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Special Issue "Obesity Prevention: Systems change for healthy environments and healthy people"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (28 February 2016).

Special Issue Editors

Dr. Sara Kirk
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Guest Editor
Applied Research Collaborations for Health, School of Health and Human Performance, Dalhousie University, 1318 Robie Street, PO Box 15000, Halifax NS B3H 4R2, Canada
Dr. Jessie-Lee Mclsaac
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Guest Editor
Applied Research Collaborations for Health, School of Health and Human Performance, Dalhousie University, 1318 Robie Street, PO Box 15000, Halifax NS B3H 4R22, Canada
Ms. Tarra Penney
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Guest Editor
UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK

Special Issue Information

Dear Colleagues,

Preventing obesity remains a significant modern challenge, in part because of the need for substantive changes to environments in which the population makes decisions that affect their health. These “obesogenic” environments have remained intractable to change and more needs to be done to create environments that support, not hinder, health, particularly as it relates to the prevention of obesity and associated chronic diseases.

Therefore, the focus of this Special Issue is to draw greater attention to the forces that shape environments, specifically in understanding the role that macro level systems play in shaping supportive environments, that in turn support healthy behaviours for obesity prevention. We invite contributions, including reviews and empirical studies, that explore some of the current systemic issues for healthy people and healthy environments, with a particular focus on:

• What governments can do to change systems (beyond a focus on environments)

• What communities can do to change systems

• What challenges and opportunities arise in evaluating systems-level changes

Dr. Sara Kirk
Dr. Jessie-Lee McIsaac
Ms. Tarra Penney
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (5 papers)

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Research

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Article
Wayfinding the Live 5-2-1-0 Initiative—At the Intersection between Systems Thinking and Community-Based Childhood Obesity Prevention
Int. J. Environ. Res. Public Health 2016, 13(6), 614; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph13060614 - 21 Jun 2016
Cited by 8 | Viewed by 3533
Abstract
Childhood obesity is complex and requires a ‘systems approach’ that collectively engages across multiple community settings. Sustainable Childhood Obesity Prevention through Community Engagement (SCOPE) has implemented Live 5-2-1-0—a multi-sector, multi-component childhood obesity prevention initiative informed by systems thinking and participatory research via an [...] Read more.
Childhood obesity is complex and requires a ‘systems approach’ that collectively engages across multiple community settings. Sustainable Childhood Obesity Prevention through Community Engagement (SCOPE) has implemented Live 5-2-1-0—a multi-sector, multi-component childhood obesity prevention initiative informed by systems thinking and participatory research via an innovative knowledge translation (KT) model (RE-FRAME). This paper describes the protocol for implementing and evaluating RE-FRAME in two ‘existing’ (>2 years of implementation) and two ‘new’ Live 5-2-1-0 communities to understand how to facilitate and sustain systems/community-level change. In this mixed-methods study, RE-FRAME was implemented via online resources, webinars, a backbone organization (SCOPE) coordinating the initiative, and a linking system supporting KT. Qualitative and quantitative data were collected using surveys and stakeholder interviews, analyzed using thematic analysis and descriptive statistics, respectively. Existing communities described the consistency of Live 5-2-1-0 and extensive local partnerships/champions as catalysts for synergistic community-wide action; new communities felt that the simplicity of the message combined with the transfer of experiential learning would inform their own strategies and policies/programs to broadly disseminate Live 5-2-1-0. RE-FRAME effectively guided the refinement of the initiative and provided a framework upon which evaluation results described how to implement a community-based systems approach to childhood obesity prevention. Full article
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Article
Weight Gain Prevention among Midlife Women: A Randomized Controlled Trial to Address Needs Related to the Physical and Social Environment
Int. J. Environ. Res. Public Health 2016, 13(6), 530; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph13060530 - 25 May 2016
Cited by 3 | Viewed by 2741
Abstract
Women tend to gain weight at midlife (40–60 years) increasing risk of obesity-related chronic diseases. Within specific eating occasions, needs related to the physical and social environment may result in less healthy eating behavior, which can lead to weight gain over time. The [...] Read more.
Women tend to gain weight at midlife (40–60 years) increasing risk of obesity-related chronic diseases. Within specific eating occasions, needs related to the physical and social environment may result in less healthy eating behavior, which can lead to weight gain over time. The purpose of this study was to determine if a dietitian-delivered nutrition counseling intervention tailored to eating occasion needs could improve diet and prevent weight gain among midlife women over two years. A randomized controlled trial was conducted with healthy midlife women (n = 354) in one U.S. metropolitan area. The intervention group (n = 185) received ten hours of individual nutrition counseling from dietitians over six months, while women in a control group (n = 169) received no counseling. Measured height, weight and waist circumference, and dietary intakes were collected at baseline and every six months over two years. Mixed linear models were used to test for intervention effect on change in outcome variables over time. Dietary intakes of fruit, reduced/low-fat dairy foods and refined grains were significantly improved over time in the intervention compared to control group. However, the intervention had no effect on weight over time (p = 0.48). Nutrition counseling tailored to address eating occasion needs improved self-reported diet but did not significantly affect weight change. Full article
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Article
Barriers to and Facilitators of the Evaluation of Integrated Community-Wide Overweight Intervention Approaches: A Qualitative Case Study in Two Dutch Municipalities
Int. J. Environ. Res. Public Health 2016, 13(4), 390; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph13040390 - 31 Mar 2016
Cited by 5 | Viewed by 2729
Abstract
To prevent overweight and obesity the implementation of an integrated community-wide intervention approach (ICIA) is often advocated. Evaluation can enhance implementation of such an approach and demonstrate the extent of effectiveness. To be able to support professionals in the evaluation of ICIAs we [...] Read more.
To prevent overweight and obesity the implementation of an integrated community-wide intervention approach (ICIA) is often advocated. Evaluation can enhance implementation of such an approach and demonstrate the extent of effectiveness. To be able to support professionals in the evaluation of ICIAs we studied barriers to and facilitators of ICIA evaluation. In this study ten professionals of two Dutch municipalities involved in the evaluation of an ICIA participated. We conducted semi-structured interviews (n = 12), observed programme meetings (n = 4) and carried out document analysis. Data were analyzed using a thematic content approach. We learned that evaluation is hampered when it is perceived as unfeasible due to limited time and budget, a lack of evaluation knowledge or a negative evaluation attitude. Other barriers are a poor understanding of the evaluation process and its added value to optimizing the programme. Sufficient communication between involved professionals on evaluation can facilitate evaluation, as does support for evaluation of ICIAs together with stakeholders at a strategic and tactical level. To stimulate the evaluation of ICIAs, we recommend supporting professionals in securing evaluation resources, providing tailored training and tools to enhance evaluation competences and stimulating strategic communication on evaluation. Full article
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Article
Healthy versus Unhealthy Suppliers in Food Desert Neighborhoods: A Network Analysis of Corner Stores’ Food Supplier Networks
Int. J. Environ. Res. Public Health 2015, 12(12), 15058-15074; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph121214965 - 30 Nov 2015
Cited by 13 | Viewed by 3502
Abstract
Background: Products in corner stores may be affected by the network of suppliers from which storeowners procure food and beverages. To date, this supplier network has not been well characterized. Methods: Using network analysis, we examined the connections between corner stores [...] Read more.
Background: Products in corner stores may be affected by the network of suppliers from which storeowners procure food and beverages. To date, this supplier network has not been well characterized. Methods: Using network analysis, we examined the connections between corner stores (n = 24) in food deserts of Baltimore City (MD, USA) and their food/beverage suppliers (n = 42), to determine how different store and supplier characteristics correlated. Results: Food and beverage suppliers fell into two categories: Those providing primarily healthy foods/beverages (n = 15) in the healthy supplier network (HSN) and those providing primarily unhealthy food/beverages (n = 41) in the unhealthy supplier network (UHSN). Corner store connections to suppliers in the UHSN were nearly two times greater (t = 5.23, p < 0.001), and key suppliers in the UHSN core were more diverse, compared to the HSN. The UHSN was significantly more cohesive and densely connected, with corner stores sharing a greater number of the same unhealthy suppliers, compared to HSN, which was less cohesive and sparsely connected (t = 5.82; p < 0.001). Compared to African Americans, Asian and Hispanic corner storeowners had on average −1.53 (p < 0.001) fewer connections to suppliers in the HSN (p < 0.001). Conclusions: Our findings indicate clear differences between corner stores’ HSN and UHSN. Addressing ethnic/cultural differences of storeowners may also be important to consider. Full article
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Review

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Review
Interventions to Support System-level Implementation of Health Promoting Schools: A Scoping Review
Int. J. Environ. Res. Public Health 2016, 13(2), 200; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph13020200 - 06 Feb 2016
Cited by 10 | Viewed by 3160
Abstract
Health promoting schools (HPS) is recognized globally as a multifaceted approach that can support health behaviours. There is increasing clarity around factors that influence HPS at a school level but limited synthesized knowledge on the broader system-level elements that may impact local implementation [...] Read more.
Health promoting schools (HPS) is recognized globally as a multifaceted approach that can support health behaviours. There is increasing clarity around factors that influence HPS at a school level but limited synthesized knowledge on the broader system-level elements that may impact local implementation barriers and support uptake of a HPS approach. This study comprised a scoping review to identify, summarise and disseminate the range of research to support the uptake of a HPS approach across school systems. Two reviewers screened and extracted data according to inclusion/exclusion criteria. Relevant studies were identified using a multi-phased approach including searching electronic bibliographic databases of peer reviewed literature, hand-searching reference lists and article recommendations from experts. In total, 41 articles met the inclusion criteria for the review, representing studies across nine international school systems. Overall, studies described policies that provided high-level direction and resources within school jurisdictions to support implementation of a HPS approach. Various multifaceted organizational and professional interventions were identified, including strategies to enable and restructure school environments through education, training, modelling and incentives. A systematic realist review of the literature may be warranted to identify the types of intervention that work best for whom, in what circumstance to create healthier schools and students. Full article
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