Peer Reviewed: The Role of State Health Departments in Supporting Community-based Obesity Prevention

Chronic Disease and Injury Section, North Carolina Division of Public Health, 1915 Mail Service Center, Raleigh, NC 27699-1915, USA.
Preventing chronic disease (Impact Factor: 2.12). 07/2011; 8(4):A87.
Source: PubMed

ABSTRACT Recent national attention to obesity prevention has highlighted the importance of community-based initiatives. State health departments are in a unique position to offer resources and support for local obesity prevention efforts.
In North Carolina, one-third of children are overweight or obese. North Carolina's Division of Public Health supports community-based obesity prevention by awarding annual grants to local health departments, providing ongoing training and technical assistance, and engaging state-level partners and resources to support local efforts.
The North Carolina Division of Public Health administered grants to 5 counties to implement the Childhood Obesity Prevention Demonstration Project; counties simultaneously carried out interventions in the community, health care organizations, worksites, schools, child care centers, and faith communities.
The North Carolina Division of Public Health worked with 5 local health departments to implement community-wide policy and environmental changes that support healthful eating and physical activity. The state health department supported this effort by working with state partners to provide technical assistance, additional funding, and evaluation.
State health departments are well positioned to coordinate technical assistance and leverage additional support to increase the strength of community-based obesity prevention efforts.

Download full-text


Available from: Cathy Thomas, Jun 24, 2014
13 Reads
  • Source
    • "These findings are similar to those from other obesity prevention infrastructure initiatives that demonstrated the effectiveness of partnerships in leveraging additional funding (9). Other program evaluations describe the critical role of state health departments in supporting and strengthening community-based obesity prevention by providing technical assistance, resources, and evaluation (10). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Although various factors affect the sustainability of public health programs, funding levels can influence many aspects of program continuity. Program evaluation in public health typically does not assess the progress of initiatives after discontinuation of funding. The objective of this study was to describe the effect of funding loss following expiration of a 5-year federal grant awarded to state health departments for development of statewide obesity prevention partnerships. The study used qualitative methods involving semistructured key informant interviews with state health departments. Data were analyzed using thematic analysis for effect of funding loss on staffing, programs, partnerships, and implementation of state plans. Many of the programs that continued to run after the grant expired operated at reduced capacity, either reaching fewer people or conducting fewer program activities for the same population. Although many states were able to leverage funding from other sources, this shift in funding source often resulted in priorities changing to meet new funding requirements. Evaluation capacity suffered in all states. Nearly all states reported losing infrastructure and capacity to communicate widely with partners. All states reported a severe or complete loss of their ability to provide training and technical assistance to partners. Despite these reduced capacities, states reported several key resources that facilitated continued work on the state plan. Decisions regarding continuation of funding are often dependent on budget constraints, evidence of success, and perceived ability to succeed in the future. Evaluating public health funding decisions may help guide development of best practice strategies for supporting long-term program success.
    Preventing chronic disease 11/2013; 10(11):E190. DOI:10.5888/pcd10.130130 · 2.12 Impact Factor
  • Source
    • "Over the past decade, PCPs have been encouraged to build partnerships across disciplines to work collaboratively with public health departments and other colleagues, to identify and decrease barriers to the health and well-being of the children in their communities, and to coordinate and focus new and existing services for the benefit for all local children [34, 35]. In the articles we reviewed, health care providers participated in six multisector obesity prevention and treatment initiatives that achieved intermediate policy and systems goals [78–80]; changes in children's food and physical activity environments [80, 81]; and population-level health outcomes, including reduced BMI scores [82, 83] and changes in overweight and obesity prevalence trends [78, 79, 83]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Although pediatric providers have traditionally assessed and treated childhood obesity and associated health-related conditions in the clinic setting, there is a recognized need to expand the provider role. We reviewed the literature published from 2005 to 2012 to (1) provide examples of the spectrum of roles that primary care providers can play in the successful treatment and prevention of childhood obesity in both clinic and community settings and (2) synthesize the evidence of important characteristics, factors, or strategies in successful community-based models. The review identified 96 articles that provide evidence of how primary care providers can successfully prevent and treat childhood obesity by coordinating efforts within the primary care setting and through linkages to obesity prevention and treatment resources within the community. By aligning the most promising interventions with recommendations published over the past decade by the Institute of Medicine, the American Academy of Pediatrics, and other health organizations, we present nine areas in which providers can promote the prevention and treatment of childhood obesity through efforts in clinical and community settings: weight status assessment and monitoring, healthy lifestyle promotion, treatment, clinician skill development, clinic infrastructure development, community program referrals, community health education, multisector community initiatives, and policy advocacy.
    Journal of obesity 04/2013; 2013(11):172035. DOI:10.1155/2013/172035
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To examine the extent to which local health department (LHD) assurance of select services known to promote and protect the health of older adults is associated with more favorable population health indicators among seniors. Data from the California Health Interview Survey (CHIS: 2003, 2005, and 2007) were linked with the 2005 wave of the National Association of County and City Health Officials profile survey and the Area Resource File to assess the association of LHD assurance and senior health indicators. Assurance was measured by an index of 5 services, either directly provided or contracted by LHDs: cancer screening, injury prevention, comprehensive primary care, home health care, and chronic disease prevention. Multilevel regression models estimated the association of LHD assurance of services and each of 6 older adult health indicators, controlling for individual, LHD, and county characteristics that included key social determinants of health, such as poverty. Fifty-seven California counties. 33,154 older adults (age 65 and older). Colorectal cancer screening, mammography, healthy eating, physical activity, and multiple falls among older adults. Local health departments provided or contracted a median of 2 of the 5 services. In adjusted analyses, LHD assurance of services was generally unassociated with the seniors' health behaviors, screening, and falls. Greater LHD expenditures per capita were associated with significantly better mammography screening rates (adjusted odds ratio [AOR] = 1.22, P < 0.01) compared to jurisdictions in the bottom one-third of per capita LHD spending. Greater county-level poverty (a social determinant of health) was associated with greater junk food consumption (AOR = 1.14, P < 0.01) and worse fruit and vegetable consumption (AOR = 0.97, P < 0.01). Highly impoverished counties were consistently in the bottom quartile of performance across all indicators. The LHD's assurance of select services known to promote and protect the health of older adults does not appear to translate into higher rates of colorectal cancer screening, mammography, healthy eating, physical activity, and fewer falls among seniors. County-level poverty is most strongly associated with older adult health, underscoring a key barrier to address in local senior health improvement efforts.
    Journal of public health management and practice: JPHMP 07/2013; 19(6). DOI:10.1097/PHH.0b013e31828e25e5 · 1.47 Impact Factor
Show more