A mixed-method evaluation of the New York State Eat Well Play Hard Community Projects: Building local capacity for sustainable childhood obesity prevention.

This study used a mixed-method, comparative case study approach to assess the level of capacity built for childhood obesity prevention among seven New York State Eat Well Play Hard-Community Projects (EWPH-CP). Data were collected through a self-reported survey in 2007, semi-structured interviews in 2009, and EWPH-CP program documentation throughout the 2006-2010 funding cycle. Quantitative and qualitative analyses were used along with an integrative framework for assessing local capacity building to characterize the capacity built by the study coalitions. Four coalitions rated membership characteristics as a challenge at the beginning of the funding cycle. Towards the end of the funding cycle, all seven coalitions reported activities that were initially focused on building their membership (i.e., member capacity) or positive working relationships (i.e. relational capacity), before eventually pursuing support and resources (i.e., organizational capacity) for implementing their chosen community-oriented programmatic goals (i.e., programmatic capacity). Five coalitions reported environmental changes aimed at increasing physical activity or fruit and vegetable intake. Technical assistance provided to coalitions was credited with contributing to the achievement of programmatic goals. These results suggest that the coalitions succeeded in building local capacity for increasing age-appropriate physical activity or fruit and vegetables intake in the target communities.

Evaluation of public health professionals' capacity to implement environmental changes supportive of healthy weight.

Community-based interventions to promote healthy weights by making environmental and policy changes in communities may be an important strategy in reversing the obesity epidemic. However, challenges faced by local public health professionals in facilitating effective environmental and policy change need to be better understood and addressed. To better understand capacity-building needs, this study evaluated the efforts of the Healthy Start Partnership, a university-community project to promote healthy weights in young families in a rural eight-county area of upstate New York. Qualitative interviews (n=30) and pre/post surveys (n=31) were conducted over three years of the intervention. Challenges faced by partners significantly slowed progress of environmental interventions in some communities. First, many partners did not feel their "regular" jobs afforded them sufficient time to do community work. Second, many partners did not feel they had the personal political power to work on broader environmental, policy, or system change issues. Third, facilitating and policy change and reaching out to non-traditional partners, like businesses, required developing a new set of public health skills. Fourth, the long-time frame of environmental and policy work meant that many efforts would exceed the grant period. Building local public health leaders for environmental and policy change necessitates that these challenges are acknowledged and addressed.