Integrated interventions on behavioural, social and environmental changes in active prevention programmes: the childhood obesity case

Issue/Problem Childhood obesity is one of the most important issues in Public Health. Besides being an independent risk factor for adult obesity, leading to many complications both physical and socio-psychological, it has a significant impact in economic terms. Hence, the adoption of innovative preventive integrated approaches is increasingly needed. Description of the problem The objective of this study was to find the presence in Europe of coordinated and integrated programmes, aimed at preventing childhood obesity and based on innovative large-scale approaches. In March 2013 a literature review was conducted by means of PubMed, using the following keywords: ‘‘prevention and control’’, ‘childhood obesity’, ‘‘coordinated programme’’. A snowballing search was then performed on bibliography of the full text primarily found. Results (effects/changes) The search retrieved three articles, one of which (‘‘Ensemble Pre´venons l’Obe´site´ De Enfants’’, activated in France) described a programme characterized by an integrated and coordinated community-based approach. Other two programmes with similar characteristics (‘‘Healthy Weight Communities’’ developed in Scotland, and JOGG, diffused in the Netherlands) were found from snowballing. The activities and the staff of these programmes share common aims and active participation of different stakeholders, which allowed changes in physical and social environment, resulting in new and innovative elements for lifestyle modifications. The outcome indicators referred to children show a 95% response rate to the programmes activities, with a reduction of 1,8% of prevalence of obesity in children 5-12 years aged (p < 0,0001). Lessons The innovative coordinated and integrated approach of the three above-mentioned programmes should be considered in other European countries in order to obtain effective improvements in childhood obesity reduction. To achieve this goal, a strong stewardship function should necessarily be exercised by Public Health, according to the mechanisms of governance considered most appropriate for the political and social context considered. Key messages Preventive measures aimed at reducing childhood obesity should be characterized by integrated interventions on behavioural, social and environmental changes to be really effective. Every kind of stakeholder should be involved in the prevention of childhood obesity in order to implement effective coordinated and integrated programmes for childhood obesity reduction.