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Challenges and Lessons Learned from Multi-Level Multi-Component Interventions to Prevent and Reduce Childhood Obesity

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  • Joel Gittelsohn

    (Center for Human Nutrition, International Health Department, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA)

  • Rachel Novotny

    (Children’s Healthy Living Center of Excellence, College of Tropical Agriculture and Human Resources – University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA)

  • Angela Cristina Bizzotto Trude

    (Center for Human Nutrition, International Health Department, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA)

  • Jean Butel

    (Children’s Healthy Living Center of Excellence, College of Tropical Agriculture and Human Resources – University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA)

  • Bent Egberg Mikkelsen

    (Department of Learning & Philosophy, Aalborg University, A.C. Meyers Vænge 15, DK-2450 Copenhagen SV, Denmark)

Abstract

Multi-level multi-component (MLMC) strategies have been recommended to prevent and reduce childhood obesity, but results of such trials have been mixed. The present work discusses lessons learned from three recently completed MLMC interventions to inform future research and policy addressing childhood obesity. B’more Healthy Communities for Kids (BHCK), Children’s Healthy Living (CHL), and Health and Local Community (SoL) trials had distinct cultural contexts, global regions, and study designs, but intervened at multiple levels of the socioecological model with strategies that address multiple components of complex food and physical activity environments to prevent childhood obesity. We discuss four common themes: (i) How to engage with community partners and involve them in development of intervention and study design; (ii) build and maintain intervention intensity by creating mutual promotion and reinforcement of the intervention activities across the multiple levels and components; (iii) conduct process evaluation for monitoring, midcourse corrections, and to engage stakeholder groups; and (iv) sustaining MLMC interventions and its effect by developing enduring and systems focused collaborations. The paper expands on each of these themes with specific lessons learned and presents future directions for MLMC trials.

Suggested Citation

  • Joel Gittelsohn & Rachel Novotny & Angela Cristina Bizzotto Trude & Jean Butel & Bent Egberg Mikkelsen, 2018. "Challenges and Lessons Learned from Multi-Level Multi-Component Interventions to Prevent and Reduce Childhood Obesity," IJERPH, MDPI, vol. 16(1), pages 1-14, December.
  • Handle: RePEc:gam:jijerp:v:16:y:2018:i:1:p:30-:d:192814
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    References listed on IDEAS

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    1. Joel Gittelsohn & Angela C. Trude & Lisa Poirier & Alexandra Ross & Cara Ruggiero & Teresa Schwendler & Elizabeth Anderson Steeves, 2017. "The Impact of a Multi-Level Multi-Component Childhood Obesity Prevention Intervention on Healthy Food Availability, Sales, and Purchasing in a Low-Income Urban Area," IJERPH, MDPI, vol. 14(11), pages 1-15, November.
    2. Ulla Toft & Paul Bloch & Helene C. Reinbach & Lise L. Winkler & Tine Buch-Andersen & Jens Aagaard-Hansen & Bent Egberg Mikkelsen & Bjarne Bruun Jensen & Charlotte Glümer, 2018. "Project SoL—A Community-Based, Multi-Component Health Promotion Intervention to Improve Eating Habits and Physical Activity among Danish Families with Young Children. Part 1: Intervention Development ," IJERPH, MDPI, vol. 15(6), pages 1-21, May.
    3. Bent Egberg Mikkelsen & Paul Bloch & Helene Christine Reinbach & Tine Buch-Andersen & Lise Lawaetz Winkler & Ulla Toft & Charlotte Glümer & Bjarne Bruun Jensen & Jens Aagaard-Hansen, 2018. "Project SoL—A Community-Based, Multi-Component Health Promotion Intervention to Improve Healthy Eating and Physical Activity Practices among Danish Families with Young Children Part 2: Evaluation," IJERPH, MDPI, vol. 15(7), pages 1-15, July.
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    Cited by:

    1. Michelle Estradé & Ellen J. I. van Dongen & Angela C. B. Trude & Lisa Poirier & Sheila Fleischhacker & Caroline R. Wensel & Leslie C. Redmond & Marla Pardilla & Jacqueline Swartz & Margarita S. Treuth, 2021. "Exposure to a Multilevel, Multicomponent Obesity Prevention Intervention (OPREVENT2) in Rural Native American Communities: Variability and Association with Change in Diet Quality," IJERPH, MDPI, vol. 18(22), pages 1-11, November.
    2. Trine Top Klein-Wengel & Jonas Vestergaard Nielsen & Søren Smedegaard & Thomas Skovgaard, 2021. "The Role of Local Leaders in the Implementation of Adult-Initiated Motor Skill Development and Physical Activity in Preschool—A Case Study," IJERPH, MDPI, vol. 18(24), pages 1-18, December.
    3. Courtney T. Luecking & Cody D. Neshteruk & Stephanie Mazzucca & Dianne S. Ward, 2021. "Efficacy of an Enhanced Implementation Strategy to Increase Parent Engagement with a Health Promotion Program in Childcare," IJERPH, MDPI, vol. 19(1), pages 1-15, December.

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