Moving clinic- and community-based practice into policy to address child healthy weight (and vice versa)

Abstract

As mentioned in previous chapters, childhood obesity and the attendant clinical manifestations of metabolic syndrome and type 2 diabetes have a strong, negative effect on a child's organs, bones, sleep patterns, cancer risk, psychological health, and overall future cardiometabolic risk. And despite the fact that the prevalence of childhood overweight and obesity in the USA continues to grow, especially among underserved subgroups, there is hope for reversing these trends. One approach with much potential is a model of collaborative care for child healthy weight that uses a “hub and spoke” design whereby the school/child care center is a “hub” of good nutrition and healthy living in action, with messages and activities filtering out into the community organically through the “spokes” (clinics, after-school programs, grocery stores, etc.). This multi-sector, community contextually specific collaborative approach helps child healthy weight activities become embedded in clinical- and community-based practice and transforms policies to improve child health, which in turn provide ongoing guidance for practice implementation in all settings. Implementing evidence-based programming throughout the hub and the spokes, linking activities to sustainable, currently operationalized programs (such as the United States Department of Agriculture Supplementation Nutrition Assistance Program-Education, school wellness policies/Coordinated School Health programming, etc.), and commencing strategic community-wide social marketing efforts, allows a wide variety of partnerships to develop that share consistent healthy messaging. The true power of this model lies in community collaborations of diverse organizations. It will take all of us working together to achieve healthy weight on our communities, the USA at large, as well as other countries that are struggling with similar challenges of keeping children at a healthy weight.