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Childhood obesity prevention: in need of urban governance?

Joke Van Assche (UGent), Stefaan De Henauw (UGent) and Herwig Reynaert (UGent)
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Abstract
Introduction: Screening of policy documents leads us to suppose that local governments constitute the tailpiece of any public intervention in the field of childhood obesity prevention. Up till now, little research has been undertaken to identify the leadership of local politicians in childhood obesity prevention. Objective: To test the leadership of local politicians in the implementation of community based interventions on childhood obesity prevention. Within the framework of the Epode European Network, we study the role of two Flemish city authorities in obesity prevention. Epode is a methodology to prevent childhood obesity by means of community based interventions, initiated and developed in France in 2004. Methods Case studies: in two Flemish cities, Genk and Hasselt, we refer to as ‘G’ and ‘H’. Sampling frame: G and H were selected on the basis of an explorative questionnaire send to all Flemish LOGO’s, relevant for the 13 biggest cities in Flanders Method: we use qualitative research methods by interviewing about ten key persons in both cities, relevant for the role of local governments in obesity prevention. Results: In both cities we see similarities and differences, which are illustrated in the figures below . The most important institutional elements determining the role of local governments in the success of ‘obesity prevention projects are highlighted in the text. Similarity: - both vice-mayors, competent on public health, are really concerned about the wellbeing of the children and youngsters at school. The vice-mayor in H is a doctor who was touched by the problems of truants and was confronted with the need to take action, also from a public health perspective. The vice-mayor in G. is a former school director and has a growing awareness of the need to take local action in health promotion towards children. Statistics on the prevalence of obesity and overweight of children in his own city (we provided for) gave him a sense of urgency. Immediately, he put them on the agenda of the city council. - similar institutional context at provincial (co funding and LOGO) and higher government levels Differences in political climate and position of vice-mayor: - In G there is a stable political climate, with one political party in the local government since the second world war. And there is a big team spirit, not only within the city council, but also in relation to other local autonomous public partners, such as the police or the organization on social welfare. - In H the vice-mayor is competent for public health since 1995. In the last coalition another vice-mayor (of another political party) got a so-called horizontal responsibility on ‘Healthy city’, which should be complementary to the vertical competence on public health. This situation is leading to a lot of confusion and is hindering mutual collaboration. Differences in planning the support by city government: - In G the local health policy plan was developed within the framework of the local social policy plan. A leading civil servant used the method of strategic planning and translated strategic goals with representatives of all relevant departments of city governments into operational actions. The planning process was followed by a steering committee (with representatives of main health actors in the city) and tested in an advisory council (with a larger representation of the local public health network). As an effect of this participatory approach the local health policy plan is coordinated with other local policy domains, such as sports, environment, youth, seniors, library, etc. - In H the vice-mayor started a programme on wellbeing and education, in reaction to the problems with the truants. This programme was inspired by the extended school approach. This programme provided the framework for the commissioning of a diversity of projects, that could promote health, sustainable mobility and environmental care at schools. Differences in target group: - Vice-mayor in H launched several projects (on having breakfast, fruit, etc.) in the framework of a local programme on wellbeing for children and students at school. Because that programme gets little support by the city council, the vice-mayor needs to turn to external experts, in order to get things done. So, every external expert (dietician, consultant, etc.) needs to produce a format for a project, that is targeted towards the wellbeing of children and students in local schools. - Vice-mayor of G supports the first-level actors in several projects (on heaving breakfast, 10.000 steps, health walks, healthy cooking lessons, etc.) within the framework of the local health policy plan. Internal people are supporting those first-level actors. Differences in policy networking. - Because of the integrated public health policy planning, civil servants are building expertise within the city authority and trust towards the stakeholders. The flow of trust to external stakeholders is the basis of real collaboration within policy networks, relevant for different projects in this domain. - In H the city authority is commissioning projects in which every external expert (dietician, consultant, etc.) needs to put a lot of effort in the communication with stakeholders. So, in these projects, the policy networking has the character of an ad hoc collaboration. Conclusions: There are five elements determining our view on leadership in the obesity prevention: 1. the double awareness of local politicians about health problems of children, 2. and about the political climate and their own position in the city council, 3. the role of policy pursuer, in terms of stimulator of the policy process (in G: by developing a health policy plan, integrated within a local social policy plan of the city authority, and in H: by a programme for an extended school approach) and collaborating with leading civil servants (as in G) or with internal and external project managers (as in H) 4. directing the local public support towards the target groups (such as children, adolescents, etc.) or the first-level actors (such as parents, schools, sports organisations, associations for a healthy nutrition, etc.). 5. support existing collaboration with external stakeholders in all relevant policy domains (such as sports, environment, youth, seniors, education, etc.). So, these conclusions provide some input for the discussion about the role local politicians should play in supporting or steering the urban governance for childhood obesity prevention.
Keywords
childhood obesity prevention, urban governance, public health policy, community based intervention, local policy networks

Citation

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Chicago
Van Assche, Joke, Stefaan De Henauw, and Herwig Reynaert. 2010. “Childhood Obesity Prevention: In Need of Urban Governance?” In Obesity, 11th International Conference, Abstracts.
APA
Van Assche, Joke, De Henauw, S., & Reynaert, H. (2010). Childhood obesity prevention: in need of urban governance? Obesity, 11th International conference, Abstracts. Presented at the 11th International conference on Obesity.
Vancouver
1.
Van Assche J, De Henauw S, Reynaert H. Childhood obesity prevention: in need of urban governance? Obesity, 11th International conference, Abstracts. 2010.
MLA
Van Assche, Joke, Stefaan De Henauw, and Herwig Reynaert. “Childhood Obesity Prevention: In Need of Urban Governance?” Obesity, 11th International Conference, Abstracts. 2010. Print.
@inproceedings{1094103,
  abstract     = {Introduction: Screening of policy documents leads us to suppose that local governments constitute the tailpiece of any public intervention in the field of childhood obesity prevention. Up till now, little research has  been undertaken to identify the leadership of local politicians in childhood obesity prevention. 
Objective: To test the leadership of local politicians in the implementation of community based interventions on childhood obesity prevention. Within the framework of the Epode European Network, we study the role of two Flemish city authorities in obesity prevention. Epode is a methodology to prevent childhood obesity by means of community based interventions, initiated and developed in France in 2004.
Methods
Case studies: in two Flemish cities, Genk and Hasselt, we refer to  as {\textquoteleft}G{\textquoteright} and {\textquoteleft}H{\textquoteright}. 
Sampling frame: G and H were selected on the basis of an explorative questionnaire send to all Flemish LOGO{\textquoteright}s, relevant for the 13 biggest cities in Flanders
Method: we use qualitative research methods by interviewing about ten key persons in both cities, relevant for the role of local governments in obesity prevention. 
Results: In both cities we see similarities and differences, which are illustrated in  the figures below . The most important  institutional elements determining the role of local governments in the success of {\textquoteleft}obesity prevention projects are highlighted in the text. 
Similarity: 
- both vice-mayors, competent on public health, are really concerned about the wellbeing of the children and youngsters at school. The vice-mayor in H is a doctor who was touched by the problems of truants and was confronted with the need to take action, also from a public health perspective. The vice-mayor in G. is a former school director and has a growing awareness of the need to take local action in health promotion towards children. Statistics on the prevalence of obesity and overweight of children in his own city (we provided for) gave him a sense of urgency.  Immediately, he put them on the agenda of the city council. 
- similar institutional context at provincial (co funding and LOGO) and higher government levels
 Differences in political climate and position of vice-mayor:
- In G there is a stable political climate, with one political party in the local government since the second world war. And there is a big team spirit, not only within the city council, but also in relation to other local autonomous public partners, such as the police or the organization on social welfare. 
- In H the vice-mayor is competent for public health since 1995. In the last coalition another vice-mayor (of another political party) got a so-called horizontal responsibility on {\textquoteleft}Healthy city{\textquoteright}, which should be complementary to the vertical competence on public health. This situation is leading to a lot of confusion and is hindering mutual collaboration.
Differences in planning the support by city government:
- In G the local health policy plan was developed within the framework of the local social policy plan. A leading civil servant used the method of strategic planning and translated strategic goals with representatives of all relevant departments of city governments into operational actions. The planning process was followed by a steering committee (with representatives of main health actors in the city) and tested in an advisory council (with a larger representation of the local public health network).  As an effect of this participatory approach the local health policy plan is coordinated with other local policy domains, such as sports, environment, youth, seniors, library, etc. 
- In H the vice-mayor started a programme on wellbeing and education, in reaction to the problems with the truants. This programme was inspired by the extended school approach. This programme provided the framework for the commissioning of a diversity of projects, that could promote health, sustainable mobility and environmental care at schools.  
Differences in target group:
- Vice-mayor in H launched several projects (on having breakfast, fruit, etc.) in the framework of a local programme on wellbeing for children and students at school. Because that programme gets little support by the city council, the vice-mayor needs to turn to external experts, in order to get things done. So, every external expert (dietician, consultant, etc.) needs to produce a format for a project, that is targeted towards the wellbeing of children and students in local schools. 
- Vice-mayor of G supports the first-level actors in several projects (on heaving breakfast, 10.000 steps, health walks, healthy cooking lessons, etc.) within the framework of the local health policy plan. Internal people are supporting those first-level actors. 
Differences in policy networking. 
- Because of the integrated public health policy planning, civil servants are building expertise within the city authority and trust towards the stakeholders. The flow of trust to external stakeholders is the basis of real collaboration within policy networks, relevant for different projects in this domain. 
- In H the city authority is commissioning projects in which every external expert (dietician, consultant, etc.) needs to put a lot of effort in the communication with stakeholders. So, in these projects, the policy networking has the  character of an ad hoc collaboration.  
Conclusions: There are five elements determining our view on leadership in the obesity prevention: 
1. the double awareness of local politicians about health problems of children, 
2. and about the political climate and their own position in the city council,
3. the role of policy pursuer, in terms of stimulator of the policy process (in G: by developing a  health policy plan, integrated within a local social policy plan of the city authority, and in H: by a programme for an extended school approach) and collaborating with leading civil servants (as in G) or with internal and external project managers (as in H)
4. directing the local public support towards the target groups (such as children, adolescents, etc.) or the first-level actors (such as parents, schools, sports organisations, associations for a healthy nutrition, etc.).
5. support existing collaboration with external stakeholders in all relevant policy domains (such as sports, environment, youth, seniors, education, etc.).  
So, these conclusions provide some input for the discussion about the role local politicians should play in supporting or steering the urban governance for childhood obesity prevention.},
  author       = {Van Assche, Joke and De Henauw, Stefaan and Reynaert, Herwig},
  booktitle    = {Obesity, 11th International conference, Abstracts},
  keyword      = {childhood obesity prevention,urban governance,public health policy,community based intervention,local policy networks},
  language     = {eng},
  location     = {Stockholm, Sweden},
  title        = {Childhood obesity prevention: in need of urban governance?},
  year         = {2010},
}