Increasing community capacity and decreasing prevalence of overweight and obesity in a community based intervention among Australian adolescents

Background: Community capacity building is a promising approach in reducing childhood obesity. The objective was to determine changes in capacity over a 3 year intervention (2005-2008) in schools and whether greater increases in capacity were associated with greater decreases in overweight/obesity.

Methods: "It's your Move!" (IYM) was an obesity prevention project, in 12 Australian secondary schools (5 intervention; 7 comparison), that aimed to increase community capacity to promote healthy eating and physical activity. Capacity was assessed pre/post intervention using the 'Community Readiness to Change (RTC)' tool. Comparisons from baseline to follow-up were tested using Wilcoxon Signed-Ranks and results plotted against changes (Newcombe's paired differences) in prevalence of overweight/obesity (WHO standards).

Results: RTC increased in intervention schools (p=0.04) over time but not for comparison schools (p=0.50). The intervention group improved on 5 of 6 dimensions and the three intervention schools that increased three levels on the RTC scale each had significant reductions in overweight/obesity prevalence.

Conclusion: There were marked increases in capacity in the intervention schools and those with greater increases had greater decreases in the prevalence of overweight/obesity. Community-based obesity prevention efforts should specifically target increasing community capacity as a proximal indicator of success.