Evaluating Multi-Component Interventions for Childhood Obesity Using the RE-AIM Framework

Background:

Childhood obesity is a public health crisis across the U.S. One intervention being implemented to prevent and respond to this crisis is a multi-component (campaign and policy/systems/environmental (PSE) efforts), multi-setting intervention modeled off the success of Maine’s Let’s Go! 5-2-1-0 intervention. The mission of 5-2-1-0 interventions is to encourage children to engage in healthy habits like fruit and vegetable consumption and physical activity.

Methods:

A mixed-methods evaluation of the first two years of the implementation of a 5-2-1-0 campaign and PSE efforts was conducted in Iowa in ten communities using the RE-AIM Framework. A parent survey (total N=1363) was conducted in each community to assess reach and effectiveness. Semi-structured interviews with campaign and PSE change implementers (n=44) and document reviews were then conducted to assess factors that affected adoption, implementation and maintenance of the intervention components in each community. Interviews were transcribed and analyzed using applied thematic analysis techniques. Results from the five communities with highest reach and effectiveness (RE) were compared to communities with lower RE to identify program and community elements that

Findings:

For the campaign component, implementers from high RE communities identified facilitators to the adoption and implementation including: strong organization and planning capabilities in the community, existing anti-obesity efforts, strong connections between implementers, and the presence of a community champion. For the PSE change component, high RE communities identified clear expectations and guidance, links to national organizations, funding, personal dedications to addressing childhood obesity in addition to many of the same facilitators identified for the campaign component as leading facilitators to adoption and implementation. Almost unanimously implementers from high RE communities were not yet working on sustainability or maintenance aspects of the intervention.

Implications for D&I Research:

The RE-AIM Framework provided an effective means of identifying metrics for intervention success as well as identifying factors that contributed to that success for communities implementing a multi-component anti-obesity intervention. These findings and continued use of RE-AIM may assist other implementers and funders of this type of programming in deciding how to best structure interventions and in identifying partners with the highest capacity for success.