Engaging Coalitions in Community-Based Childhood Obesity Prevention Interventions: A Mixed Methods Assessment

Abstract

Background: Childhood obesity prevention interventions have engaged coalitions in study design, implementation, and/or evaluation to improve research outcomes; yet, no systematic reviews have been conducted on this topic. This mixed methods review aims to characterize the processes and dynamics of coalition engagement in community-based childhood obesity prevention interventions.

Methods: Data Sources: Studies extracted from Ovid MEDLINE, PubMed, and Web of Science; complementary original survey and interview data among researchers of included studies. Eligible Studies: Multisetting community-based obesity prevention interventions in high-income countries targeting children 0-12 years with anthropometric, behavioral, or environmental/policy outcomes. The Community-Based Participatory Research (CBPR) Conceptual Model was used as an overarching framework.

Results: Thirteen studies met inclusion criteria. Elements of CBPR were evident across all studies with community engagement in problem identification (n = 7), design/planning (n = 11), implementation (n = 12), evaluation (n = 4), dissemination (n = 2), and sustainability (n = 10) phases. Five studies reported favorable intervention effects on anthropometric (n = 4), behavioral (n = 1), and/or policy (n = 1) outcomes; descriptive associations suggested that these studies tended to engage community members in a greater number of research phases. Researchers involved in 7 of 13 included studies completed a survey and interview. Respondents recalled the importance of group facilitation, leadership, and shared understanding to multisector coalition work. Perceived coalition impacts included community capacity building and intervention sustainability.

Conclusions: This review contributes to a deeper understanding of intervention processes and dynamics within communities engaged in childhood obesity prevention. Future research should more rigorously assess and report on coalition involvement to assess the influence of coalitions on multiple outcomes, including child weight status.

Keywords: childhood obesity prevention; community coalitions; community-based interventions; partnership dynamics; systematic review.

Figure 1.. PRISMA flow diagram of study selection and overview of substudy with surveys and interviews. ^aSum of excluded articles exceeds 96 because of some records meeting multiple exclusion criteria. PRISMA, preferred reporting items for systematic reviews and meta-analyses.

Figure 2.. Qualitative interview themes, interpreted by the CBPR Conceptual Model. Data from interviews administered between April and July 2017: researchers (n = 7) of studies included in the systematic review. CBPR, Community-Based Participatory Research.

Figure 3.. Groups or sectors represented in community coalitions. Data from online survey administered between April and June 2017: researchers (n = 7) of studies included in the systematic review.

Figure 4.. Main achievements of coalitions. Data from online survey administered between April and June 2017: researchers (n = 7) of studies included in the systematic review.