Lessons from the field: how successful community-based coalitions on obesity, choose and prioritize interventions to improve health policy, health behaviors, and health outcomes
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Abstract
Background: Community-based coalitions could be mechanisms to foster individual and systems change in their communities in order to reduce the burden of obesity. Coalitions can increase the likelihood of reducing obesity by selecting and implementing effective interventions. Members of community-based coalitions are challenged to consider the multiple and interacting determinants of obesity and to select effective interventions from hundreds of untested recommendations. This investigation identified best practices in collective decision-making processes used to select obesity interventions. These practices may be adopted by other community coalitions working to reduce or prevent obesity in their communities.
Methods: Three exemplar community-based obesity coalitions were investigated using a multiple case study design. Data from twenty-six coalition member interviews were analyzed using methods based in Grounded Theory in order to identify practices in decision-making processes related to intervention selection. Documentation was reviewed to verify coalition activity during this planning stage.
Findings: Nine shared practices related to decision-making processes were found among the three exemplar coalitions: setting a vision and objectives that target determinants of obesity and emphasize comprehensive solutions focusing on the community environment; defining an organizational structure that maximizes collaboration and shared decision-making; leaders taking a strong role in guiding and simplifying the process; obtaining financial resources that support the objectives; gathering information from the community; communicating information with the community and coalition members; aligning community-based information with objectives; making final selections by consensus; and dispersing objectives to other community organizations to build support and momentum.
Research translation: A teaching case study was developed that documents and analyzes the practices and processes that exemplar community coalitions engage in while working to select a comprehensive intervention to prevent and reduce obesity.
Conclusions: Successful community-based obesity coalitions formulate a clear vision with strategic objectives, develop organizational structure and processes, utilize information gathered from both subject matter experts (individuals and agencies) and community members, and consider local community needs, assets, and interests in order to prioritize and select obesity interventions for their communities.
Key words: obesity, community-based coalitions, decision-making, best practices, best processes
Description
Thesis (D.P.H.)--Boston University