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Lee RE, Szeszulski J, Lorenzo E, Arriola A, Bruening M, Estabrooks PA, Hill JL, O’Connor TM, Shaibi GQ, Soltero EG, Todd M. Sustainability via Active Garden Education: The Sustainability Action Plan Model and Process. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5511. [PMID: 35564909 PMCID: PMC9102810 DOI: 10.3390/ijerph19095511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/16/2022] [Accepted: 04/27/2022] [Indexed: 02/06/2023]
Abstract
Sustainability of intervention programming is challenging to achieve under real world conditions, since few models exist and many studies do not plan far beyond the funding period. Programming content in early care and education centers (ECECs) is often driven by guidelines. However, implementation is very sensitive to contextual factors, such as the setting and implementer (teacher) characteristics. This paper presents the model, definitions, and methodology used for the sustainability action plan capitalizing on a community-based participatory research (CBPR) approach, developed for a multi-site, multi-level garden-based childhood obesity prevention study, Sustainability via Active Garden Education (SAGE). The Ecologic Model of Obesity is applied to develop a sustainability action plan (SAP) and accompanying measures to link early care and education (ECE) environment, the community, policies, and classroom practices to an early childhood obesity prevention program. The SAGE SAP provides an example of how to iteratively evaluate and refine sustainability processes for an obesity prevention intervention utilizing CBPR approaches and will be applied to assess the sustainability of SAGE in a cluster randomized controlled trial. This SAP model can also help inform intervention delivery and scalability within ECECs.
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Affiliation(s)
- Rebecca E. Lee
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 550 N. 3rd St., Phoenix, AZ 85004, USA;
| | - Jacob Szeszulski
- Institute for Advancing Health through Agriculture (IHA), Texas A&M AgriLife Research, 17360 Coit Rd., Dallas, TX 75252, USA;
| | - Elizabeth Lorenzo
- School of Nursing, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA;
| | - Anel Arriola
- City of Phoenix Office of Arts and Culture, 200 W. Washington St., 10th Floor, Phoenix, AZ 85003, USA;
| | - Meg Bruening
- College of Health Solutions, Arizona State University, 550 N. 3rd St., Phoenix, AZ 85004, USA;
| | - Paul A. Estabrooks
- College of Health, University of Utah, 260 1850 E, Salt Lake City, UT 84112, USA;
| | - Jennie L. Hill
- Population Health Sciences, University of Utah, 295 S Chipeta Way, Salt Lake City, UT 84108, USA;
| | - Teresia M. O’Connor
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA; (T.M.O.); (E.G.S.)
| | - Gabriel Q. Shaibi
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 550 N. 3rd St., Phoenix, AZ 85004, USA;
| | - Erica G. Soltero
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA; (T.M.O.); (E.G.S.)
| | - Michael Todd
- Edson College of Nursing and Health Innovation, Arizona State University, 550 N. 3rd St., Phoenix, AZ 85004, USA;
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Lee RE, Parker NH, Hallett AM, Kao D, Modelska MJ, Rifai HS, Soltero EG, O'Connor DP. Stakeholder perspectives and sustainability of an integrated care model for the prevention and management of obesity: the Childhood Obesity Research Demonstration (CORD) project. Transl Behav Med 2021; 11:393-407. [PMID: 32667038 DOI: 10.1093/tbm/ibaa058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Although reliable strategies exist to promote healthy habits that reduce childhood obesity, the sustainability of these strategies remains an ongoing public health challenge. This study aimed to identify factors experienced in a large, multisite project aimed at reducing childhood obesity that might contribute to project sustainability. Hypothesized constructs underpinning sustainability included replicability, continuation of benefits, institutionalization, and community capacity. Key informants (n = 27) completed 60 min, in-depth interviews, which were audio recorded and transcribed. Transcripts were first coded using a combined deductive and inductive approach. Four major themes emerged (with numerous subthemes): developing partnerships, challenges to the sustainability of implemented programming, the importance of intervening in multiple settings, and ongoing implementation and evaluation strategies. Replicability of complex childhood obesity interventions is possible when there are strong partnerships. Benefits can continue to be conferred from programming, particularly when evidence-based strategies are used that employ best practices. Implementation is facilitated by institutionalization and policies that buffer challenges, such as staffing or leadership changes. Community capacity both enhances the sustainability of interventions and develops as a result of strengthening partnerships and policies that support childhood obesity programming.
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Affiliation(s)
- Rebecca E Lee
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Nathan H Parker
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Allen M Hallett
- Department of Epidemiology, Human Genetics and Environmental Sciences, Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin, Austin, TX, USA
| | - Dennis Kao
- School of Social Work, Carleton University, Ottawa, Ontario, Canada
| | - Maria J Modelska
- Department of Civil and Environmental Engineering, Cullen College of Engineering, University of Houston, Houston, TX, USA
| | - Hanadi S Rifai
- Department of Civil and Environmental Engineering, Cullen College of Engineering, University of Houston, Houston, TX, USA
| | - Erica G Soltero
- Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, TX, USA
| | - Daniel P O'Connor
- Department of Health and Human Performance, HEALTH Research Institute, University of Houston, Houston, TX, USA
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