Collaborative school-based obesity interventions: lessons learned from 6 southern districts.
BACKGROUND
Although studies have shown that school-based obesity interventions can be effective, little is known about how to translate and implement programs into real-world school settings.


METHODS
Semistructured interviews were conducted in spring 2012 with 19 key informants who participated in a multifaceted childhood obesity intervention involving school nurses and wellness coordinators in 6 school districts and over 100 schools.


RESULTS
The intervention changed form according to the needs and interests of the school districts. Despite funding support, schools and nurses had little capacity to address childhood obesity without the help of the coordinator. Initiating programs at the beginning of the school year was particularly difficult for schools. Applying for grants from internal and external sources and assisting with planning and logistics for wellness activities were significant activities of the coordinator. Although some school personnel and families preferred a focus on wellness rather than obesity, those working with individual at-risk children and families found the experience especially gratifying.


CONCLUSIONS
In contrast to controlled studies, real-world implementation of obesity interventions in schools that are intended to create sustained change requires flexibility in intervention design, timing, and personnel. A single change agent focused on obesity-related activities was essential to success.
The Lewin Group, Fairview Park Drive, Suite 500, Falls Church, VA 22042, USA. anjali.jain@lewin.com
Anjali
A
Jain
Casey
C
Langwith
D000293:Adolescent; D002648:Child; D003299:Cooperative Behavior; D005431:Florida; D005845:Georgia; D006801:Humans; D007407:Interviews as Topic; D009765:Obesity / Q000517:prevention & control*; D012572:School Health Services / Q000458:organization & administration*; D012573:School Nursing / Q000458:organization & administration; D012574:Schools / Q000458:organization & administration; D013781:Texas