AJPM’s Childhood Obesity Challenge: A Grand Success

May 15 marked the end of the 3rd and final round of AJPM’s Childhood Obesity Challenge. In the scientific publishing world,creative ideas with the potential to transform health and health care but not yet backed by volumes of data, are often dismissed. Consequently, at the AJPM’s 2010 Strategic Planning Meeting it was agreed that the Journal would strive to be a conduit of innovation for clinical practitioners and policymakers. The following year the Childhood Obesity Challenge was launched, sponsored by the Robert Wood Johnson Foundation’s Pioneer Portfolio.

The Challenge was an online competition encouraging proposed solutions to childhood obesity, not only from academia, but also from sectors such as industry, small businesses, social entrepreneurs, and media providers. In addition to receiving cash prizes for at least three judge-selected entries in each round, the first-place submissions were featured in the print and online editions of the AJPM.

"The concept of speeding promising information to both practitioners and policymakers underpinned the competition; having that information come from arenas outside the typical academic or government settings was the icing on the cake,” said Jill Waalen, Deputy Editor of AJPM and the Co-Principal Investigator on the project. And the response was very gratifying. The Challenge website had a total of 239,355 page views and 67,671 site visits during the course of the three challenges.

The three rounds of competition received 141 entries. "With Round 1 of the Challenge, we had a broad focus and attempted to capture any type of solution with the potential for the largest reach, " said Kevin Patrick, AJPM’s Editor-in-Chief. Round 2 sought submissions aiming at innovative policies, as well as strategies for getting those policies adopted and applied to schools, institutions, municipalities, or other organizations. Round 3 concentrated on interventions for children and their families delivered in clinical settings, or involving partnerships between clinics and communities.

A glance at the winning selections reveals the broad range and high caliber of innovative thinking.

Decision support tools included a caloric calculator that presented energy balance at the population level on a daily basis. The tool, by synthesizing the best existing evidence on approaches that hold the promise, will make it easier for decision-makers in a broad range of roles—policymakers, teachers, administrators, community leaders, parents—to compare the relative impacts of making changes to local, state, or federal policies. Another winning submission included decision support tools in the electronic health record, such as alerts delivered to pediatric clinicians at annual patient visits.

Entries focusing on environmental factors included design guidelines for school architecture to provide optimal healthy eating spaces, and another offered a plan to transform popular neighborhood streets and avenues to boost children’s activity levels and consumption of healthy food.

A food education proposal deployed a nationwide team of AmeriCorps service members in public schools to directly focus on healthy eating, and two submissions addressed afterschool settings. One initiative produced three guiding principles that address nutrition and physical activity in out-of-school (OST) environments, and encouraged the country’s leading OST organizations to integrate the principles into their policies. A second winning idea leveraged professional development training and technical assistance to achieve afterschool physical activity and nutrition programs and policy changes.

Exceptional proposals for local government action included a model ordinance to help communities set a healthy baseline for retail outlets that sell foods and beverages. Another described formal collaboration between a healthcare provider and a municipal community center to offer patients the opportunity to learn cooking skills and get exercise, neither of which was possible in the clinic setting. A first-ever joint use agreement between the clinic and the city parks and recreation department complemented healthy lifestyle interventions provided by an interdisciplinary team during monthly patient and family visits.

A healthcare team was also central to a project to provide group medical visits for obese and overweight Latino children. During interactive sessions at health centers, a team consisting of a doctor, a nutritionist, and a promotora (community health worker) discuss nutrition, physical activity and stress with the children and their families, and help them develop weight loss action plans.

To see details of these, and all other entries, visit the Challenge archives at: ajpmchallenge.calit2.net.