Open AccessDeveloping the logic framework underpinning a whole‐systems approach to childhood overweight and obesity prevention: Amsterdam Healthy Weight Approach
Author(s) -
Sawyer Alexia,
den Hertog Karen,
Verhoeff Arnoud P,
Busch Vincent,
Stronks Karien
Publication year - 2021
Publication title -
obesity science and practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.654
H-Index - 14
ISSN - 2055-2238
DOI - 10.1002/osp4.505
Subject(s) - operationalization , overweight , childhood obesity , underpinning , context (archaeology) , gerontology , logic model , public health , obesity , medicine , environmental health , sociology , social science , geography , nursing , epistemology , philosophy , civil engineering , archaeology , engineering
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.