For the purposes of this appendix, the experience with public health programs, such as tobacco control, injury prevention, underage alcohol use, gun control, and others are qualitatively examined with particular attention to their possible relevance for the prevention of childhood obesity.

PUBLIC HEALTH LESSONS LEARNED

The purpose of this paper is not to suggest specific intervention strategies to prevent childhood obesity, but rather to learn from other public health experiences and to glean lessons that might help inform efforts to prevent childhood obesity. There is certainly no shortage of theories, models, and approaches to help guide public health program planning. There are multiple health behavior theories that are commonly used to guide public health efforts (Glanz et al., 2002), and popular planning models have been designed to help diagnose health problems (Green and Kreuter, 2000), identify the factors that contribute to these problems, and devise appropriate interventions. In general, these theories and models recommend taking a broad view of changing health behaviors and conditions, suggesting multifactorial, comprehensive interventions that address multiple aspects of the problem. Recently, the Institute of Medicine (2002) endorsed this broad approach to public health interventions, recommending the adoption of an “ecological model” for viewing public health problems and interventions, where the individual is viewed within a larger context of family, community, and society. Overall, there is increasing interest in public health interventions being comprehensive, addressing the multiple factors that influence the health problem, and striving to strike a balance between efforts directed at the individual and the social-environmental context in which people live. It is likely that this approach will be as relevant for the prevention of childhood obesity as it is for other contemporary public health challenges. However, as previously stated, the purpose here is not to propose a comprehensive intervention program for childhood obesity, but rather to identify the factors associated with success in other public health areas, both as a result of planned interventions and also corresponding to social, cultural, or temporal factors.

Despite the notable successes in public health over the past century, there are no generally agreed on approaches or interventions that can be applied to multiple public health problems, with the same intervention effect seen with different problems. There are general guidelines and recommendations, core functions for public health, but no generic model program, best practices, or common lessons learned that could be applied to most or all public health problems.

There are “best practices” for specific public health problems, but little research or insight of the extent to which these categorical approaches are



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