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Schröder M, Babitsch B, Hassel H. Assessing readiness for childhood obesity prevention in German municipalities: application of the community readiness model. Health Promot Int 2023; 38:daad169. [PMID: 38071434 DOI: 10.1093/heapro/daad169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
The World Health Organization has identified childhood obesity as one of the most serious public health problems of the 21st century. Understanding a municipality's readiness to address it is crucial to achieve successful interventions. However, the preparedness of German municipalities to address childhood obesity has not yet been investigated. This study is the first in Germany to apply the community readiness model (CRM) in this context. The purpose was to determine readiness of five municipalities for childhood obesity prevention and to identify factors that influence their readiness. Therefore, 27 semi-structured key informant interviews were conducted. First, the interviews were analysed following the CRM protocol to categorize the municipalities into a readiness level between one and nine. In a second step, a content analysis was carried out for an in-depth interpretation of the readiness scores. The municipalities achieved an average readiness of 3.84, corresponding to the 'Vague Awareness' stage. A lack of prioritization and leadership support, insufficient low-threshold efforts, a lack of knowledge and problem awareness as well as a lack of structures and resources were identified as factors that can determine municipal readiness to prevent childhood obesity. This study not only extends the application of the CRM to childhood obesity in German municipalities but also offers practical implications for professionals in assessing readiness.
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Affiliation(s)
- Maike Schröder
- Department of New Public Health, Osnabrück University, Nelson-Mandela-Straße 13, 49076, Osnabrück, Germany
- Department of Applied Sciences and Health, Coburg University of Applied Sciences and Arts, Friedrich-Streib-Straße 2, 96450, Coburg, Germany
| | - Birgit Babitsch
- Department of New Public Health, Osnabrück University, Nelson-Mandela-Straße 13, 49076, Osnabrück, Germany
| | - Holger Hassel
- Department of Applied Sciences and Health, Coburg University of Applied Sciences and Arts, Friedrich-Streib-Straße 2, 96450, Coburg, Germany
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Tandoh A, Laar A, Pradeilles R, Le Port A, Osei-Kwasi H, Amevinya GS, Aryeetey RNO, Agyemang C, Holdsworth M. Addressing the marketing and availability of unhealthy food and beverages in and around selected schools in Ghana: a community readiness appraisal. BMJ Open 2023; 13:e075166. [PMID: 37770260 PMCID: PMC10546112 DOI: 10.1136/bmjopen-2023-075166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/21/2023] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVE This study assessed stakeholder readiness to address unhealthy food and beverage marketing and availability in/around Public Basic Schools (for children 4-15 years) in Greater Accra Region, the highly urbanised administrative capital of Ghana. DESIGN The community readiness model was used to conduct in-depth mixed methods interviews with stakeholders. Using predefined anchored rating statements, quantitative readiness scores ranging from 1 to 9 were generated. Thematic qualitative analysis was undertaken to understand barriers and facilitators that could influence the implementation of interventions. SETTING Greater Accra Region, Ghana. PARTICIPANTS 18 key informants from various school/education/citizen sectors, which together represented the 'school community' of Greater Accra Region. RESULTS The mean readiness scores indicated that the 'school community' was at the 'preplanning' stage of readiness (4.44±0.98) to address the marketing and availability of unhealthy food and beverages in and around schools. The mean readiness score for 'leadership' was the highest of all dimensions (5.36±1.60), corresponding to the 'preparation' stage. The lowest scores were found for 'community knowledge of efforts' (3.19±2.45) and 'resources for efforts' (3.64±0.87), both of which were at a 'vague awareness' stage. CONCLUSIONS The 'school community' recognised that the marketing and availability of unhealthy food and beverages was a problem. Additionally, current leadership was actively supportive of continuing/improving efforts that create healthier children's food environments. However, actions that aim to increase the 'school community's' knowledge of existing interventions and securing resources to sustain those interventions are needed before introducing readiness appropriate strategies.
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Affiliation(s)
- Akua Tandoh
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Greater Accra, Ghana
- UMR MoISA (Montpellier Interdisciplinary centre on Sustainable Agri-food systems), Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro Montpellier, IRD, Montpellier, France
| | - Amos Laar
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Greater Accra, Ghana
| | - Rebecca Pradeilles
- UMR MoISA (Montpellier Interdisciplinary centre on Sustainable Agri-food systems), Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro Montpellier, IRD, Montpellier, France
| | - Agnes Le Port
- UMR MoISA (Montpellier Interdisciplinary centre on Sustainable Agri-food systems), Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro Montpellier, IRD, Montpellier, France
| | - Hibbah Osei-Kwasi
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Gideon Senyo Amevinya
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Greater Accra, Ghana
| | - Richmond Nii Okai Aryeetey
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Greater Accra, Ghana
| | - Charles Agyemang
- Department of Public & Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
- Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University, Baltimore, Maryland, USA
| | - Michelle Holdsworth
- UMR MoISA (Montpellier Interdisciplinary centre on Sustainable Agri-food systems), Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro Montpellier, IRD, Montpellier, France
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He L, Svelnis I, Ferraro A, McCrindle BW, Moon T, Salmon A, Longmuir PE. Community Readiness Assessment of the "Take TIME for Your Child's Health" Intervention. Healthcare (Basel) 2023; 11:2386. [PMID: 37685420 PMCID: PMC10487062 DOI: 10.3390/healthcare11172386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
Take TIME (Tobacco-free, Injury-free, Moving daily, Eating healthy) was an early intervention strategy targeting community readiness to support healthy lifestyles for young children in Uxbridge, Canada. This study aimed to assess the effectiveness of Take TIME using the Community Readiness Model adapted for childhood obesity prevention. Six interviews were completed in Uxbridge, before and after the intervention, with purposively selected community leaders in education, political, business, religious, not-for-profit, and healthcare fields. Each interview was rated independently by two scorers. Interview content was scored (scale from 1 to 9, with 1 being no awareness and 9 being a high level of community ownership) according to the Community Readiness Model criteria on six dimensions, with overall readiness calculated as the mean score of all dimensions. T-tests compared readiness by time-point and between communities. Overall community readiness significantly improved (p = 0.03) in Uxbridge from pre-intervention (3.63 ± 1.14 vague awareness) to post-intervention (5.21 ± 0.97 preparation). Seven interviews were also completed with leaders in the matched town of Rockwood, Canada which served as the control community. Rockwood readiness was close to the Uxbridge post-intervention score (5.35 ± 1.11). Results indicated increased awareness and leadership support post-intervention in Uxbridge, but further improvements in community knowledge, formalized efforts, and additional leadership support are desired. Take TIME increased community readiness to support healthy lifestyles for young children and may be useful to other communities at similar stages, given its theoretical alignment with the community readiness model. Future research should investigate the impact of Take TIME in demographically diverse communities and appropriate interventions to move communities from the preparation to the action stage.
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Affiliation(s)
- Lisa He
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada;
| | - Ingrid Svelnis
- Township of Uxbridge, Uxbridge, ON L9P 1H1, Canada; (I.S.); (A.F.)
| | - Amanda Ferraro
- Township of Uxbridge, Uxbridge, ON L9P 1H1, Canada; (I.S.); (A.F.)
| | - Brian W. McCrindle
- Division of Cardiology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada;
| | - Tyler Moon
- Heart and Stroke Foundation, Toronto, ON M4P 1E4, Canada;
| | - Art Salmon
- Canadian Fitness and Lifestyle Research, Ottawa, ON K1B 0A9, Canada;
| | - Patricia E. Longmuir
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada;
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
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Niknam M, Omidvar N, Eini-Zinab H, Kalantari N, Olazadeh K, Amiri P. Improving community readiness among Iranian local communities to prevent childhood obesity. BMC Public Health 2023; 23:344. [PMID: 36793004 PMCID: PMC9931445 DOI: 10.1186/s12889-023-15163-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Community Readiness Intervention for Tackling Childhood Obesity (CRITCO) is a theory-based intervention being developed to improve the readiness of an Iranian urban population to engage in childhood obesity prevention programs. This study aimed to explore changes in readiness of intervention and control local communities from diverse socio-economic areas of Tehran. METHODS This study was a seven-month quasi-experimental intervention implemented in four intervention communities and compared with four controls. Aligned strategies and action plans were developed around the six dimensions of community readiness. The Food and Nutrition Committee was established in each intervention community to make collaborative efforts among different sectors and assess the fidelity of the intervention. The pre-and post- readiness change was explored through interviews with 46 community key informants. RESULTS The total readiness of intervention sites increased by 0.48 units (p < 0.001) and shifted to the next higher level, from preplanning to the preparation stage. At the same time, the readiness of control communities decreased by 0.39 units (p < 0.001), although their readiness stage remained unchanged, reflecting the fourth stage. Also, a sex-dependent CR change was observed, such that the girls' schools showed a more remarkable improvement in interventions and less decline in controls. The readiness stages of interventions significantly improved for four dimensions related to community efforts, knowledge of the efforts, knowledge of childhood obesity issue, and leadership. Furthermore, the readiness of control communities significantly decreased on three of six dimensions related to community effort, knowledge of efforts, and resources. CONCLUSIONS The CRITCO successfully improved the readiness of intervention sites for addressing childhood obesity. It is hoped that the present study can be a spark for developing readiness-based childhood obesity prevention programs in Middle Eastern and other developing countries. TRIAL REGISTRATION The CRITCO intervention was registered at Iran Registry for Clinical Trials ( http://irct.ir ; IRCT20191006044997N1) on 11/11/2019.
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Affiliation(s)
- Mahdieh Niknam
- grid.411600.2Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Velenjak St., Shahid Chamran Highway, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI), Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran.
| | - Hassan Eini-Zinab
- grid.411600.2Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI), Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran
| | - Naser Kalantari
- grid.411600.2Department of Community Nutrition, National Nutrition and Food Technology Research Institute (NNFTRI), Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran
| | - Keyvan Olazadeh
- grid.411600.2Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Velenjak St., Shahid Chamran Highway, Tehran, Iran
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Velenjak St., Shahid Chamran Highway, Tehran, Iran.
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Niknam M, Omidvar N, Amiri P, Eini-Zinab H, kalantari N. Adapting the Community Readiness Model and Validating a Community Readiness Tool for Childhood Obesity Prevention Programs in Iran. J Prev Med Public Health 2023; 56:77-87. [PMID: 36746425 PMCID: PMC9925285 DOI: 10.3961/jpmph.22.409] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES It is critical to assess community readiness (CR) when implementing childhood obesity prevention programs to ensure their eventual success and sustainability. Multiple tools have been developed based on various conceptions of readiness. One of the most widely used and flexible tools is based on the community readiness model (CRM). This study aimed to adapt the CRM and assess the validity of a community readiness tool (CRT) for childhood obesity prevention programs in Iran. METHODS A Delphi study that included 26 individuals with expertise in 8 different subject areas was conducted to adapt the CRM into a theoretical framework for developing a CRT. After linguistic validation was conducted for a 35-question CR interview guide, the modified interview guide was evaluated for its content and face validity. The quantitative and qualitative analyses were performed using Stata version 13 and MAXQDA 2010, respectively. RESULTS The Delphi panelists confirmed the necessity/appropriateness and adequacy of all 6 CRM dimensions. The Persian version of the interview guide was then modified based on the qualitative results of the Delphi study, and 2 more questions were added to the community climate dimension of the original CRT. All questions in the modified version had acceptable content and face validity. The final CR interview guide included 37 questions across 6 CRM dimensions. CONCLUSIONS By adapting the CRM and confirming linguistic, content, and face validity, the present study devised a CRT for childhood obesity prevention programs that can be used in relevant studies in Iran.
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Affiliation(s)
- Mahdieh Niknam
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Corresponding author: Nasrin Omidvar, Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan Street, Shahrak Qods, Tehran 1981629573, Iran E-mail:
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Co-corresponding author: Parisa Amiri, Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Velenjak Street, Shahid Chamran Highway, Tehran 1985717413, Iran E-mail:
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Naser kalantari
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Assessing community readiness for overweight and obesity prevention among Ghanaian immigrants living in Greater Manchester, England. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01777-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Abstract
Aim
This study assesses community readiness to prevent overweight/obesity among Ghanaian immigrants in Greater Manchester, England.
Subject and method
The Community Readiness Model (CRM) was applied using a semi-structured interview tool with 13 key informants (religious and other key community members) addressing five readiness dimensions. A maximum of 9 points per dimension (from 1 = no awareness to 9 = high level of community ownership), was assigned, alongside qualitative textual thematic analysis.
Results
The mean readiness score indicated that the study population was in the “vague awareness stage” (3.08 ± 0.98). The highest score was observed for community knowledge of the issue (4.42 ± 0.99) which was in the pre-planning phase, followed by community climate (vague awareness; 3.58 ± 0.62). The lowest scores were seen for resources (denial/resistance; 2.70 ± 0.61) and knowledge of efforts (no awareness; 1.53 ± 0.44). Findings identified structural barriers, including poor living conditions as a result of poorly paid menial jobs and high workload, contributing to the adoption of unhealthy lifestyle behaviours. Socio-cultural factors such as fatalism, hereditary factors, and social status were associated with acceptance of overweight.
Conclusion
Despite recognising overweight/obesity as an important health issue in these communities, especially among women, it is not seen as a priority for targeting change. To help these communities to become more ready for interventions that tackle overweight/obesity, the focus should initially be to address the structural barriers identified, including reducing poverty, alongside designing interventions that work with these structural barriers, and thereafter focus on the socio-cultural factors.
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Schröder M, Schnabel M, Hassel H, Babitsch B. Application of the Community Readiness Model for childhood obesity prevention: a scoping review. Health Promot Int 2022; 37:6680028. [PMID: 36047636 DOI: 10.1093/heapro/daac120] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Community Readiness Model (CRM) provides an approach to determine community readiness (CR), which is the degree of a community's preparedness to address a health issue. This scoping review aims to characterize internationally existing applications of the CRM for childhood obesity prevention. Therefore, a systematic literature research was conducted in PubMed, Cochrane Library, LIVIVO and Google Scholar. Of 285 identified records, 17 studies met the eligibility criteria and were included in the scoping review. The CRM has already been applied to childhood obesity prevention in the USA (n = 10), Australia (n = 4), UK (n = 1), Iran (n = 1) and South Africa (n = 1). Mainly geographically defined communities (n = 12) like counties and cities were analysed but also schools (n = 4) and churches (n = 1). The scoping review revealed various methodological changes to the standard protocol of which some are particularly relevant for the application to childhood obesity prevention. The identified studies reported readiness scores in the low to mid-range of the nine-point readiness scale. To increase CR, strategies were proposed that addressed raising awareness and knowledge of childhood obesity, but also supporting connectivity in and between settings. This scoping review provides researchers and health promoters with an overview of international CR measurements and setting-specific strategies to increase CR. It highlights the potential of targeted interventions to increase readiness and shows tentative support for the assumption of a possible link between CR level and changes in obesity prevalence.
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Affiliation(s)
- Maike Schröder
- Coburg University of Applied Sciences and Arts, Department of Holistic Health Sciences, Coburg, Germany.,Osnabrück University, Department of New Public Health, Osnabrück, Germany
| | - Monika Schnabel
- Coburg University of Applied Sciences and Arts, Department of Holistic Health Sciences, Coburg, Germany
| | - Holger Hassel
- Coburg University of Applied Sciences and Arts, Department of Holistic Health Sciences, Coburg, Germany
| | - Birgit Babitsch
- Osnabrück University, Department of New Public Health, Osnabrück, Germany
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Abstract
AbstractThe rapid rise in the prevalence of overweight and obesity, and the associated health problems, is an emerging challenge in Ghana, and for women in particular. This study contributes to the understanding of this emerging phenomenon in Ghana by analyzing it from a community perspective, applying the Community Readiness Model in two small cities in Ghana. A series of Key Informant Interviews were undertaken and analyzed, using the model’s scoring structure and supplementary textual analysis. We find that communities are aware of overweight and obesity as a health issue, but that it is not prioritized or championed. Furthermore, the diet counseling and keep-fit programs put the responsibility on individuals to address, rather than considering the upstream and structural causes and solutions.
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Niknam M, Omidvar N, Amiri P, Eini-Zinab H, Kalantari N. Community readiness for childhood obesity prevention programs: findings from an urban population in Iran. Health Promot Int 2021; 36:824-835. [PMID: 33111938 DOI: 10.1093/heapro/daaa101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to examine the Iranian local communities' readiness stage to engage with childhood obesity prevention programs for late primary school children in districts 2 and 16 of Tehran as the representatives of high and low socio-economic districts, respectively. First, a Delphi approach was conducted to assess the socio-cultural necessity/appropriateness and adequacy of the community readiness model and its dimensions as a planning basis for childhood obesity prevention program(s) in Iran. Then, the community readiness interview guide's translation, modification, content and face validity were performed. Finally, 66 interviews with key informants were conducted and scored to assess community readiness. The socio-cultural necessity/appropriateness and adequacy of community readiness model and its dimensions were confirmed by Delphi participants and two questions were added to the interview guide. Content and face validity of the interview guide were at acceptable levels. Assessment of the community readiness based on the key informants' perspective showed that the overall mean readiness score of targeted local communities was 4.61 ± 0.54 and 4.22 ± 0.26 in high and low socio-economic districts, respectively, corresponded to 'preplanning stage'. The highest score was 5.00 ± 0.48 correspond to the 'preparation stage', which belonged to girls' schools in district 2. Small differences were found in the readiness stage of local communities by sex and socio-economic status of schools. The results highlight the need to increase community awareness, gain their support to recognize childhood obesity as a priority, address cultural misconceptions and improve the obesity prevention programs to achieve a higher level of readiness.
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Affiliation(s)
- Mahdieh Niknam
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran 1981629573
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran 1981629573
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Velenjak St., Shahid Chamran Highway, Tehran, Iran 1985717413
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran 1981629573
| | - Naser Kalantari
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, West Arghavan, St. Farahzadi Blvd., Shahrak Qods, Tehran, Iran 1981629573
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Nigusie A, Azale T, Yitayal M, Derseh L. Low level of community readiness prevails in rural northwest Ethiopia for the promotion of institutional delivery. Pan Afr Med J 2021; 38:281. [PMID: 34122708 PMCID: PMC8179980 DOI: 10.11604/pamj.2021.38.281.27300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 03/08/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction the health benefits of institutional delivery with the support of skilled professional are one of the indicators of maternal health status which have an impact on the health of women and new coming generation. Despite these benefits, many pregnant women in Ethiopia are not actively bringing delivery at health facility. This study was aimed at determining the readiness level of community for promoting child birth at health facility. Methods a population-based cross-sectional study was conducted. We interviewed 96 key informants using a semi-structured questionnaire adapted from the community readiness assessment model and translated to Amharic language. The key informants were purposively selected in consultation with the district health office to represent the community. The interviews were transcribed verbatim and survey scores were matched with the readiness stage of 1 of the 9 for the five dimensions using the assessment guidelines. Results this study placed nine kebeles at stage 3 (vague awareness), which indicates the need for more institutional delivery service strategy programming; efforts of the community were not focused and low leadership concern and one kebele was in stage 2 (denial/resistance). Six kebeles were placed at high level of readiness i.e. in stage 7 (stabilization), indicating actions are sustained by the local managers or opinion leaders. Conclusion evidence derived from the present study can be used to match intervention tactics for promoting health facility child birth service utilization to communities based on their level of readiness.
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Affiliation(s)
- Adane Nigusie
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Telake Azale
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mezgebu Yitayal
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Lemma Derseh
- Department of Epidemiology and Biostatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Muellmann S, Brand T, Jürgens D, Gansefort D, Zeeb H. How many key informants are enough? Analysing the validity of the community readiness assessment. BMC Res Notes 2021; 14:85. [PMID: 33750436 PMCID: PMC7941941 DOI: 10.1186/s13104-021-05497-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 02/23/2021] [Indexed: 11/10/2022] Open
Abstract
Objective Communities are important settings for health promotion and prevention. The community readiness assessment offers a structured approach to assess resources and opportunities to tackle a health problem within a community. The assessment relies on semi-structured interviews with key informants from the communities. A number of 4–6 key informant interviews are recommended in the literature. However, it is unclear whether this is sufficient to obtain a valid representation of the respective community. This study analysed whether increasing the number of key informants from 4–6 to 12–15 alters the results of the community readiness assessment. Results A total of 55 community readiness interviews were carried out in 4 communities. Overall, the community readiness scores showed little variation after having interviewed 10 key informants in a community. However, even after completing 10 interviews in a community, key informants were still able to identify up to 6 new information items regarding community efforts for physical activity promotion among the elderly, contact and communication channel for informing or approaching the target group, or barriers to participation. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-021-05497-9.
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Affiliation(s)
- Saskia Muellmann
- Department of Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Achterstr 30, 28359, Bremen, Germany
| | - Tilman Brand
- Department of Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Achterstr 30, 28359, Bremen, Germany
| | - Dorothee Jürgens
- Department of Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Achterstr 30, 28359, Bremen, Germany
| | - Dirk Gansefort
- Department of Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Achterstr 30, 28359, Bremen, Germany.,Association for Health Promotion and Academy of Social Medicine Lower Saxony, Fenskenweg 2, 30165, Hannover, Germany
| | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Achterstr 30, 28359, Bremen, Germany. .,Health Sciences Bremen, University of Bremen, Bremen, Germany.
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Larcombe L, McLeod A, Samuel S, Samuel J, Payne M, Van Haute S, Singer M, Ringaert L, Meyers AFA, Kinew K, Keynan Y, MacDonald K, Antsanen J, Orr P. A Dene First Nation's community readiness assessment to take action against HIV/AIDS: a pilot project. Int J Circumpolar Health 2020; 78:1588092. [PMID: 30935345 PMCID: PMC6450605 DOI: 10.1080/22423982.2019.1588092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Among Indigenous people in Canada the incidence of HIV is 3.5 times higher than other ethnicities. In Manitoba First Nations, Metis and Inuit people are disproportionately represented (40%) among people who are new to HIV care. Northlands Denesuline First Nation (NDFN) identified the need to revisit their level of knowledge and preparedness for responding to the increasing rates of HIV. NDFN piloted a community readiness assessment (CRA) tool to assess its appropriateness for use in northern Manitoba. Methods: A First Nation and non-First Nation research team trained to administer the CRA tool at NDFN in Manitoba. Five informants were interviewed using the CRA tool and the responses were scored, analysed and reviewed at community workshops and with stakeholders to develop a 1-year action plan. Results: CRA training was best conducted in the community. Using the readiness score of 2.4 along with feedback from two workshops, community members, the research team and stakeholders, we identified priorities for adult education and youth involvement in programmes and planning. Conclusions: In response to the increasing incidence of HIV, a northern First Nation community successfully modified and implemented a CRA tool to develop an action plan for culturally appropriate interventions and programmes.
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Affiliation(s)
- Linda Larcombe
- a Max Rady College of Medicine , University of Manitoba , Winnipeg , Manitoba
| | - Albert McLeod
- b Two-Spirited Peoples of Manitoba , Winnipeg , Manitoba
| | - Sarah Samuel
- c Northlands Denesuline First Nation , Lac Brochet , Manitoba
| | - Jennifer Samuel
- c Northlands Denesuline First Nation , Lac Brochet , Manitoba
| | - Michael Payne
- d Nine Circles Community Health Centre/MB HIV Collective Impact Network , Winnipeg , Manitoba
| | | | - Matthew Singer
- a Max Rady College of Medicine , University of Manitoba , Winnipeg , Manitoba
| | | | - Adrienne F A Meyers
- f National HIV and Retrovirology Laboratories, JC Wilt Infectious Diseases Research Centre , Public Health Agency of Canada , Winnipeg , Manitoba
| | - Kathi Kinew
- g First Nation Health and Social Secretariat , Winnipeg , Manitoba
| | - Yoav Keynan
- a Max Rady College of Medicine , University of Manitoba , Winnipeg , Manitoba
| | - Kelly MacDonald
- a Max Rady College of Medicine , University of Manitoba , Winnipeg , Manitoba
| | - Joe Antsanen
- c Northlands Denesuline First Nation , Lac Brochet , Manitoba
| | - Pamela Orr
- a Max Rady College of Medicine , University of Manitoba , Winnipeg , Manitoba
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Villanueva-Borbolla MÁ, Cervantes-Ortega E, Campos-Rivera M. Análisis de la capacidad de respuesta comunitaria para desarrollar iniciativas de promoción de la salud. Glob Health Promot 2020. [DOI: 10.1177/1757975919893982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objetivo: analizar la capacidad de respuesta comunitaria (CR) hacia la obesidad, diabetes e hipertensión (ODH) para el desarrollo de iniciativas de promoción de la salud en una comunidad de origen náhuatl en México. Material y métodos: estudio basado en el Modelo de Capacidad de Respuesta Comunitaria (MCRC) con abordaje cualitativo. Entrevistamos ocho informantes clave. Realizamos la asignación de valores por dimensión utilizando la escala del MCRC y el análisis de contenido para comprender los factores involucrados en la CR. Resultados: la etapa de CR identificada fue de “concientización vaga” (valor 3). Se reconocieron los elementos que dificultan el involucramiento de la comunidad. Discusión: valorar la CR es imprescindible para generar estrategias apropiadas. El MCRC resultó útil para profundizar en la ODH como fenómeno social en un contexto como el de Xoxocotla. El análisis cualitativo fue indispensable para comprender la CR y las consideraciones necesarias para generar iniciativas efectivas.
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Whelan J, Love P, Millar L, Allender S, Morley C, Bell C. A rural community moves closer to sustainable obesity prevention - an exploration of community readiness pre and post a community-based participatory intervention. BMC Public Health 2019; 19:1420. [PMID: 31666042 PMCID: PMC6820900 DOI: 10.1186/s12889-019-7644-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 09/20/2019] [Indexed: 11/21/2022] Open
Abstract
Background Understanding levels of community readiness can result in prevention efforts that align with communities’ ability and capacity for change and, therefore, be more effective and sustainable. Our study aimed to use baseline (pre-intervention) community readiness scores to assist with the development of obesity prevention strategies, and to assess changes in community readiness over time (pre/post- intervention), to provide evidence of intervention impact. Method Our study was located in a rural and remote area of Victoria, Australia. Community readiness was part of a broader obesity prevention intervention designed to create healthier food and physical activity environments through the combination of systems thinking and collaborative community-led solutions. Interviews were conducted using the community readiness to change tool in 2016 (pre) and 2018 (post) with a community representative sample. Baseline data informed the development of community relevant strategies and the pre/post results formed part of the overall evaluation. Results The tool generated both quantitative and qualitative (quotes) data. A final readiness score was calculated that corresponded to one of the nine stages of readiness. Four of the five domains of the community readiness to change tool showed statistically significant improvements over time (p < 0.05): knowledge of effort, knowledge of issue, community climate, and leadership. The resources domain that did not improve pre/post intervention. Conclusion Community readiness to change interviews, pre- and post- intervention, provided essential information related to the appropriate targeting and pitch of the prevention strategies, as well as providing an overall evaluation of the positive movement in the community’s readiness to implement change.
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Affiliation(s)
- Jillian Whelan
- Institute for Health Transformation, Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, Australia.
| | - Penelope Love
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Lynne Millar
- Adjunct Fellow, Victoria University, Melbourne, Australia
| | - Steven Allender
- Institute for Health Transformation, Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, Australia
| | | | - Colin Bell
- Institute for Health Transformation, Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong, Australia
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Pradeilles R, Marr C, Laar A, Holdsworth M, Zotor F, Tandoh A, Klomegah S, Coleman N, Bash K, Green M, Griffiths PL. How ready are communities to implement actions to improve diets of adolescent girls and women in urban Ghana? BMC Public Health 2019; 19:646. [PMID: 31138180 PMCID: PMC6537223 DOI: 10.1186/s12889-019-6989-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/15/2019] [Indexed: 11/16/2022] Open
Abstract
Background Ghana has reached an advanced stage of nutrition transition, contributing to an increase in nutrition-related non-communicable diseases, particularly amongst urban women. Community involvement is an important factor in the success of efforts to promote healthy eating. The readiness of populations to accept a range of interventions needs to be understood before appropriate interventions can be implemented. Therefore, this study assessed how ready urban communities are to improve diets of women of reproductive age in Ghana. Methods Using the Community Readiness Model (CRM), in-depth interviews were conducted with 24 key informants from various sectors in low income communities across two cities in Ghana: Accra and Ho. The CRM consists of 36 open questions addressing five readiness dimensions (community knowledge of efforts, leadership, community climate, knowledge of the issue and resources). Interviews were scored using the CRM protocol with a maximum of 9 points per dimension (from 1 = no awareness to 9 = high level of community ownership). Thematic analysis was undertaken to gain insights of community factors that could affect the implementation of interventions to improve diets. Results The mean community readiness scores indicated that both communities were in the “vague awareness stage” (3.35 ± 0.54 (Accra) and 3.94 ± 0.41 (Ho)). CRM scores across the five dimensions ranged from 2.65–4.38/9, ranging from denial/resistance to pre-planning. In both communities, the mean readiness score for ‘knowledge of the issue’ was the highest of all dimensions (4.10 ± 1.61 (Accra); 4.38 ± 1.81 (Ho)), but was still only at the pre-planning phase. The lowest scores were found for community knowledge of efforts (denial/resistance; 2.65 ± 2.49 (Accra)) and resources (vague awareness; 3.35 ± 1.03 (Ho)). The lack of knowledge of the consequences of unhealthy diets, misconceptions of the issue partly from low education, as well as challenges faced from a lack of resources to initiate/sustain programmes explained the low readiness. Conclusions Despite recognising that unhealthy diets are a public health issue in these urban Ghanaian communities, it is not seen as a priority. The low community readiness ratings highlight the need to increase awareness of the issue prior to intervening to improve diets. Electronic supplementary material The online version of this article (10.1186/s12889-019-6989-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rebecca Pradeilles
- Public Health Section, School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, UK.
| | - Colette Marr
- Public Health Section, School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, UK
| | - Amos Laar
- Department of Population, Family & Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Michelle Holdsworth
- Public Health Section, School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, UK
| | - Francis Zotor
- Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana
| | - Akua Tandoh
- Department of Population, Family & Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Senam Klomegah
- Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana
| | - Nathaniel Coleman
- Department of Population, Family & Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Kristin Bash
- Public Health Section, School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, UK
| | - Mark Green
- School of Environmental Sciences, University of Liverpool, Liverpool, UK
| | - Paula L Griffiths
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Cyril S, Polonsky M, Green J, Agho K, Renzaho A. Readiness of communities to engage with childhood obesity prevention initiatives in disadvantaged areas of Victoria, Australia. AUST HEALTH REV 2017; 41:297-307. [PMID: 27414153 DOI: 10.1071/ah16069] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 05/23/2016] [Indexed: 11/23/2022]
Abstract
Objective Disadvantaged communities bear a disproportionate burden of childhood obesity and show low participation in childhood obesity prevention initiatives. This study aims to examine the level of readiness of disadvantaged communities to engage with childhood obesity prevention initiatives. Methods Using the community readiness model, 95 semi-structured interviews were conducted among communities in four disadvantaged areas of Victoria, Australia. Community readiness analysis and paired t-tests were performed to assess the readiness levels of disadvantaged communities to engage with childhood obesity prevention initiatives. Results The results showed that disadvantaged communities demonstrated low levels of readiness (readiness score=4/9, 44%) to engage with the existing childhood obesity prevention initiatives, lacked knowledge of childhood obesity and its prevention, and reported facing challenges in initiating and sustaining participation in obesity prevention initiatives. Conclusion This study highlights the need to improve community readiness by addressing low obesity-related literacy levels among disadvantaged communities and by facilitating the capacity-building of bicultural workers to deliver obesity prevention messages to these communities. Integrating these needs into existing Australian health policy and practice is of paramount importance for reducing obesity-related disparities currently prevailing in Australia. What is known about the topic? Childhood obesity prevalence is plateauing in developed countries including Australia; however, obesity-related inequalities continue to exist in Australia especially among communities living in disadvantaged areas, which experience poor engagement in childhood obesity prevention initiatives. Studies in the USA have found that assessing disadvantaged communities' readiness to participate in health programs is a critical initial step in reducing the disproportionate obesity burden among these communities. However, no studies in Australia have assessed disadvantaged communities' readiness to engage in obesity prevention initiatives. What does this paper add? This paper addresses the current gap in the knowledge of disadvantaged communities' level of readiness to engage in childhood obesity prevention initiatives in Australia. The study also identified the key factors responsible for low readiness of disadvantaged communities to participate in current childhood obesity prevention services. By using the Community Readiness model this study shows the readiness levels specific to the various dimensions of the model; Understanding dimension-specific readiness allows us to identify strategies that are tailored to each dimension, as guided by the model. What are the implications for practitioners? With the increasing burden of childhood obesity on disadvantaged communities, policymakers and health practitioners are facing a crisis in obesity prevention and management. Almost every year, new interventions are being planned and implemented. However if the target communities are not ready to participate in the available interventions these efforts are futile. This study exposes the key factors responsible for low readiness to participate in current obesity prevention services by disadvantaged communities. Addressing these key factors and improving readiness before designing new interventions will improve the participation of disadvantaged communities in those interventions. The study findings ultimately have the potential of reducing obesity-related disparities in Australia.
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Affiliation(s)
- Sheila Cyril
- School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Michael Polonsky
- Department of Marketing, Deakin Business School, Deakin University, 221 Burwood Highway, Burwood, Vic. 3125, Australia. Email
| | - Julie Green
- Murdoch Children's Research Institute, and Department of Paediatrics, The University of Melbourne, and Parenting Research Centre, 323 Victoria Parade, East Melbourne, Vic. 3002, Australia. Email
| | - Kingsley Agho
- School of Science and Health, Western Sydney University, Locked Bag 1797, Penrith, NSW 2571, Australia. Email
| | - Andre Renzaho
- School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia. Email
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Hoque KE, Kamaluddin MA, Abdul Razak AZ, Abdul Wahid AA. Building healthy eating habits in childhood: a study of the attitudes, knowledge and dietary habits of schoolchildren in Malaysia. PeerJ 2016; 4:e2651. [PMID: 27904803 PMCID: PMC5126617 DOI: 10.7717/peerj.2651] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 10/04/2016] [Indexed: 11/20/2022] Open
Abstract
Background Overweight and obesity have increased rapidly in incidence to become a global issue today. Overweight and obesity problems are significantly linked to unhealthy dietary patterns, physical inactivity and misperception of body image. This study aimed to determine whether Malaysian children build healthy eating habits from childhood. Methods A survey on eating habits was conducted among primary school students in standards 4 to 6 in the state of Selangor, Malaysia. The findings of the study were reported in the form of descriptive statistics involving frequencies and percentages. Data from 400 respondents were analyzed. Results Our findings showed that the students understood the definition of healthy food and the types of food that are considered healthy. Although the students knew that food such as deep-fried drumsticks and hamburgers contain a high amount of saturated fat and cholesterol, these foods were still consumed by them. There was also a high consumption of foods that are fried and contain sugar, salt and saturated fat. In choosing food, two major factors contributed to the students’ decisions: cleanliness (65.8%) and the preference of their parents (12.3%). Discussion Our findings indicate that by implementing the Integrated School Health Program (ISHP) properly, students’ eating habits can be improved by creating a school with a healthy environment.
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Affiliation(s)
- Kazi Enamul Hoque
- Faculty of Education, University of Malaya , Kuala Lumpur , Malaysia
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18
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Pradeilles R, Rousham EK, Norris SA, Kesten JM, Griffiths PL. Community readiness for adolescents' overweight and obesity prevention is low in urban South Africa: a case study. BMC Public Health 2016; 16:763. [PMID: 27515802 PMCID: PMC4982405 DOI: 10.1186/s12889-016-3451-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 08/05/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND South Africa is undergoing epidemiological and nutrition transitions with associated increases in the incidence of overweight, obesity and diet-related chronic diseases. With the emergence of the nutrition transition in South Africa, there is an urgent need for interventions to prevent overweight and obesity in children and adolescents as risk factors for chronic diseases in adolescence may track throughout later life. This research explored the potential for faith-based organisations (FBOs) to be used as community organisations for overweight and obesity prevention interventions in adolescents by assessing the readiness of religious leaders to engage in such interventions. METHODS Surveys and focus group discussions (FGDs) were conducted with 51 religious leaders in Johannesburg and Soweto. The Community Readiness Model (CRM) survey was chosen to determine the stage of readiness of this community regarding overweight and obesity prevention. Six different dimensions were assessed in the CRM (community efforts, knowledge of efforts, leadership, community climate, knowledge of the issue, resources). The surveys were scored according to the CRM protocol. The survey data were supplemented with findings from FGDs. Thematic analysis was used to analyse the FGDs. RESULTS The mean community readiness score was 2.57 ± 0.76 which equates with the "denial/resistance stage". The mean readiness score for resources was the highest of all the dimensions (3.77 ± 0.28), followed by knowledge of the issue (3.20 ± 0.51). The lowest score was seen for community knowledge of efforts (1.77 ± 1.50), followed by community climate (2.00 ± 0.64). FGDs helped interpret the CRM scores. FGDs showed that religious leaders were enthusiastic and recognised that their role was not limited solely to spiritual guidance and mentoring, but also to physical well-being. CONCLUSIONS Religious leaders recognised that they act as role models within the community and thus have a role to play in improving adolescent health. They have some knowledge about the overweight/obesity issue and some of the resources could be made available to support overweight/obesity prevention-related initiatives. However, the low community knowledge of efforts and the negative prevailing attitude of the community towards overweight and obesity highlight the need to increase awareness of this issue prior to implementing initiatives on overweight and obesity prevention.
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Affiliation(s)
- Rebecca Pradeilles
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
- MRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
| | - Emily K Rousham
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Shane A Norris
- MRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Joanna M Kesten
- NIHR Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- NIHR Health Protection Research Unit on Evaluation of Interventions, University of Bristol, Bristol, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Paula L Griffiths
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- MRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
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Åhström M, Larsson N, Lindberg L. Change of Community Readiness Over Time: Measurements of Reduction of Parental Support and Availability of Alcohol in Seven Communities. Health Promot Pract 2016; 17:586-95. [PMID: 27095038 DOI: 10.1177/1524839916632741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim To test the possibility of identifying community readiness changes over time. Method Key responders in seven municipalities in Stockholm County were interviewed about the availability of alcohol and parental support. The results were analyzed with paired t tests. Changes in community readiness were assessed. Ninety-three key responders from the participating communities were interviewed three times each, resulting in a total of 315 interviews. Data were collected on three occasions separated by ten months from semistructured telephone interviews based on the community readiness model. Findings Significant readiness changes were found for both issues from baseline to the first follow-up. In terms of the six dimensions of community readiness, significant differences were evident from baseline to the first follow-up for parental support and the reduction of alcohol availability. Apart from knowledge of reduced alcohol availability, there were no significant changes in overall readiness or in the dimensions from the first follow-up to the second. The findings of this study are discussed in relation to earlier studies. Conclusion In communities with an initial vague awareness of issues, a change in readiness level occurs in less than a year.
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Affiliation(s)
| | | | - Lene Lindberg
- Stockholm County Council, Solna, Sweden Karolinska Institutet, Stockholm, Sweden
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Trudeau KJ. Development of a Community Readiness Survey for Coalitions to Address Prescription Opioid Misuse. JOURNAL OF ALCOHOL AND DRUG EDUCATION 2015; 59:67-90. [PMID: 27516644 PMCID: PMC4976946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A community readiness survey for coalitions to address the growing epidemic of prescription opioid misuse was developed in this four-part study. A total of 70 coalition members participated. 1) We conducted 30-minute phone interviews with coalition members (n=30) and a literature review to develop an item list. 2) Coalition members rated these 60 items for three criteria: importance, confidence in own answer, confidence in others' answer. 3) Highly rated items were included in a revised survey that was tested with coalition members (n=10) using in-person cognitive interviewing to assess how coalition members were interpreting the questions. 4) Lastly, pre-testing and satisfaction testing with additional coalition members (n=30). Most (83%) of the respondents reported positive overall impressions of the survey.
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Kesten JM, Griffiths PL, Cameron N. A critical discussion of the Community Readiness Model using a case study of childhood obesity prevention in England. HEALTH & SOCIAL CARE IN THE COMMUNITY 2015; 23:262-271. [PMID: 25429845 DOI: 10.1111/hsc.12139] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/20/2014] [Indexed: 06/04/2023]
Abstract
Recent reforms to the public health system in England aim to generate co-ordinated action between local authorities, healthcare systems and communities to target local health priorities. To support this effort, researchers must contribute and evaluate appropriate strategies for designing interventions tailored to community-specific needs. One strategy is to apply the Community Readiness Model (CRM), which uses key informant interviews to assess a community's readiness to address local issues. This article presents a critical discussion of the CRM developed from a case study of obesity prevention in pre-adolescent girls within a community in the United Kingdom. Data were collected between February and November 2011. We offer lessons learnt and recommendations relating to (i) modifications to the interview guide; (ii) key informant identification; (iii) conducting interviews to theoretical saturation; (iv) using key informants to define their community; (v) key informant's ability to respond on behalf of the community; (vi) using a qualitative model with a quantitative scoring system; and (vii) the optimum application of transcript scoring. In conclusion, the CRM can help researchers, health professionals and local authorities identify the priorities of a community. It is recommended that users of the model be careful to identify and recruit suitable key informants with the help of the community under study, select an appropriate 'community' and utilise the qualitative findings to strengthen the interpretation of the readiness score.
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Affiliation(s)
- Joanna May Kesten
- Centre for Global Health and Human Development, Loughborough University, Loughborough, UK
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Economos CD, Hatfield DP, King AC, Ayala GX, Pentz MA. Food and physical activity environments: an energy balance approach for research and practice. Am J Prev Med 2015; 48:620-9. [PMID: 25891062 DOI: 10.1016/j.amepre.2014.12.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 11/14/2014] [Accepted: 12/13/2014] [Indexed: 10/23/2022]
Abstract
Increases in the prevalence of overweight and obesity are a function of chronic, population-level energy imbalance, whereby energy intakes exceed energy expenditures. Although sometimes viewed in isolation, energy intakes and expenditures in fact exist in a dynamic interplay: energy intakes may influence energy expenditures and vice versa. Obesogenic environments that promote positive energy balance play a central role in the obesity epidemic, and reducing obesity prevalence will require re-engineering environments to promote both healthy eating and physical activity. There may be untapped synergies in addressing both sides of the energy balance equation in environmentally focused obesity interventions, yet food/beverage and physical activity environments are often addressed separately. The field needs design, evaluation, and analytic methods that support this approach. This paper provides a rationale for an energy balance approach and reviews and describes research and practitioner work that has taken this approach to obesity prevention at the environmental and policy levels. Future directions in research, practice, and policy include moving obesity prevention toward a systems approach that brings both nutrition and physical activity into interdisciplinary training, funding mechanisms, and clinical and policy recommendations/guidelines.
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Affiliation(s)
- Christina D Economos
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts.
| | - Daniel P Hatfield
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Abby C King
- Health Research and Policy Department and the Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford
| | - Guadalupe X Ayala
- San Diego State University and the Institute for Behavioral and Community Health, San Diego
| | - Mary Ann Pentz
- Keck School of Medicine, University of Southern California, Los Angeles, California
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Frerichs L, Brittin J, Robbins R, Steenson S, Stewart C, Fisher C, Huang TTK. SaludABLEOmaha: improving readiness to address obesity through healthy lifestyle in a Midwestern Latino community, 2011-2013. Prev Chronic Dis 2015; 12:E20. [PMID: 25674679 PMCID: PMC4329951 DOI: 10.5888/pcd12.140328] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background A community’s readiness for change is a precursor to the effective application of evidence-based practices for health promotion. Research is lacking regarding potential strategies to improve readiness to address obesity-related health issues in underserved communities. Community Context This case study describes SaludABLEOmaha, an initiative to increase readiness of residents in a Midwestern Latino community to address obesity and adopt healthy lifestyles. Methods SaludABLEOmaha emphasized 2 core approaches, youth activism and collaboration among public and private institutions, which we applied to planning and implementing tactics in support of 3 interconnected strategies: 1) social marketing and social media, 2) service learning in schools (ie, curricula that integrate hands-on community service with instruction and reflection), and 3) community and business engagement. Following the Community Readiness Model protocol (http://triethniccenter.colostate.edu/communityReadiness.htm), structured interviews were conducted with community leaders and analyzed before and 2.5 years after launch of the program. Outcome The community increased in readiness from stage 3 of the Community Readiness Model, “vague awareness,” at baseline to stage 5, “preparation,” at follow-up. Interpretation SaludABLEOmaha improved community readiness (eg, community knowledge, community climate), which probably contributed to the observed increase in readiness to address obesity through healthy lifestyle. Community mobilization approaches such as youth activism integrated with social marketing and social media tactics can improve community responsiveness to obesity prevention and diminish health disparities.
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Affiliation(s)
| | - Jeri Brittin
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
| | - Regina Robbins
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
| | - Sharalyn Steenson
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
| | | | - Christopher Fisher
- College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
| | - Terry T-K Huang
- School of Public Health, City University of New York, 555 W 57th Street, Room 1132, New York, NY 10019.
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