A Systems-Based Typological Framework for Understanding the Sustainability, Scalability, and Reach of Childhood Obesity Interventions

作者：Huang Terry T K^*; Grimm Brandon; Hammond Ross A

来源：Children's Health Care, 2011, 40(3): 253-266.

DOI：10.1080/02739615.2011.590399

This article proposes a systems-based framework to examine 3 structural dimensions of childhood obesity interventions that can impact intervention sustainability, scalability, and reach. These 3 dimensions are the locus of intervention drivers (top-down vs. bottom-up), the locus of change effected (policy vs. individual behavior), and the public versus private sector. Interventions focused on individual behavior change often rely on bottom-up approaches and have generally been less sustainable than policy interventions. However, top-down (government or industry) support can lead to better funding and shifts in social norms. In the public sector, top-down efforts targeting individual behavior are generally also more scalable and have wider reach to diverse communities. In the private sector, behavior-change interventions tend to have greater resources and are sustained over longer periods, even when efficacy is in question; they may also be quite scalable. In a systems approach, a combination of approaches that encompass the structural dimensions in systems space will likely be needed to significantly impact childhood obesity. Next-generation childhood obesity interventions should be able to demonstrate sustainability, scalability, and reach as benchmarks of plausible success and criteria for investment.

• 出版日期2011