Running head: SHAPE UP SOMERVILLE CASE STUDY

Shape up Somerville Case Study

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Shape up Somerville Case Study

A primary prevention strategy for most disorders is good nutrition and regular physical

activity, but very few people engage in healthy eating habits and physical activities. DHHS

(2017) indicates that in three children, only one is physically active with about 5% of all adults

participating in a 30-minute physical exercise in a day. The typical American diets kin four

categories, calories, refined grains, saturated fats, and sodium, exceed the recommended intake

levels. Coupled together, the two factors are a major cause of obesity and especially in children.

The paper introduces the SUS community-based prevention program and applies the intervention

to the interactive PH intervention wheel.

SUS Community Based Prevention Program

About SUS Program

SUS is a citywide campaign with the goal of overcoming the problem of obesity by

enhancing healthy eating habits and daily physical activity through policy work, improvement of

the physical environment, and program development. In response to a threatening community

and national obesity rates, the CDC funded the program which began as community-based

research targeting 1st, 2nd, and 3rd graders in Somerville public schools (Chomitz, Garnett,

Arsenault, & Hudson, 2017). The goal of the SUS program is to undertake community-based

environmental changes with the objective of preventing obesity. The program began back in

2002 as a three-year research project which began in 1998 to explore the obesity and overweight

rates in school going children. Later, the program aimed at building Somerville city as a healthy

and equitable environment encouraging healthy practices (Coffield, Nihiser, Sherry, &

Economos, 2015).
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Ingredients for Program Success

The success of the SUS program was associated with many factors. Critical ingredients

for its success include community participation and partnership, financial support, leadership,

and political will (Chomitz et al. 2017). Community engagement and participation was deemed a

cornerstone of this program as members of the Somerville City were actively involved in the

planning process ensuring that the program is matched to the community priorities and

preferences. The other important ingredient is the availability of funding from the local and

federal grants. Initially, the CDC, Vitamin Company Litigation Settlement Funds, and the Robert

Wood Johnson Foundation provided the much-needed funding in phase 1 (Coffield et al. 2015).

Somerville City political will and leadership were also critical in the success of the program. The

political leaders prioritized childhood obesity prevention through the institutionalization of the

SUS mission. The community and political leaders kept the resources for the SUS program

flowing facilitating successful implementation of the program (Chomitz et al. 2017). All four

ingredients were essential for the success of the program from 1998 through 2010.

Stakeholders’ Stance on SUS Program and Population of Interest

Obesity and overweight have been a major health problem affecting a majority of people

in the United States. The fact that Somerville is a multicultural community each with varying

beliefs, the potential for unhealthy eating habits as well as inactivity is high which might be one

of the factors promoting the support for the program. Among the most affected individual by

obesity and overweight issues are the school going children with the U.S. Department of Health

(2017) indicating that over 70% of the adolescent is at risk of becoming obese or overweight.

45% of children living in poverty are overweight or obese, 40% of Latino and black children of

between 2 and 19 years are obese or overweight. These are factual data that indicate that the
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issue of obesity and overweight is critical in communities and having a program such as the SUS

would improve the status of the community. While everybody is at risk of obesity children are at

greater risk of this problem. Due to this fact, the program focused on 1st through 3rd graders, a

population that is at increased risk of the problem (Coffield et al. 2015).

Healthy People 2020 Objective

The program is comprehensive in improving the health of the community by enhancing

healthy eating habits as well as the physical activity of the community. The Healthy People 2020

(HP2020) objective addressed by the program is the nutrition and weight status objective.

According to ODPHP (n.d), the objective is related to promoting health and reduction of the risk

of chronic diseases through maintaining healthy body weights achievable through healthy diets

and physical activities.

Application to Public Health Intervention Wheel

Active Living by Design

The SUS had seven grant programs of which one of them is the “Active living by design”

that aimed at improving Somerville infrastructure and its capacity to promote active living and

physical activity for the people living in the city. The program also sought to build an

environment that promotes physical activity by the residents of the city (Chomitz et al. 2017).

The program was actively funded by the Robert Wood Johnson Foundation to support city

planning infrastructure for walking and biking opportunities in the city between 2003 and 2008.

System Level Intervention

From the SUS grant, the “food service enhancement and food service infrastructure

improvement” is a system level intervention whose goal is to improve the eating habit of the
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target population. Mostly, children engage in unhealthy eating practices due to lack of proper

food services and equipment that enhance healthy foods provision and consumption. As a system

level intervention, the intervention is an example of a consultation in the PH intervention wheel.

Center for Public Health Nursing - Minnesota Dept. of Public Health (2001) defines consultation

as a practice of seeking information which is used to generate potential solutions to a given

problem, in this case, the issue of obesity and overweight associated with poor eating habits.

Enhancing food services has the potential of influencing the decisions of the quality of food

served to the target population.

Community Level Intervention

Advocacy for pedestrian and bicycle changes in Somerville City is a community level

intervention that aims at improving physical activity of the community by providing

opportunities and resources that promote the practice. The intervention as outlined in the SUS

program falls under the PH intervention of “advocacy” which Center for Public Health Nursing -

Minnesota Dept. of Public Health (2001) define as an individual or agency’s cause to act on

another individual’s behalf with the goal of developing the individual’s capacity to plead for

oneself. While the community may have been willing to engage in physical activities, the lack of

resources and opportunities might have hindered them. Advocating for the community increases

their capacity to engage in physical activities.

Individual/Family-Level Intervention

Walk to school activities is an individual-level intervention that promotes physical

activity. While some children may not have access to certain resources for fitness and physical

exercises, walking is a less costly practice which encourages the school going children to keep

fit. Walk to school activities is an example of a PH intervention of case finding. Case finding, as
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posited by Center for Public Health Nursing - Minnesota Dept. of Public Health (2001) is a

practice of locating individuals with certain identifiable risk factors and connecting them to

important resources that help them avoid these risk factors. The school going children are at

increased risk of obesity and overweight problems and providing them with free resources such

as walk paths, and bikes are a way of addressing the issue.

Conclusion

The issue of obesity and overweight has been a major threat to the health and wellbeing

of the U.S. citizens. The “Shape up Somerville” is a program that was focused on Somerville

City and specifically for school going children to help improve their physical and eating habits

thereby addressing the issue of obesity and overweight. Through the seven grant programs within

the SUS, several interventions were identified and implemented to influence the community’s

eating and physical activities.

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References

Center for Public Health Nursing - Minnesota Dept. of Public Health. (2001). Public health

interventions: Applications for public health nursing practice. St. Paul: Minnesota Dept.

of Health, Division of Community Health Services, Public Health Nursing Section.

Chomitz, V., Garnett, B., Arsenault, L., & Hudson, D., (2017). Shape up Somerville: Building

and Sustaining a Healthy Community – Reflections over 15 years (1998 – 2013).

Somerville. Retrieved from https://www.somervillema.gov/sites/default/files/shape-up-

somerville-story.pdf

Coffield, E., Nihiser, A. J., Sherry, B., & Economos, C. D. (2015). Shape up Somerville: change

in parent body mass indexes during a child-targeted, community-based environmental

change intervention. American journal of public health, 105(2), e83-e89.

ODPHP (n.d). Healthy People 2020 Objectives: Nutrition and weight status. Retrieved from

https://www.healthypeople.gov/2020/topics-objectives/topic/nutrition-and-weight-status

U.S. Department of Health and Human Services, (2017). Facts & Statistics. President’s Council

on Sports, Fitness, and Nutrition. Retrieved from https://www.hhs.gov/fitness/resource-

center/facts-and-statistics/index.html