Tracking implementation within a community-led whole of system approach to address childhood overweight and obesity in south west Sydney, Australia

Abstract Background Obesity is a chronic disease that contributes to additional comorbidities including diabetes, kidney disease and several cancers. Change4Campbelltown implemented a ‘whole of system’ approach to address childhood overweight and obesity. We present methods to track implementation and stakeholder engagement in Change4Campbelltown. Methods Change4Campbelltown aimed to build capacity among key leaders and the broader community to apply techniques from systems thinking to develop community-led actions that address childhood obesity. Change4Campbelltown comprised development of a stakeholder-informed Causal Loop Diagram (CLD) and locally-tailored action plan, formation of key stakeholder and community working groups to prioritise and implement actions, and continuous monitoring of intervention actions. Implementation data included an action register, stakeholder engagement database and key engagement activities and were collected quarterly by the project management team over 2 years of reporting. Results Engagement activities increased level of community engagement amongst key leaders, the school-sector and community members. Community-led action increased as engagement increased and this action is mapped directly to the primary point of influence on the CLD. As action spread diversified across the CLD, the geographical spread of action within the community increased. Conclusions This paper provides a pragmatic example of the methods used to track implementation of complex interventions that are addressing childhood overweight and obesity.

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An urban, community-based whole of systems approach to address childhood overweight and obesity

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.451 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

K Wardle ◽

N Maitland ◽

S Allender ◽

B Jalaludin ◽

F Haigh

Keyword(s):

System Approach ◽

Systems Approach ◽

Urban Community ◽

Childhood Overweight ◽

Overweight And Obesity ◽

Group Model ◽

Healthy Weight ◽

Community Members ◽

Community Based ◽

Childhood Overweight And Obesity

Abstract Background In 2015 two billion people were estimated to be above a healthy weight globally, contributing to a rapid increase of non-communicable diseases. Evidence indicates multi-faceted and community-led interventions are most effective in addressing the complexity of childhood overweight and obesity. Campbelltown - Changing our Future is a practical example of an urban, community-based whole of system approach to identify, develop and implement community-led interventions to address this issue. Methods Key community stakeholders and leaders, who had power to change environments and norms, were engaged in a series of three workshops to develop a systems map. A Group Model Building (GMB) framework was used across the workshops to facilitate community perception of the key factors that compose the system that influences childhood overweight and obesity within an urban community. Community members were asked to identify and commit to community-led actions to effect change on various elements of the system. Results Over 200 community members were engaged in the GMB process, establishing the following systems map themes: physical activity and sedentary behaviour, healthy eating, knowledge and education and social factors. A further 200 community members are contributing to 90 ongoing community-led comprehensive interventions to address childhood overweight and obesity. Conclusions Over 90 actions are active within the community, ranging from high profile athletes’ role modelling reading to children through to a Council healthy food and drink policy. These actions contribute to creating change across multiple levels of the system, an effective, sustainable solution to addressing childhood overweight and obesity. Key messages Practical implementation of a whole of system approach in an urban community produces community-led action. A whole of systems approach facilitates community engagement to address complex issues.

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Campbelltown – Changing our Future: study protocol for a whole of system approach to childhood obesity in South Western Sydney

BMC Public Health ◽

10.1186/s12889-019-7936-1 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Nicola Maitland ◽

Mandy Williams ◽

Bin Jalaludin ◽

Steven Allender ◽

Claudia Strugnell ◽

...

Keyword(s):

Childhood Obesity ◽

Future Study ◽

Primary Schools ◽

System Approach ◽

Quantitative Methods ◽

Childhood Overweight ◽

Overweight And Obesity ◽

Local Context ◽

Childhood Overweight And Obesity ◽

Key Stakeholders

Abstract Background In Australia, around 67% of adults and 25% of children (5–17 years) are currently overweight or obese (Australian Bureau of Statistics, 4364.0.55.001 - National Health Survey: First Results, 2017–18, 2018). The Campbelltown – Changing our Future study will translate ‘a whole of system’ approach, previously trialed in rural communities in Victoria and the Australian Capital Territoty, to Campbelltown Local Government Area (LGA), a socioeconomically and ethnically diverse urban community in south western Sydney, NSW. Methods The study intervention will use a five-step approach; 1 – set up a childhood obesity monitoring system by collecting baseline data from children in primary schools across Campbelltown LGA to give a local context to the community when developing the systems map; 2 - key stakeholders develop systems maps which inform the development of the interventions; 3 - key stakeholders and community groups identify priority areas for action and form working groups; 4 - implementation of the interventions; 5 - evaluation of the interventions. The study will adopt a longitudinal pre/post design with repeated measures at baseline, 2 years and 4 years. Both qualitative and quantitative methods will be used to collect and analyse the data. Discussion Addressing childhood overweight and obesity is complex and requires a multifaceted intervention. This approach has the capacity to impact a range of factors that influence childhood overweight and obesity utilising existing capacity of multiple partners with broad community reach. Findings will develop local responses which capture the complexity of obesity at a community level and further our understanding of the interrelationships and relative importance of local factors impacting childhood overweight and obesity. This study aims to provide evidence for systems methods and approaches suitable for adaption and scaling and may provide evidence of successful community intervention elements.

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