Obesity-related policy must occur “in all places” to form a long-term movement toward better health. The development of comprehensive frameworks for community efforts to create healthy environments is under way. The need persists to educate, convince, and inform actors and decision makers in other sectors that health and health policy are their allies in changing the shape of community environments for the better.
Communication is key to this work. Communication is needed to develop a common understanding of obesity prevention and to articulate the shift from individual interventions to environmental change in combating the obesity epidemic. Differences in expectations and professional paradigms can lead to a breakdown in communication. Dialogue on how different sectors view evidence, for example, can help bridge these divides. The importance of communication also relates to how best to present research and other evidence to draw the attention of policy makers.
The question remains of whether a set of data should be collected consistently across communities. Some divergence of opinion arose about the use of body mass index (BMI) data in community-based interventions, yet no recommendation for an alternative has emerged. Another issue voiced by several speakers is whether assembling the entire chain of evidence—from environmental interventions, to changes in food and physical activity behaviors, to changes in BMI—is necessary for every intervention. Moreover, many community residents have expressed that they do not want to serve constantly as the subject of research studies that lead to no visible improvement.
Community knowledge is an essential building block in reducing childhood obesity. Community knowledge is the cultural context. Local information about the population and knowledge about what programs are more likely to work or have been shown to work help form and set policy priorities for communities and different contexts, from soccer fields in Santa Ana to green carts in New York City. Ongoing engagement of neighborhoods and residents strengthens leadership and power within communities, which in turn helps create and sustain change.