Implementing complex community interventions targeting childhood obesity: importance of tailoring and an ecological system approach

Abstract

Background. The aetiology of childhood obesity is embedded in the interaction between the child and the social and physical context. Numerous Complex Community Interventions to address Childhood Obesity (CCIOs) have been developed. So far, insight into the critical conditions for implementation of such programmes is scares. Methods. We conducted a longitudinal, mixed-method multiple case study on the implementation of a CCIO in the Netherlands. Not only degree and determinants of programme implementation were assessed, but also processes of intersectoral collaboration and network development that were expected to be important for preserving a sustainable change in the prevention of childhood obesity. Findings. Determinants operating at distinct system levels appeared to affect programme implementation and appeared to a great extent specific per sector and the stage of innovation. Also degree of collaboration and network development appeared to affect programme implementation. Discussion: In order to anticipate implementation failures of CCIOs, strategies should account for a diversity of determinants and should be tailored to specific sectors and stages of innovation.