Better Health project found that church-based interventions (including group activities, changes in food served at church events, and dissemination of educational materials) resulted in increased fruit and vegetable consumption by adults participating in the intervention (Campbell et al., 1999). Pilot studies from the Girls Health Enrichment Multi-site Study (GEMS), a research program designed to develop and test interventions for preventing overweight and obesity in African-American girls, have included a variety of community, after-school, and family-based components in a range of settings (Baranowski et al., 2003; Beech et al., 2003; Robinson et al., 2003; Story et al., 2003). For example, the Stanford GEMS pilot study in 61 families tested a model that combined after-school dance classes for girls with family-based efforts to reduce time spent watching television. Positive trends were observed regarding body mass index (BMI), waist circumference, physical activity, and television viewing in the treatment group when compared to the control group (Robinson et al., 2003). These studies demonstrate the feasibility of implementing relevant community programs; two of these studies have been expanded to evaluate programs with larger study populations over a 2-year period (Kumanyika et al., 2003).
However, much remains to be learned about interventions that can reduce or alleviate the risk factors for childhood obesity in high-risk populations. Prevention efforts must be considerate of culture, language, and inequities in social and physical environments (PolicyLink, 2002). Furthermore, because these populations traditionally have been disenfranchised, special efforts must be made to gain their trust, both among individuals and at the community level. The 39-community Partnership for the Public’s Health project in California and other community-centered public health initiatives have demonstrated that the most progress is made when an intervention engages community members themselves in the program’s assessment, planning, implementation, and evaluation (Partnership for the Public’s Health, 2004).
Private and public efforts that work to eliminate health disparities should include obesity prevention as one of their primary areas of focus. Some of the many ongoing efforts span the public and private sectors as well as the local, regional, state, and national levels and focus on diabetes and other chronic diseases for which obesity is a risk factor. For example, the Centers for Disease Control and Prevention’s (CDC’s) REACH 2010 initiative has broad-based collaboration within the U.S. Department of Health and Human Services (DHHS) and the private sector (CDC, 2004b) to fund and support demonstration projects and community coalitions focused on eliminating health disparities. Each coalition includes community-based organizations and the local or state health department or a university or research organization. Efforts to date have included community and tribal efforts to address diabetes and cardiovascular disease risk factors.