Abstract
OBJECTIVES: Obesity is disproportionately represented among low-income women and children, racial ethnic minorities including American Indian/Alaskan Native (AI/AN) populations and in rural settings. Reducing health disparities is a Healthy People 2020 goal, yet few strategies have proven successful long-term or at the population level. Healthy eating and active living (HEAL) initiatives realize greater impact when including Policy, System and Environmental (PSE) actions. These are widely informed through the Spectrum of Prevention framework. However, this framework does not include contributions from the individual level (I) – often where many nutrition interventions begin. Therefore, the objectives of this project are to: 1) Test a PSE conceptual framework with four, State Department of Public Health (DPH), MCH nutrition teams that are part of a larger technical assistance effort (TA) for capacity building; and 2) Inform the science and practice of applying a PSE framework for action through development of best practices protocols in these settings. METHODS: State DPH nutrition teams are provided PSE training via completion of an online series of 5 modules. Additionally, they will receive MCH-specific TA tailored for each state team including the PSE framework that is being tested. Each team will develop a strategic plan to be evaluated for: 1) resource allocation for implementation; 2) commitment of essential partners; 3) alignment with state childhood obesity strategic plan; 4) potential changes in infrastructure/systems to promote sustainability, 5) potential to reduce state healthcare costs; and 6) feasibility of replication in other states. Informing PSE science and practice will be assessed by inclusion of the PSE conceptual framework and the methods chosen for implementation. RESULTS: N/A. CONCLUSIONS: HEAL initiatives have proven more successful than individual approaches in improving community health indicators. Rural and AI/AN communities have unique challenges to preventing childhood obesity. Utilizing an approach that includes both individual and PSE strategies may be a more effective way to address these specific communities’ health challenges. FUNDING SOURCES: Health Resources Services Administration, Maternal and Child Health Bureau.