How do I find resources for working with my community to address childhood obesity?
What are the key evidence-based programs and resources available to review?
What are the important elements to consider in culturally competent programs?
This chapter will address the following American College of Graduate Medical Education competencies: professionalism and systems-based practice.
Professionalism: Professionalism is important in working with communities just as it is in clinical care. This chapter will review an approach to community engagement that emphasizes commitment to professional responsibilities, acting on ethical principles, and sensitivity to diversity and values of respect.
Systems-Based Practice: Engagement in community work demonstrates that the pediatric health care provider has an awareness of the larger system of health care delivery, and this chapter will help the provider learn to interact with the system to optimize patient outcomes.
According to the socioecological model (see Chapters 20 and 21), addressing health problems like obesity requires approaches at multiple levels.1 Given the widespread prevalence of obesity and its multifactorial etiology, the need to address obesity prevention in community settings is evident. The Chronic Care Model as applied to obesity (see Chapter 12) highlights the importance of linking clinical and community resources.2
While the optimal program models are still emerging, sufficient evidence has demonstrated that community-based programs engaging families can make a difference both in primary prevention and secondary prevention or treatment of obesity.3,4 While these programs may exist, pediatric health care providers may not know about them or where to look for them. Even in the current information age, this can be a challenge! Programs are sometimes developed or adapted locally and may have limited marketing resources. What exists in each community is rapidly evolving because more resources are directed to the obesity problem, and yet substantial gaps in availability remain. Therefore, health care providers are especially needed as advocates for obesity prevention and intervention in their communities.
In order to find and access community-based programs for obesity prevention and intervention, pediatric health care providers should “think globally, act locally.” In other words, health care providers should be knowledgeable about evidence for effective programs—now being developed globally—and then apply that evidence locally to their community and patient population. A few “go-to” program sites are suggested, many of which have distilled the evidence in tools that can be used clinically, to find repositories of program information and educational materials (Table 19-1).5, 6, 7, 8, 9
Table 19-1SELECTED EVIDENCE-BASED OBESITY RESOURCES AND PROGRAMS, BY STAGE AND AGE