Community-Based Participatory Research in Childhood Obesity Prevention: The Community and Schools Together Program

Introduction: The growing prevalence of childhood obesity has become a major public health concern in the United States. There is growing awareness that the complex, systemic influences that have created the current obesity epidemic require new forms of health promotion across multiple dimensions of our economy, public policy frameworks, and community environments. Community-based participatory research (CBPR) is an action-research approach that can engage multiple community sectors in developing coordinated obesity prevention research and interventions with schools. The Communities and Schools Together for Childhood Obesity Prevention (CAST) project was a NIH funded research and capacity-building partnership between an elementary school district, community-based organizations, and families focused on childhood obesity prevention. This paper discusses how CAST generated  longitudinal research on the social and environmental obesity risks for elementary students in a middle class school district in Oregon.

Methods: CAST integrated multiple levels of community (schools, community organizations, families and researchers) in a community-based participatory research structure. This approach was used to assemble multiple years of community health data, pilot nutrition and physical activity programs in the schools and community, and develop a feasibility study of a project designed bi-lingual (Spanish/English) family-based obesity prevention program.  

Results: Analyses are presented on the project’s longitudinal assessment of elementary school children Body Mass Index (2008-2012), outcomes of community participatory mapping of school pedestrian environments for children, longitudinal surveys of family nutrition and physical activity practices, and changes in parenting practices and child eating/nutrition behavior in the CAST Family Health Program.

Conclusions:  Effective childhood obesity prevention requires new paradigms of scientist-community research to reverse decades of obesogenic nutrition and activity patterns in American society. Obesity is a cross-cutting problem that will depend on a multi-level and simultaneous transformation of the dietary content of American food, the design of community transportation networks, and the promotion of public and cultural norms among individuals and families that lead to active and nutritionally empowering lifestyles for children. To accomplish these systemic changes, communities themselves must be engaged in the process of transforming environments, developing new organizational content and expertise, and create new socially accepted, evidence-based practice for improving the public’s health.