Physical Activity and Obesity Prevention

Obesity substantially contributes to the etiology and progression of noncommunicable diseases and presents significant public health complexities across the life span.1 Contrary to international2 and national3 goals to reverse pandemic and epidemic trends, respectively, pediatric and adult obesity remains a critical public health priority. Physical activity is an essential component of caloric-energy balance and, concomitantly, the treatment and prevention of obesity.4 Selective and universal strategies2 to increase the adoption and maintenance of physical activity across multiple societal sectors and ecological levels that are tailored to geographic, social, and cultural characteristics present a promising constellation of intervention approaches to bolster physical activity and prevent obesity.1,5-8 In a recent call to action, Kohl and colleagues8 underscored the need to cultivate capacity in physical activity research, practice, evaluation, surveillance, dissemination, and sustainability.8 In addition, they presented the requisite for a life-course approach to address the needs of families and pediatric and gerontological populations, as well as in targeted settings such as rural locale, worksites, schools, and places of worship.8

Low rates of physical activity and high rates of obesity and subsequent chronic disease are notably problematic among low-income and minority and ethnic populations typically constrained by inadequate family and community support and insufficient access to physical activity resources.9,10 With an emphasis on translational research to improve intervention outcomes within diverse cultures and contexts, community-based approaches that engage selective populations, communities, and families in the process of identifying health problems and sustainable solutions are paramount.11 In public health, a community can be defined as a group of people with diverse characteristics who are linked by social ties; who share common perspectives, attitudes, interests, or goals; or who engage in joint action within a particular setting.12 Thus, community context can describe a multitude of settings and populations and can be a conduit to identify appropriate methods in physical activity intervention research and practice.

In this special issue of Family & Community Health, the contributing authors evaluate community-based approaches to improve behavioral outcomes and bolster programmatic sustainability. They also explore the application of tailored intervention methods and strategies to meet the needs of various communities and selective populations and settings, as well as further underscore the value of community-engaged formative research conducted through community-academic partnerships.

This special issue begins with 3 articles that highlight important methodological considerations to conducting and evaluating community-based intervention research within African American, Latino, and faith communities in the United States. Guided by a theory of organizational implementation, Arredondo et al identify the importance of church leader support and the strength of parishioners' connection to the church as critical contexts of organizational readiness for physical activity interventions in faith communities. Next, using community health advisors trained as research partners, Wynn et al undercovered the need for community-led health promotion strategies that extend beyond faith communities to influence previously unreached high-risk persons. The authors go on to describe 5 constructive lessons in community-based participatory research that will guide future intervention strategies and initiatives. The findings from Brandt et al provide support for the use of documentary filmmaking as a tool in community-based participatory research to increase awareness and impact beliefs about health problems and related health behaviors within targeted communities. The concepts and methods discussed in these studies are important to advance the field of community-based physical activity research.

The next 2 articles report on the design and outcomes of 2 selective physical activity intervention studies targeting minority adults through various community and home settings. In a noncontrolled pilot study, Yanek and colleagues explore the impact of a 1-year self-selection community- and home-based physical activity intervention to reduce cardiometabolic risk among African American adults. Next, Turk et al described a 12-week pilot study tailored for 6 urban senior communities to increase physical activity among racially diverse low-income older adults. Each of these intervention studies demonstrates the importance of tailoring strategies to meet the needs of selective high-risk populations. Future controlled community trials and comprehensive evaluations are needed to determine the magnitude and sustainability of these intervention effects on physical activity and related health outcomes over time.

The final 4 articles examined contextual factors at various levels of the ecological model that influence physical activity in school and community settings. Hill et al described a community-academic partnership leveraged to investigate environmental factors related to physical activity in rural residents, which yielded 4 actionable environmental and policy-related strategies to support physical activity. In the next article by Gill and colleagues, the quality of physical education is explored among middle school adolescents. Subsequent findings feature the importance of class context, location, and size as factors that contribute to increased levels of physical activity during physical education. Next, Mude and Mwanri described parental perceived complex barriers to youth physical activity in South Sudanese migrant communities in South Australia. In the final article by Nichols et al, Photovoice is used to explore female adolescent and parental perceptions of multiple levels of influence on adolescent physical activity. The culmination of these articles provides support for community- and family-based approaches to identify ecological factors that influence physical activity practices in high-risk, selective populations.

The articles in this special issue expand our knowledge of community-based approaches to increase physical activity and other health behaviors related to the prevention of obesity and subsequent chronic disease. The scope of the articles underlies the multiple influences on physical activity across levels of the ecological model and the life span and emphasizes the importance of community and family roles in translating evidence-based strategies to meaningful and sustainable practices. I am hopeful that the research presented in this special issue, coalesced with other evidence, will be used to improve physical activity intervention research and practice in an effort to prevent obesity across the life span.

-Abigail Gamble, PhD

Assistant Professor

College of Public Health

Kent State University

Kent, Ohio

[email protected]

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