Towards an integrated community approach of overweight prevention: the experiences of practitioners and policymakers.

BACKGROUND: Fighting overweight effectively asks for a community-based coherent integrated approach. The first step in improving the local prevention of overweight is to retrieve practice-based information on the interventions used and the experiences of practitioners.
OBJECTIVES: A variety of practitioners and policymakers in three different cities in The Netherlands were interviewed to investigate: what kind of interventions are used in practice today? What is helpful and what does not to implement these interventions? What is needed? How is the collaboration between the parties involved?
METHODS: Three observers classified all statements systematically according to the four categories from the implementation model by Fleuren M, Wiefferink K, Paulussen T (Determinants of innovation within health care organizations: literature review and Delphi study. Int J Qual Health Care 2004; 16: 107-123).
RESULTS: In Nijmegen, 29 interventions for the prevention or treatment of overweight were identified for the target group youth and 22 for adults. In Wijchen, these were, respectively, 22 and 13 interventions, and in Maasdriel, 24 interventions were found for youth. Most interventions addressed healthy eating and/or physical activity, a few paid attention to psychological or pedagogical aspects. Most participants were satisfied with the intervention(s) they used. For the question 'what does not work?', 61% of the answers were related to characteristics of the organization or social and political context of the intervention. Merely, all sectors expressed difficulties in involving parents.
CONCLUSIONS: Many different interventions are applied in everyday practice within each city, but in a fragmented way. Too little attention is being paid to pedagogical aspects and to involving parents in preventing overweight.