8. Children And Neighbors Defeat Obesity/La Comunidad Ayudando A Los Niños A Derrotar La Obesidad (CAN DO Houston)
Background: After Men’s Fitness magazine named Houston the “Fattest City in America” in 2005, the Office of the Mayor initiated the Mayor’s Wellness Council (MWC) to encourage and motivate Houstonians to eat healthfully and engage in regular physical activity. The following year, the MWC created the Houston Wellness Association (HWA), a nonprofit association that endeavored to engage businesses and the wellness industry in efforts to increase the wellness of all Houston residents. Through informal networks of HWA and MWC members, momentum and interest began to grow, and a large consortium of stakeholders, including city services, experts in health disparities and childhood obesity, pediatricians, universities, and community programs, coordinated efforts to tackle childhood obesity. From this collaboration, CAN DO Houston (Children And Neighbors Defeat Obesity; la Comunidad Ayudando a los Niños a Derrotar la Obesidad) was created as a comprehensive, community-based childhood obesity prevention program.
Methods: CAN DO Houston stakeholders chose the city’s Sunnyside and Magnolia Park neighborhoods to be the pilot sites for the program. They then selected an elementary school and park within each neighborhood to serve as anchors for the program. With the locations finalized, the stakeholders researched the available programs in the Houston area that addressed childhood obesity. They posted a database of more than 60 programs online so the participants in the program could become aware of and use them. Subsequently, interviews were conducted with key informants, including the school principals, park managers, physical education teachers, staff of the Metropolitan Transit Authority of Harris County, and police officers, to prioritize the needs for each community. Additionally, CAN DO Houston held multiple focus groups with parents from Sunnyside and Magnolia Park. Interviewees and the focus group members were asked to describe both strengths and barriers in their communities relative to being physically active, accessing good nutrition, and developing healthy minds. They also were asked to identify and prioritize possible initiatives.
Results: The findings showed the unique strengths within each community as well as the specific challenges that the program initiatives could address. For example, in Magnolia Park, participants indicated that children had good access to resources for healthy eating, and in Sunnyside the participants indicated that children were engaging in more than the recommended 60 minutes of moderate-to-vigorous activity each day. The primary barrier identified in Magnolia Park was the lack of physical activity; in Sunnyside, it was the lack of education on nutrition for the children and parents. With this information, the CAN DO Houston program was able to tailor specific interventions for each community.
The interviews and focus groups in Magnolia Park revealed a safety and logistical problem that was contributing to the underuse of the free after-school program in the city park. The park was only 0.4 miles from the elementary school, but a busy four-lane street and a bayou prevented most parents from allowing their children to walk to it. To address the problem of safe access, CAN DO Houston partnered with the park recreation staff and arranged for them to conduct an after-school program at the school twice per week. The park staff led the activities, and CAN DO Houston provided volunteers to assist the park staff and supervise the students. More than 80 students signed up for the program. Because of the pilot’s success, the school district agreed to provide bus transportation between the school and the park during the 2009–2010 school year.
In Sunnyside, CAN DO Houston coordinated a monthly wellness seminar to educate parents on good nutrition and various wellness topics. In addition, it offered tours of grocery stores that focused on how to buy healthy foods on a budget. A nutrition carnival was hosted during the park’s after-school program, and the project provided the park with supplies to incorporate education on nutrition into this program.
Comment: The pilot initiative of CAN DO Houston successfully formed a consortium of people and organizations interested in addressing childhood obesity that continues to link Houston neighborhoods with resources that can be used to address the unique challenges that these communities face. CAN DO demonstrates that, through the use of existing resources, implementing a successful initiative on the prevention of childhood obesity in an urban setting is feasible even with minimal funding.
Applications of Principles of Community Engagement: More than 70 organizations participated in the development of the CAN DO Houston pilot program, establishing a broad collaboration of community members, institutions, organizations, and local government. Uniting so many groups reflects Principle 2, which asks organizers of community engagement to establish relationships and work with existing leadership structures. The implementers of CAN DO Houston coordinated various activities to promote healthy living, including after-school programs, grocery store tours, wellness seminars, cooking classes, and staff wellness clubs, all on the basis of the input and priorities of community members. By implementing the initiatives chosen by the community through the existing community organizations and resources, CAN DO Houston provides opportunities for partner ownership, consistent with Principle 4, which stresses that no external entity should assume that it can bestow on a community the power to act in its own self-interest. Finally, engaging and listening to the communities and allowing them to prioritize the initiatives of the program fulfills Principle 8, which counsels the engaging organization to be prepared to relinquish control of actions to the community.
Correa NP, Murray NG, Mei CA, Baun WB, Gor BJ, Hare NB, et al. CAN DO Houston: a community-based approach to preventing childhood obesity. Preventing Chronic Disease 2010;7(4):A88.