TY - JOUR
T1 - Developing the logic framework underpinning a whole-systems approach to childhood overweight and obesity prevention: Amsterdam Healthy Weight Approach
T2 - Amsterdam Healthy Weight Approach
AU - Sawyer, Alexia
AU - den Hertog, Karen
AU - Verhoeff, Arnoud P.
AU - Busch, Vincent
AU - Stronks, Karien
N1 - Funding Information: All authors have completed the ICMJE COI disclosure form (available on request from the corresponding author) and declare: Alexia Sawyer, Karen den Hertog, Arnoud P Verhoeff, and Vincent Busch had financial support from Public Health Service (GGD), City of Amsterdam, for the submitted work; Karien Stronks received no specific funding for the submitted work. Public Health Service (GGD), City of Amsterdam, is a governmental organization; as the submitted work articulates the development and implementation of an existing program, the interests in the outcome of the work is low. Authors had no financial relationships with any organizations that might have an interest in the submitted work in the previous 36 months and no other relationships or activities that could appear to have influenced the submitted work. Publisher Copyright: © 2021 The Authors. Obesity Science & Practice published by World Obesity and The Obesity Society and John Wiley & Sons Ltd.
PY - 2021/10
Y1 - 2021/10
N2 - Background: Whole-systems approaches (WSAs) are well placed to tackle the complex local environmental influences on overweight and obesity, yet there are few examples of WSAs in practice. Amsterdam Healthy Weight Approach (AHWA) is a long-term, municipality-led program to improve children's physical activity, diet, and sleep through action in the home, neighborhood, school, and city. Adopting a WSA, local political, physical, social, educational, and healthcare drivers of childhood obesity are viewed as a complex adaptive system. Since 2013, AHWA has reached >15,000 children. During this time, the estimated prevalence of 2–18-year-olds with overweight or obesity in Amsterdam has declined from 21% in 2012 to 18.7% in 2017. Declining trends are rarely observed in cities. There is a need to formally articulate AHWA program theory in order to: (i) inform future program evaluation which can interpret this decline within the context of AHWA and (ii) contribute a real-life example of a WSA to the literature. Methods: This study aimed to formally document the program theory of AHWA to permit future evaluation. A logic framework was developed through extensive document review and discussion, during program implementation. Results: The working principles of the WSA underpinning AHWA were made explicit in an overarching theory of change, articulated in a logic framework. The framework was operationalized using an illustrative example of sugar intake. Conclusions: The logic framework will inform AHWA development, monitoring, and evaluation and responds to a wider need to outline the working principles of WSAs in public health.
AB - Background: Whole-systems approaches (WSAs) are well placed to tackle the complex local environmental influences on overweight and obesity, yet there are few examples of WSAs in practice. Amsterdam Healthy Weight Approach (AHWA) is a long-term, municipality-led program to improve children's physical activity, diet, and sleep through action in the home, neighborhood, school, and city. Adopting a WSA, local political, physical, social, educational, and healthcare drivers of childhood obesity are viewed as a complex adaptive system. Since 2013, AHWA has reached >15,000 children. During this time, the estimated prevalence of 2–18-year-olds with overweight or obesity in Amsterdam has declined from 21% in 2012 to 18.7% in 2017. Declining trends are rarely observed in cities. There is a need to formally articulate AHWA program theory in order to: (i) inform future program evaluation which can interpret this decline within the context of AHWA and (ii) contribute a real-life example of a WSA to the literature. Methods: This study aimed to formally document the program theory of AHWA to permit future evaluation. A logic framework was developed through extensive document review and discussion, during program implementation. Results: The working principles of the WSA underpinning AHWA were made explicit in an overarching theory of change, articulated in a logic framework. The framework was operationalized using an illustrative example of sugar intake. Conclusions: The logic framework will inform AHWA development, monitoring, and evaluation and responds to a wider need to outline the working principles of WSAs in public health.
KW - childhood obesity
KW - childhood overweight
KW - diet
KW - inequalities
KW - physical activity
KW - whole-systems approach
UR - http://www.scopus.com/inward/record.url?scp=85104137262&partnerID=8YFLogxK
UR - https://pure.uva.nl/ws/files/74932302/osp4505_sup_0001_fig_s1.docx
U2 - https://doi.org/10.1002/osp4.505
DO - https://doi.org/10.1002/osp4.505
M3 - Article
C2 - 34631137
SN - 2055-2238
VL - 7
SP - 591
EP - 605
JO - Obesity Science and Practice
JF - Obesity Science and Practice
IS - 5
ER -