title: Sustainable prevention of obesity through integrated strategies: The SPOTLIGHT project's conceptual framework and design.
abstract: BACKGROUND
  The prevalence of overweight and obesity in Europe is high. It is a major cause of the overall rates of many of the main chronic (or non communicable) diseases in this region and is characterized by an unequal socio-economic distribution within the population. Obesity is largely determined by modifiable lifestyle behaviours such as low physical activity levels, sedentary behaviour and consumption of energy dense diets. It is increasingly being recognised that effective responses must go beyond interventions that only focus on a specific individual, social or environmental level and instead embrace system-based multi-level intervention approaches that address both the individual and environment. The EU-funded project "sustainable prevention of obesity through integrated strategies" (SPOTLIGHT) aims to increase and combine knowledge on the wide range of determinants of obesity in a systematic way, and to identify multi-level intervention approaches that are strong in terms of Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM).
  
  
  METHODS
  SPOTLIGHT comprises a series of systematic reviews on: individual-level predictors of success in behaviour change obesity interventions; social and physical environmental determinants of obesity; and on the RE-AIM of multi-level interventions. An interactive web-atlas of currently running multi-level interventions will be developed, and enhancing and impeding factors for implementation will be described. At the neighbourhood level, these elements will inform the development of methods to assess obesogenicity of diverse environments, using remote imaging techniques linked to geographic information systems. The validity of these methods will be evaluated using data from surveys of health and lifestyles of adults residing in the neighbourhoods surveyed. At both the micro- and macro-levels (national and international) the different physical, economical, political and socio-cultural elements will be assessed.
  
  
  CONCLUSIONS
  SPOTLIGHT offers the potential to develop approaches that combine an understanding of the obesogenicity of environments in Europe, and thus how they can be improved, with an appreciation of the individual factors that explain why people respond differently to such environments. Its findings will inform governmental authorities and professionals, academics, NGOs and private sector stakeholders engaged in the development and implementation of policies to tackle the obesity epidemic in Europe.
authors.affiliation: The EMGO Institute for Health and Care Research and the departments of General Practice and Epidemiology & Biostatistics, VU University Medical Center, van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands. j.lakerveld@vumc.nl
authors.forename: Jeroen
authors.initials: J
authors.lastname: Lakerveld
authors.forename: Johannes
authors.initials: J
authors.lastname: Brug
authors.forename: Sandra
authors.initials: S
authors.lastname: Bot
authors.forename: Pedro J
authors.initials: PJ
authors.lastname: Teixeira
authors.forename: Harry
authors.initials: H
authors.lastname: Rutter
authors.forename: Euan
authors.initials: E
authors.lastname: Woodward
authors.forename: Oddrun
authors.initials: O
authors.lastname: Samdal
authors.forename: Lynn
authors.initials: L
authors.lastname: Stockley
authors.forename: Ilse
authors.initials: I
authors.lastname: De Bourdeaudhuij
authors.forename: Patricia
authors.initials: P
authors.lastname: van Assema
authors.forename: Aileen
authors.initials: A
authors.lastname: Robertson
authors.forename: Tim
authors.initials: T
authors.lastname: Lobstein
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Oppert
authors.forename: Róza
authors.initials: R
authors.lastname: Adány
authors.forename: Giel
authors.initials: G
authors.lastname: Nijpels
mesh_terms: D003210:Concept Formation; D005060:Europe; D006284:Health Plan Implementation; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D051188:Knowledge Bases; D009765:Obesity / Q000209:etiology* / Q000517:prevention & control*; D040242:Risk Reduction Behavior