title: Pediatric obesity community programs: barriers & facilitators toward sustainability.
abstract: Our current generation of young people could become the first generation to live shorter lives than their parents. Families need resources in their community to address this issue. Identifying barriers and facilitators of community organizations to offer obesity-related services is a first step in understanding sustainable community programs. The objective of this study is to identify common barriers and facilitators in community organizational programs designed to prevent or reduce pediatric obesity. We conducted an exploratory qualitative research study based on grounded theory. Thirty-six community organizations were identified based on self-descriptions of goals involving pediatric obesity. Semi-structured, systematic, face-to-face interviews among program directors (n = 24) were recorded, transcribed, and coded for recurrent themes. Relevant themes were abstracted from interviews by a standardized iterative process by two independent reviewers between December 2007 and November 2008. Theme discordance was reconciled by a third reviewer. Seventy percent of organizations indicated that obesity prevention/treatment was their explicit goal with remaining groups indicating healthy lifestyles as a more general goal. Facilitators to provision of these programs included: programmatic enhancements such as improved curriculums (73%), community involvement such as volunteers (62.5%), and partnerships with other programs (54.2%). Barriers that threatened sustainability included lack of consistent funding (43.8%), lack of consistent participation from the target population (41.7%) and lack of support staff (20.8%). New approaches in fostering partnerships between organizations need to be developed. Building coalitions and engaging community members in developing community based programs may be a helpful strategy to strengthen community-based programs to address the pediatric obesity epidemic.
authors.affiliation: Division of General Pediatrics, Pediatric Clinical and Translational Research, Vanderbilt University Medical Center, S0119 MCN, Nashville, TN 37232, USA. eli.poe@vanderbilt.edu
authors.forename: Eli K
authors.initials: EK
authors.lastname: Po'e
authors.forename: Sabina B
authors.initials: SB
authors.lastname: Gesell
authors.forename: T
authors.initials: T
authors.lastname: Lynne Caples
authors.forename: Juan
authors.initials: J
authors.lastname: Escarfuller
authors.forename: Shari L
authors.initials: SL
authors.lastname: Barkin
mesh_terms: D002648:Child; D002662:Child Health Services / Q000191:economics / Q000458:organization & administration*; D003153:Community Health Services / Q000191:economics / Q000458:organization & administration*; D003256:Community Participation / Q000706:statistics & numerical data; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D003479:Curriculum; D005260:Female; D005378:Financial Support; D006801:Humans; D008297:Male; D009765:Obesity / Q000517:prevention & control*; D009937:Organizational Objectives; D010372:Pediatrics; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data; D036301:Qualitative Research