Preventing Chronic Disease | Community Stakeholders’ Perceptions of Barriers to Childhood Obesity Prevention in Low-Income Families, Massachusetts 2012–2013 - CDC

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Preventing Chronic Disease | Community Stakeholders’ Perceptions of Barriers to Childhood Obesity Prevention in Low-Income Families, Massachusetts 2012–2013 - CDC

Community Stakeholders’ Perceptions of Barriers to Childhood Obesity Prevention in Low-Income Families, Massachusetts 2012–2013

Claudia Ganter, MPH; Emmeline Chuang, PhD; Alyssa Aftosmes-Tobio, MPH; Rachel E. Blaine, MPH, RD; Mary Giannetti, MS, RD; Thomas Land, PhD; Kirsten K. Davison, PhD

Suggested citation for this article: Ganter C, Chuang E, Aftosmes-Tobio A, Blaine RE, Giannetti M, Land T, et al. Community Stakeholders’ Perceptions of Barriers to Childhood Obesity Prevention in Low-Income Families, Massachusetts 2012–2013. Prev Chronic Dis 2015;12:140371. DOI: http://dx.doi.org/10.5888/pcd12.140371.

MEDSCAPE CME Medscape, LLC is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit. This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medscape, LLC and Preventing Chronic Disease. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians. Medscape, LLC designates this Journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 75% minimum passing score and complete the evaluation at www.medscape.org/journal/pcd; (4) view/print certificate. Release date: March 26, 2015; Expiration date: March 26, 2016

Learning Objectives Upon completion of this activity, participants will be able to: Assess perceived barriers to treating child obesity in the domain of family history and structure Analyze stakeholder perceptions regarding cultural barriers to reducing childhood obesity Assess perceived community barriers to treating child obesity Evaluate other variables that might impede the care of children with obesity   EDITORS Rosemarie Perrin, Editor, Preventing Chronic Disease. Disclosure: Rosemarie Perrin has disclosed no relevant financial relationships. CME AUTHOR Charles P. Vega, MD, Clinical Professor of Family Medicine, University of California, Irvine. Disclosure: Charles P. Vega, MD, has disclosed the following relevant financial relationships: Served as an advisor or consultant for: Lundbeck, Inc.; McNeil Pharmaceuticals; Takeda Pharmaceuticals North America, Inc. AUTHORS AND CREDENTIALS Disclosures: Claudia Ganter, MPH; Emmeline Chuang, PhD; Alyssa Aftosmes-Tobio, MPH; Rachel E. Blaine, MPH, RD; Mary Giannetti, MS, RD; Thomas Land, PhD; Kirsten K. Davison, PhD have disclosed no relevant financial relationships. Affiliations: Claudia Ganter, MPH, Department of Nutrition, Harvard School of Public Health, Boston, MA; Emmeline Chuang, University of California, Los Angeles, Los Angeles, California; Alyssa Aftosmes-Tobio, Rachel E. Blaine, Kirsten K. Davison, Harvard School of Public Health, Boston, Massachusetts; Mary Giannetti, Montachusett Opportunity Council, Fitchburg, Massachusetts; Thomas Land, Massachusetts Department of Public Health, Boston, Massachusetts; Ms. Ganter is also affiliated with the Technical University of Berlin, Department of Health Care Management, Berlin, Germany.

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Abstract

Introduction
The etiology of childhood obesity is multidimensional and includes individual, familial, organizational, and societal factors. Policymakers and researchers are promoting social–ecological approaches to obesity prevention that encompass multiple community sectors. Programs that successfully engage low-income families in making healthy choices are greatly needed, yet little is known about the extent to which stakeholders understand the complexity of barriers encountered by families. The objective of this study was to contextually frame barriers faced by low-income families reported by community stakeholders by using the Family Ecological Model (FEM).

Methods
From 2012 through 2013, we conducted semistructured interviews with 39 stakeholders from 2 communities in Massachusetts that were participating in a multisector intervention for childhood obesity prevention. Stakeholders represented schools; afterschool programs; health care; the Special Supplemental Nutrition Program for Women, Infants, and Children; and early care and education. Interviews were audio-recorded, transcribed, coded, and summarized.

Results
Stakeholder reports of the barriers experienced by low-income families had a strong degree of overlap with FEM and reflected awareness of the broader contextual factors (eg, availability of community resources, family culture, education) and social and emotional dynamics within families (eg, parent knowledge, social norms, distrust of health care providers, chronic life stressors) that could affect family adoption of healthy lifestyle behaviors. Furthermore, results illustrated a level of consistency in stakeholder awareness across multiple community sectors.

Conclusion
The congruity of stakeholder perspectives with those of low-income parents as summarized in FEM and across community sectors illustrates potential for synergizing the efforts necessary for multisector, multilevel community interventions for the prevention of childhood obesity.

Acknowledgments

This research was supported by the Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, award no. U18DP003370, and by the Pilot Studies Core of the Johns Hopkins Global Obesity Prevention Center, which is funded by the National Institute of Child Health and Human Development, no. U54HD070725. The authors thank the community participants, Jo-Ann Kwass for connecting us to the communities, the MA-CORD coalition leaders in both communities, and the MA-CORD project team.

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Author Information

Corresponding Author: Claudia Ganter, MPH, Department of Nutrition, Harvard School of Public Health, Landmark Center, 401 Park Drive, 3rd floor East, Boston, MA 01225. Telephone: 617-768-7277. Email: cgehre@hsph.harvard.edu.

Author Affiliations: Emmeline Chuang, University of California, Los Angeles, Los Angeles, California (Dr. Chuang was at University of California, San Diego, at the time this article was written); Alyssa Aftosmes-Tobio, Rachel E. Blaine, Kirsten K. Davison, Harvard School of Public Health, Boston, Massachusetts; Mary Giannetti, Montachusett Opportunity Council, Fitchburg, Massachusetts; Thomas Land, Massachusetts Department of Public Health, Boston, Massachusetts; Ms. Ganter is also affiliated with the Technical University of Berlin, Department of Health Care Management, Berlin, Germany.

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