Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-21T23:51:23.089Z Has data issue: false hasContentIssue false
  • English
  • Français

Community Interventions: A Brief Overview and Their Application to the Obesity Epidemic

Published online by Cambridge University Press:  01 January 2021

Christina D. Economos  and
Sonya Irish-Hauser
Get access Rights & Permissions [Opens in a new window]

Extract

Defining “community” from a research perspective is difficult. Communities consist of environmental, social, and geographic components. In addition, race, ethnicity, socio-economic status (SES), and group memberships often play roles in community identity. Barry Wellman and Scot Wortley urge that to truly understand and influence a community, and most certainly to conduct research within communities, one must take into account the varied nature of relationships and networks and how they may work together synergistically to meet the needs of community members. Using the Social Ecological Model, with its delineation of multiple spheres of influence (individual-interpersonal-organizational-community-public policy), community-based research has attempted to reach this understanding. Although dramatic shifts have not yet been realized, many studies suggest improved health behaviors and healthy environments, which indicate a promising future for community intervention work. The discussion that follows reviews the theory and rationale for community-based interventions, the socialecological approach to understanding and studying obesity, and the progress and promise of community interventions.

Type
Symposium
Information
Journal of Law, Medicine & Ethics , Volume 35 , Issue 1 , Spring 2007 , pp. 131 - 137
Copyright
Copyright © American Society of Law, Medicine and Ethics 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Westfall, J. M. et al., “Community-based Participatory Research in Practice-based Research Networks,” Annals of Family Medicine 4, no. 1 (2006): 8–14; MacQueen, K. M., Metzger, D. S., Kegeles, S., Strauss, R. P., Scotti, R., Blanchard, L., and Trotter, R. T., “What Is Community? An Evidence-based Definition for Participatory Public Health,” American Journal of Public Health 91, no. 12 (2001): 1929–1938.CrossRefGoogle Scholar
Wellman, B., “Different Strokes from Different Folks: Community Ties and Social Support,” American Journal of Sociology 96 (1990): 558.CrossRefGoogle Scholar
Glanz, K., Lewis, F. M., and Rimer, B. K., Health Behavior and Health Education, 2nd ed. (San Francisco: Jossey-Bass, 1997); Fortmann, S. P. et al., “Effect of Health Education on Dietary Behavior: The Stanford Three Community Study,” American Journal of Clinical Nutrition 34, no. 10 (1981): 2030–8; Killen, J. D. et al., “The Stanford Adolescent Heart Health Program,” Health Education Quarterly 16, no. 2 (1989): 263–83; Farquhar, J. W. et al., “Effects of Communitywide Education on Cardiovascular Disease Risk Factors: The Stanford Five-City Project,” JAMA 264, no. 3 (1990): 359–65; COMMIT Research Group, “Community Intervention Trial for Smoking Cessation (COMMIT): Summary of Design and Intervention,” Journal National Cancer Institute 83, no. 22 (1991): 1620–8; Carleton, R. A. et al., “The Pawtucket Heart Health Program: Community Changes in Cardiovascular Risk Factors and Projected Disease Risk,” American Journal of Public Health 85, no. 6 (1995): 777–85.Google Scholar
Ewing, R. et al., “Relationship between Urban Sprawl and Physical Activity, Obesity, and Morbidity,” American Journal of Health Promotion 18, no. 1 (2003): 47–57.CrossRefGoogle Scholar
Drewnowski, A., “Obesity and the Food Environment: Dietary Energy Density and Diet Costs,” American Journal of Preventive Medicine 27, Supplement 3 (2004): 154–62; Handy, S. L. et al., “How the Built Environment Affects Physical Activity: Views from Urban Planning,” American Journal of Preventive Medicine 23, Supplement 2 (2002): 64–73; Booth, K. M., Pinkston, M. M., and Poston, W. S., “Obesity and the Built Environment,” Journal of the American Dietetic Association 105, no. 5, Supplement 1 (2005): S110–7.Google Scholar
Prevention Institute, “The Built Environment and Health: 11 Profiles of Neighborhood Transfomation” (Oakland, CA: Prevention Institute, 2004): 1–57.Google Scholar
Farooqi, I. S., “Genetic and Hereditary Aspects of Childhood Obesity,” Best Practice and Research Clinical Endocrinology and Metabolism 19, no. 3 (2005): 359–74.CrossRefGoogle Scholar
Flegal, K. M. et al., “Prevalence of Overweight in U.S. Children: Comparison of U.S. Growth Charts from the Centers for Disease Control and Prevention with other Reference Values for Body Mass Index,” American Journal of Clinical Nutrition 73, no. 6 (2001): 1086–93; Hill, O. J. and Peters, J. C., “Environmental Contributions to the Obesity Epidemic,” Science 280, no. 5368 (1998): 1371–4.CrossRefGoogle Scholar
French, S. A., Story, M., and Jeffery, R. W., “Environmental Influences on Eating and Physical Activity,” Annual Review of Public Health 22 (2001): 309–35.CrossRefGoogle Scholar
Glanz, K., Patterson, R. E., and Kristal, A. R. et al., “Impact of Worksite Health Promotion on Stages of Dietary Change: The Working Well Trial,” Health Behavior & Education 25 (1998): 448–463; Steptoe, A., Kerry, S., Rink, E., and Hilton, S., “The Impact of Behavioral Counseling on Stage of Change in Fat Intake, Physical Activity, and Cigarette Smoking in Adults at Risk of CHD,” American Journal of Public Health 91, no. 2 (2001): 265–9; Janz, N. K., Schottenfeld, D., Doerr, K. M., Selig, S. M., Dunn, R. L., Strawderman, M., and Levine, P. A., “A Two-step Intervention to Increase Mammography among Women 65 and Older,” American Journal of Public Health 87, no. 10 (1997): 1683–86.CrossRefGoogle Scholar
Caballero, B., “Obesity Prevention in Children: Opportunities and Challenges,” International Journal of Obesity Related Metabolic Disorders 28, Supplement 3 (2004): S90–5; Lobstein, T., Baur, L., and Uauy, R., “Obesity in Children and Young People: A Crisis in Public Health,” Obesity Reviews 5, Supplement 1 (2004): 4–104.CrossRefGoogle Scholar
Ravussin, E. and Bouchard, C., “Human Genomics and Obesity: Finding Appropriate Drug Targets,” European Journal of Pharmacology 410, nos. 2, 3 (2000): 131–145.CrossRefGoogle Scholar
Shiu-Thornton, S., “Addressing Cultural Competency in Research: Integrating a Community-based Participatory Research Approach,” Alcohol Clinical and Experimental Research 27, no. 8 (2003): 1361–4.CrossRefGoogle Scholar
Ammerman, A. et al., “Research Expectations among African American Church Leaders in the PRAISE! Project: A Randomized Trial Guided by Community-based Participatory Research,” American Journal of Public Health 93, no. 10 (2003): 1720–7.CrossRefGoogle Scholar
Wickizer, T. M. et al., “Implementation of the Henry J. Kaiser Family Foundation's Community Health Promotion Grant Program: A Process Evaluation,” Milbank Quarterly 76, no. 1 (1998): 121–47.CrossRefGoogle Scholar
Wagner, E. H. et al., “The Evaluation of the Henry J. Kaiser Family Foundation's Community Health Promotion Grant Program: Design,” Journal of Clinical Epidemiology 44, no. 7 (1991): 685–99; Wagner, A. H. et al., “The Kaiser Family Foundation Community Health Promotion Grants Program: Findings from an Outcome Evaluation,” Health Services Research 35, no. 3 (2005): 561–89.CrossRefGoogle Scholar
See Wickizer, supra note 15.Google Scholar
Johns Hopkins Urban Health Institute, “What Is Community-based Participatory Research?” available at <http://www.jhu.edu/uhi/cbpr.html> (last visited December 6, 2006); Leung, M. W., Yen, I. H., and Minkler, M., “Community Based Participatory Research: A Promising Approach for Increasing Epidemiology's Relevance in the 21st Century,” International Journal of Epidemiology 33, no. 3 (2004): 499–506.CrossRefGoogle Scholar
Minkler, M., “Community-based Research Partnerships: Challenges and Opportunities,” Journal of Urban Health 82, Supplement 2 (2005): ii3–12.CrossRefGoogle Scholar
See Westfall, supra note 1.Google Scholar
Burhansstipanov, L., Christopher, S., and Schumacher, S. A., “Lessons Learned from Community-based Participatory Research in Indian Country,” Cancer Control 12, Supplement 2 (2005): 70–6; Chandra, A. and Batada, A., “Exploring Stress and Coping among Urban African American Adolescents: The Shifting the Lens Study,” Preventing Chronic Disease 3, no. 2 (2006): A40.CrossRefGoogle Scholar
Horn, K. et al., “Applying Community-based Participatory Research Principles to the Development of a Smoking-cessation Program for American Indian Teens: ‘Telling Our Story,’” Health Education & Behavior, OnlineFirst, published on May 31, 2006 as <doi:10.1177/1090198105285372>.CrossRefGoogle Scholar
See Minkler, supra note 19.Google Scholar
Koplan, J., Liverman, C., and Kraak, V., Preventing Childhood Obesity: Health in the Balance (Washington, D.C.: The National Academies Press, Institute of Medicine of the National Academies, 2004).Google Scholar
Dietz, W. and Gortmaker, S., “Preventing Obesity in Children and Adolescents,” Annual Review of Public Health 22 (2001): 337–353.CrossRefGoogle Scholar
Pronk, N. P. and Boucher, J., “Systems Approach to Childhood and Adolescent Obesity Prevention and Treatment in a Managed Care Organization,” International Journal of Obesity Related Metabolic Disorders 23, Supplement 2 (1999): S38–42.Google Scholar
Flodmark, C. E. et al., “New Insights into the Field of Children and Adolescents' Obesity: The European Perspective,” International Journal of Obesity Related Metabolic Disorders 28, no. 10 (2003): 1189–96; Institute of Medicine, Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences (Washington, D.C.: National Academies Press, 2001).Google Scholar
Addy, C. L. et al., “Associations of Perceived Social and Physical Environmental Supports with Physical Activity and Walking Behavior,” American Journal of Public Health 94, no. 3 (2004): 440–3; Fitzgibbon, M. L. and Stolley, M. R., “Environmental Changes May be Needed for Prevention of Overweight in Minority Children,” Pediatric Annals 33, no. 1 (2004): 45–9; Travers, K. D., “Reducing Inequities through Participatory Research and Community Empowerment,” Health Education & Behavior 24, no. 3 (1997): 344–56.CrossRefGoogle Scholar
Economos, C., “What Lessons Have Been Learned from Other Attempts to Guide Social Change?” Nutrition Reviews 59, no. 3 (2000): S40:S56.CrossRefGoogle Scholar
See Minkler, supra note 19.Google Scholar
McCarron, D. A., Oparil, S., Chait, A., Haynes, R. B., Kris-Etherton, P., Stern, J. S., Resnick, L. M., Clark, S., Morris, C. D., Hatton, D. C., Metz, J. A., McMahon, M., Holcomb, S., Snyder, G. W., and Pi-Sunyer, B. X., “Nutritional Management of Cardiovascular Risk Factors: A Randomized Clinical Trial,” Archives of Internal Medicine 157, no. 3 (1997): 169–77; Miller, E. R. III, Erlinger, T. P., Young, D. R., Jehn, M., Charleston, J., Rhodes, D., Wasan, S. K., and Appel, L. J., “Results of the Diet, Exercise, and Weight Loss Intervention Trial (DEW-IT),” Hypertension 40, no. 5 (2002): 612–8. Elmer, P. J., Obarzanek, E., Vollmer, W. M., Simons-Morton, D., Stevens, V. J., Young, D. R., Lin, P. H., Champagne, C., Harsha, D. W., Svetkey, L. P., Ard, J., Brantley, P. J., Proschan, M. A., Erlinger, T. P., L. J. Appel, and PREMIER Collaborative Research Group, “Effects of Comprehensive Lifestyle Modification on Diet, Weight, Physical Activity, and Blood Pressure Control: 18 Month Results of a Randomized Control Trial,” Annals of Internal Medicine 144, no. 7 (2006): 127.CrossRefGoogle Scholar
“Multiple Risk Factor Intervention Trial: Risk Factor Changes and Mortality Results. Multiple Risk Factor Intervention Trial Research Group,” JAMA 248, no. 12 (1982): 1465–77.CrossRefGoogle Scholar
Puska, P. et al., “The North Karelia project: 15 Years of Community-based Prevention of Coronary Heart Disease,” Annals of Medicine 21, no. 3 (1989): 169–73; Stern, M. P. et al., “Results of a Two-Year Health Education Campaign on Dietary Behavior: The Stanford Three Community Study,” Circulation 54, no. 5 (1976): 826–33; see Fortmann, supra note 3.CrossRefGoogle Scholar
See Farquhar, supra note 3.Google Scholar
Mittelmark, M. B. et al., “Community-wide Prevention of Cardiovascular Disease: Education Strategies of the Minnesota Heart Health Program,” Preventive Medicine 15, no. 1 (1986): 1–17.CrossRefGoogle Scholar
See Carleton, supra note 3.Google Scholar
See Farquhar, supra note 3.Google Scholar
Murray, D. et al., “Prevention and Treatment of Hypertension at the Population Level: The Minnesota Heart Health Program,” Kardiologiia 26, no. 1 (1986): 78–84.Google Scholar
Jeffery, R. W., “Community Programs for Obesity Prevention: The Minnesota Heart Health Program,” Obesity Research 3, Supplement 2 (1995): 283s–288s.CrossRefGoogle Scholar
Id.Google Scholar
See Carleton, supra note 3.Google Scholar
“Community Intervention Trial for Smoking Cessation (COMMIT): I. Cohort Results from a Four-Year Community Intervention,” American Journal of Public Health 85, no. 2 (1995): 183–92; see COMMIT, supra note 3.CrossRefGoogle Scholar
Davis, S. M. et al., “Pathways: A Culturally Appropriate Obesity-Prevention Program for American Indian Schoolchildren,” American Journal of Clinical Nutrition 69, Supplement 4 (1999): 796S–802S.CrossRefGoogle Scholar
Caballero, B. D., Davis, C. E., Ethelbah, B., Evans, M., Lohman, T., Stephenson, L., Story, M., and White, J., “Pathways: A School-based Program for the Primary Prevention of Obesity in American Indian Children,” Journal of Nutritional Biochemistry 9 (2003): 535–543; see COMMIT, supra note 3.CrossRefGoogle Scholar
See Hopkins, Johns supra note 18. (see http://nutrition.tufts.edu/research/shapeupfordetails.)Google Scholar