Some of the health promotion recommendations for families outlined in "The Obesity Epidemic, Part 2: Nursing Assessment and Intervention" (January) have merit. These include keeping a variety of fruits and vegetables in the home and increasing family physical activity.

However, resource-constrained parents might otherwise find these strategies beyond reach, calling into question issues of access and affordability. In applying family-based strategies, nurses need to evaluate an intervention's effectiveness as well as discern whether or not the targeted intervention is culturally relevant and sensitive.

Nurses are in a position to provide leadership that exerts a broader influence by advocating for evidence-based community interventions and for policies that enable a healthier environment. When we commit ourselves to protecting the most vulnerable populations and empower them with real choices, then perhaps we can anticipate a shift in the fulcrum.

Kathleen M. Straka, BSN, RN

Owls Head, ME