiposity in childhood: A systematic review of cross-sectional studies 1990–2005. Obesity (Silver Spring), 16(2), 275–284.
Morgenstern, M., Sargent, J. D., & Hanewinkel, R. (2009). Relation between socioeconomic status and body mass index: Evidence of an indirect path via television use. Archives of Pediatrics and Adolescent Medicine, 163(8), 731–738.
Addy, N. A., Shaban-Nejad, A., Buckeridge, D. L., & Dube, L. (2015). An innovative approach to addressing childhood obesity: A knowledge-based infrastructure for supporting multi-stakeholder partnership decision-making in Quebec, Canada. International Journal of Environmental Research and Public Health, 12(2), 1314–1333.
World Health Organization. (2014). Global strategy on diet, physical activity and health. http://www.who.int/dietphysicalactivity/childhood_why/en/. Accessed September 21, 2015.
Davison, K. K., & Birch, L. L. (2001). Childhood overweight: A contextual model and recommendations for future research. Obesity Reviews: An official journal of the International Association for the Study of Obesity, 2(3), 159–171.
Krishnamoorthy, J. S., Hart, C., & Jelalian, E. (2006). The epidemic of childhood obesity: Review of research and implications for public policy. Society for Research in Child Development, Policy Report, 1, 1–18.
Floodmark, C., Marcus, C., & Britton, M. (2006). Interventions to prevent obesity in children and adolescents: A systematic literature review. International Journal of Obesity, 30, 579–589.
Summerbell, C. D., Waters, E., Edmunds, L. D., Kelly, S., Brown, T., & Campbell, K. J. (2005). Interventions for preventing obesity in children. The Cochrane Database of Systematic Reviews, 3, CD001871.
Oude Luttikhuis, H., Baur, L., Jansen, H., et al. (2009). Interventions for treating obesity in children (review). The Cochrane Database of Systematic Reviews, 3(1), 1–57.
Baeckstrand, K. (2006). Multi-stakeholder partnerships for sustainable development: Rethinking legitimacy, accountability and effectiveness. European Environment, 16, 290–306.
Hesketh, K., Waters, E., Green, J., Salmon, L., & Williams, J. (2005). Healthy eating, activity and obesity prevention: A qualitative study of parent and child perceptions in Australia. Health Promotion International, 20(1), 19–26.
Corrigan, M., Cupples, M. E., Smith, S. M., et al. (2006). The contribution of qualitative research in designing a complex intervention for secondary prevention of coronary heart disease in two different healthcare systems. BMC Health Services Research, 6, 90.
Davison, K. K., Falbe, J., Taveras, E. M., et al. (2015). Evaluation overview for the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) project. Childhood Obesity, 11(1), 23–36.
Taveras, E. M., Blaine, R. E., Davison, K. K., et al. (2015). Design of the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) study. Childhood Obesity, 11(1), 11–22.
Creswell, J. W. (2007). Qualitative inquiry & research design. Choosing among five approaches (2nd ed., pp. 62–68). Thousand Oaks: Sage.
United States Department of Agriculture. (2015). Choose MyPlate.gov. http://www.choosemyplate.gov/. Accessed September 21, 2015.
World Health Organization. (2012). Population-based approaches to childhood obesity prevention. http://www.who.int/dietphysicalactivity/childhood/WHO_new_childhoodobesity_PREVENTION_27nov_HR_PRINT_OK.pdf. Accessed September 21, 2015.
The Special Supplemental Nutrition Program for Women, Infants, and Children. (2015). About WIC–WIC at a glance. http://www.fns.usda.gov/wic/about-wic-wic-glance. Accessed September 21, 2015.
Eckel, R. H., & Krauss, R. M. (1998). American Heart Association call to action: Obesity as a major risk factor for coronary heart disease. AHA Nutrition Committee. Circulation, 97(21), 2099–2100.
Grundy, S. M. (1998). Multifactorial causation of obesity: Implications for prevention. The American Journal of Clinical Nutrition, 67(3 Suppl), 563S–572S.
Hill, J. O., & Peters, J. C. (1998). Environmental contributions to the obesity epidemic. Science, 280(5368), 1371–1374.
Koplan, J. P., Thacker, S. B., & Lezin, N. A. (1999). Epidemiology in the 21st century: Calculation, communication, and intervention. American Journal of Public Health, 89(8), 1153–1155.
Dehghan, M. N., Akhtar-Danesh, N., & Merchant, A. T. (2005). Childhood obesity, prevalence and prevention. Nutrition Journal, 4, 24.
Wang, Y., Cai, L., Wu, Y., et al. (2015). What childhood obesity prevention programmes work? A systematic review and meta-analysis. Obesity Reviews: An Official Journal of the International Association for the Study of Obesity, 16(7), 547–565.
Schachter, R. (2005). The end of recess. http://www.districtadministration.com/article/end-recess. Accessed September 21, 2015.
Acknowledgments
This research was supported by the Centers for Disease Control and Prevention (CDC) National Center for Chronic Disease Prevention and Health Promotion (Award#U18DP003370) and by the Pilot Studies Core of the Johns Hopkins Global Obesity Prevention Center, which is funded by the National Institute of Child Health and Human Development (U54HD070725). The authors thank the participants, Jo-Ann Kwass, Meghan Perkins, and Katie Giles for connecting us to the communities, the MA-CORD coalition leaders in both communities, and the MA-CORD project team.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Ganter, C., Aftosmes-Tobio, A., Chuang, E. et al. Community Stakeholders’ Perceptions of Major Factors Influencing Childhood Obesity, the Feasibility of Programs Addressing Childhood Obesity, and Persisting Gaps. J Community Health 41, 305–314 (2016). https://doi.org/10.1007/s10900-015-0097-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10900-015-0097-y