Solving the obesity epidemic: voices from the community.

Despite state and national campaigns and strategies, the obesity challenge in the United States is increasing in size and scope (Ford et al. 2011). This is particularly evident among African Americans and Hispanics or Latinos residing in Houston, Texas, home to approximately 4 000 000 people, of which 19.3% identify as black and 38.1% identify as Hispanic or Latino (U.S. Census Bureau 2013). Current obesity prevention and control strategies based on effective theoretically guided and laboratory-based interventions often target individual-level health behaviors and have marginal short-term effects with limited ecological validity (Huberty et al. 2008). The limited impact of these strategies suggests a need to work collaboratively with the community to create innovative solutions to reduce obesity from a ‘real world’ perspective. This perspective allows for the engagement of community members in the development of evidence- based sustainable interventions and/or guides the translation of evidence-based interventions into communities to ensure greater implementation and sustainability (Suminski et al. 2009). Community-based participatory research (CBPR) strategies include community members, organizational representatives and researchers as equal partners in the research. The goal of CBPR is to provide the community a sense of ownership while informing research design and methods to enhance generalizability of research results to the target population. In turn, this increased sense of ownership and relevancy may offer greater sustainability than traditional, laboratory-based individual-level strategies (Correa et al. 2010; Farag et al. 2010). Science and Community: Ending Obesity Improving Health (Science and Community) aimed to develop an academic–community partnership to reduce obesity by developing a shared vision and agenda via community outreach and education. The guiding framework for the study was the Ecologic Model of Physical Activity (Spence and Lee 2003), which takes into account intrapersonal factors, dynamic interpersonal relationships, the physical environment and policies and how they influence physical activity (Spence and Lee 2003). Intrapersonal factors related to physical activity may include an individual’s weight, attitudes, self-efficacy or health knowledge related to physical activity. Interpersonal, or social, factors may include dynamic social and physical linkages between people and places that promote physical activity, such as support from family and friends to do physical activity regularly. The physical environment includes the availability of, accessibility to and quality of physical activity resources and the pedestrian environment. Policies that may impact physical activity include city zoning laws, which may guide or determine where recreation facilities are built, and other policies related to the neighborhood environment, including but not limited to the speed limit, number of travel lanes and designated bicycle lanes. Ecologic models in conjunction with CBPR approaches can greatly enhance efficacy and sustainability of programs and promote long-term health behaviors. The purpose of this study was to explore and describe community perceptions of the causes of obesity and possible solutions. Use of the ecologic model fostered the examination of ecologic factors that contribute to the obesity epidemic. This study informed a collaborative research agenda developed as part of the Science and Community project and may also help to inform other health promotion research that focuses on sustainable community approaches to obesity.