How can health behavior
research have its greatest public health impact?
No system exists to improve the quality of evidence-based
obesity prevention for children and youth across collaborating
agencies
and delivery settings. To be successful, obesity prevention
initiatives must be integrated into a life-span systems view
of positive child and youth development.
For the Healthy Places
Framework© to have its greatest impact on public health,
our staff, and others who conduct and disseminate health behavior
research, should be involved in these three ways:
- Provide people in communities with systematic ways to develop
environments where people can choose healthy behaviors.
- Rely upon leaders in places where people live, learn, work,
and play to help find ways to develop healthy environments.
Give them “tools of the trade” to establish Healthy
Place processes and to institutionalize Healthy Place efforts.
- Stay in touch with place leaders. With ongoing contact, professionals
can provide new findings and strategies to community leaders.
What diffusion system can effectively convey strategies
to communities?
Local service providers have traditionally been
expected to deliver innovative theory-based strategies for
social change that were developed by experts (Baranowski and
Stables, 2000). Governing agencies typically imposed processes
upon local service providers and held them accountable for
delivering these strategies.
Because control flows in a top-down fashion in
this approach, it is considered a centralized strategy diffusion
model (Rogers, 1995). Using top-down strategies may lead to
poor implementation rates (Baranowski and Stables, 2000). One
alternative to the top-down centralized strategy is a decentralized
diffusion system (Rogers, 1995).
The Healthy Places Framework© uses a decentralized diffusion
system that provides control, autonomy,
skill building, and healthy norms to leaders who deliver
the intervention locally.
What components operate in the Healthy Places Framework?
The diffusion system used in the Healthy Places Framework
typically consists
of leaders and groups connecting and communicating knowledge
across at least three levels, where three
main components operate:
The system of nested levels, which can expand
or contract to incorporate as many levels as needed, consists
of teams that have two-way communication between adjacent levels.
To maintain connection between levels, teams on adjacent levels
have at least one member in common.
For example, the director of Communities in Schools,
an organization that operates at the state level, might be
a member of the team at the top level (state and regional leaders
with technical expertise) and a member of a regional team for
Northeast Kansas. At least one member of the Northeast Kansas
team would also be a community leader, perhaps a family physician
working in Shawnee County. Similar connections between adjacent
levels having members in common occur throughout the system.
Having the teams at various levels also allows cross-site collaboration
because the teams gather together peers working in similar
places and situations.
View a diagram of the Diffusion
System in a new window. (The diagram
shows the three levels and the corresponding framework components.)
