title: Unpacking vertical and horizontal integration: childhood overweight/obesity programs and planning, a Canadian perspective.
abstract: BACKGROUND
  Increasingly, multiple intervention programming is being understood and implemented as a key approach to developing public health initiatives and strategies. Using socio-ecological and population health perspectives, multiple intervention programming approaches are aimed at providing coordinated and strategic comprehensive programs operating over system levels and across sectors, allowing practitioners and decision makers to take advantage of synergistic effects. These approaches also require vertical and horizontal (v/h) integration of policy and practice in order to be maximally effective.
  
  
  CONCLUSIONS
  This paper examines v/h integration of interventions for childhood overweight/obesity prevention and reduction from a Canadian perspective. It describes the implications of v/h integration for childhood overweight and obesity prevention, with examples of interventions where v/h integration has been implemented. An application of a conceptual framework for structuring v/h integration of an overweight/obesity prevention initiative is presented. The paper concludes with a discussion of the implications of vertical/horizontal integration for policy, research, and practice related to childhood overweight and obesity prevention multiple intervention programs.
  
  
  CONCLUSIONS
  Both v/h integration across sectors and over system levels are needed to fully support multiple intervention programs of the complexity and scope required by obesity issues. V/h integration requires attention to system structures and processes. A conceptual framework is needed to support policy alignment, multi-level evaluation, and ongoing coordination of people at the front lines of practice. Using such tools to achieve integration may enhance sustainability, increase effectiveness of prevention and reduction efforts, decrease stigmatization, and lead to new ways to relate the environment to people and people to the environment for better health for children.
authors.affiliation: Community Health Research Unit, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada. lynne.maclean@uottawa.ca.
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Maclean
authors.forename: Kathryn
authors.initials: K
authors.lastname: Clinton
authors.forename: Nancy
authors.initials: N
authors.lastname: Edwards
authors.forename: Michael
authors.initials: M
authors.lastname: Garrard
authors.forename: Lisa
authors.initials: L
authors.lastname: Ashley
authors.forename: Patti
authors.initials: P
authors.lastname: Hansen-Ketchum
authors.forename: Audrey
authors.initials: A
authors.lastname: Walsh