Workshop participants highlighted the following key issues as ones to consider in developing a framework for joint interventions:

  • Interventions should focus on environmental changes that support individual behavior change (see discussion on the Berkley Media Series Group Report in Appendix B), and the strategy to mitigate the epidemic should be multilevel, multisectorial, and multidisciplinary.

  • Larger populations could be served by paying attention to issues derived from scaling up the programs.

  • Programs should be sustainable for the long term in terms of funding as well as feasibility.

  • Collaboration with media is critical so that consistent information can reach children and youth through diverse venues.

  • Developing appropriate (social and product) marketing campaigns for children and youth should be an integral intervention component.

  • An ongoing scientific and programmatic exchange to share educational materials, research results, and evaluation of the interventions should be established.

During working group discussions it became apparent that the main determinants associated with obesity, highlighted in Figure 7 (Chapter 1), are similar in the two countries and are based on the one complex problem of balance between energy expenditure and energy intake. However, political, social, and economic differences do exist between the United States and Mexico, and researchers should consider those differences when sharing and implementing interventions based on each country’s experiences. The following section highlights some of the barriers that might be encountered when implementing interventions.

Barriers and Challenges to Implementing Interventions

Most obesity prevention interventions present opportunities as well as challenges. The barriers that challenge our ability to combat the obesity epidemic can be divided into two categories: those related to specific interventions and those related to the social and political environment within which each population resides. For example, in the first category, using media to influence behaviors could be an effective intervention strategy to convey important messages; however, the use of media also can be counterproductive if used to promote unhealthy behaviors. Participants related that school- and community-based interventions also present challenges, such as finding additional resources and time dedicated to promoting obesity prevention. Time limitation is also one barrier often mentioned when considering healthcare interventions. With regard to the second category,

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