Stakeholder Perspectives and Sustainability of an Integrated Care Model for the Prevention and Management of Obesity: The Childhood Obesity Research Demonstration (CORD) Project.

Authors

Rebecca E Lee
Nathan H Parker
Allen M Hallett
Dennis Kao
Maria J Modelska
Hanadi S Rifai
Erica G Soltero
Daniel P O'Connor

Publication Date

3-16-2021

Journal

Translational Behavioral Medicine

DOI

10.1093/tbm/ibaa058

PMID

32667038

PMCID

PMC10310988

PubMedCentral® Posted Date

7-15-2020

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Child, Delivery of Health Care, Integrated, Humans, Pediatric Obesity, Public Health, Delivery of health care, Integrated, Provider, Interview, Obesity, Child, Community, Program sustainability

Abstract

Although reliable strategies exist to promote healthy habits that reduce childhood obesity, the sustainability of these strategies remains an ongoing public health challenge. This study aimed to identify factors experienced in a large, multisite project aimed at reducing childhood obesity that might contribute to project sustainability. Hypothesized constructs underpinning sustainability included replicability, continuation of benefits, institutionalization, and community capacity. Key informants (n = 27) completed 60 min, in-depth interviews, which were audio recorded and transcribed. Transcripts were first coded using a combined deductive and inductive approach. Four major themes emerged (with numerous subthemes): developing partnerships, challenges to the sustainability of implemented programming, the importance of intervening in multiple settings, and ongoing implementation and evaluation strategies. Replicability of complex childhood obesity interventions is possible when there are strong partnerships. Benefits can continue to be conferred from programming, particularly when evidence-based strategies are used that employ best practices. Implementation is facilitated by institutionalization and policies that buffer challenges, such as staffing or leadership changes. Community capacity both enhances the sustainability of interventions and develops as a result of strengthening partnerships and policies that support childhood obesity programming.