October 2009

Grant Results

SUMMARY

In 2002, a group of leaders in public health, healthcare, research, government, and community advocacy and programming launched the Consortium to Lower Obesity in Chicago Children (CLOCC). It is housed within the Center for Obesity Management and Prevention at the Children's Memorial Research Center of Children's Memorial Hospital.

From March 2007 to February 2009, CLOCC disseminated its community-organizing CO-OP (Community Organizing for Obesity Prevention) model, designed to enlist local partners in combating childhood obesity, to neighborhoods, throughout Chicago. CLOCC staff also provided technical assistance to organizations in five other cities on applying their consortium model to prevent obesity.

Key Results

  • Consortium staff and members developed materials on the CO-OP model and used them to disseminate it.
  • Assisted by community networkers from the consortium, Englewood and Lower West Side Chicago began implementing the CO-OP model.
  • Project staff established partnerships in three of the four newly targeted neighborhoods and identified a lead organization to host the networking interns, who then cultivated more local partners.
  • Five Chicago neighborhoods established or expanded Muévete (Move) and other physical activity programs.
  • Project staff worked with partners to promote state and local policies to prevent obesity. For example, the consortium convened and staffed Chicago's Inter-Departmental Task Force on Childhood Obesity, which completed a plan for a coordinated, citywide approach to the problem.
  • In providing technical assistance to organizations in five cities around the country to help them apply the consortium model to combating obesity, project staff engaged with representatives of some 150 organizations in Dallas; Orlando, Fla.; Kansas City, Mo.; Raleigh/Wake County, N.C.; and East Chicago, Ind.
  • The U.S. Surgeon General recognized the consortium as a Childhood Overweight and Obesity Prevention Champion in 2008.

Funding
The Robert Wood Johnson Foundation (RWJF) provided $379,486 to Children's Memorial Hospital for this project.

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THE PROBLEM

A study funded by RWJF (ID# 043026) found that almost half of the children (aged 2 to 12 years) in five of the six Chicago community areas were obese compared with 16.8 percent nationally.

Combined data for the six communities indicates that Puerto Rican, Mexican American and non-Hispanic Black children in these communities are more than four to five times as likely to be obese as non-Hispanic White children (Margellas-Anast H, Shah AM and Whitman S, "Prevalence of Obesity Among Children in Six Chicago Communities: A Health Survey," Public Health Reports, March/April 2008).

To address obesity in the city, in 2002 a group of leaders in public health, healthcare, research, government, and community advocacy and programming started the Consortium to Lower Obesity in Chicago's Children (CLOCC), which is housed at Children's Memorial Hospital. It includes hundreds of organizations and individuals in medicine, government, business, academia and advocacy. The consortium enlists schools, day care centers, churches, government agencies, businesses, parks, cultural institutions and others in promoting access to healthy food, physical activity and primary health care among children and families.

The Community Organizing Model

To support its work, the consortium developed Community Organizing for Obesity Prevention (CO-OP), a model that entails collaborating with organizations in local neighborhoods to develop local interventions to combat obesity.

For example, in the Humboldt Park neighborhood, the consortium worked with the Sinai Urban Health Institute, the Puerto Rican Cultural Center and two other organizations to develop, implement and evaluate local programs. The approach relies on a local anchor organization that organizes a steering committee of organizations to plan activities to improve access to healthy food and physical activity and a full-time community networker, who forges connections among stakeholders and the broader CLOCC network.

In Humboldt Park, intervention strategies included:

  • Organizing a neighborhood farmers market.
  • Organizing volunteers to distribute fresh produce to families in need through the Greater Chicago Food Depository's Produce mobile.
  • Organizing "walking school buses," which enable children to walk to school in supervised groups.
  • Publishing obesity prevention messages in a local newspaper with a monthly readership of more than 10,000.
  • Sponsoring Muévete (Move), culturally relevant aerobics classes for mothers.

The CO-OP model also includes advocating at the local and state level for policies that promote healthy eating and physical activity among children and adults.

Disseminating the Model

By 2007 the consortium had hired community networkers to begin working in five more largely Black and Hispanic neighborhoods with high levels of obesity, including Englewood, Lower West Side, Rogers Park, West Garfield Park and West Town. The consortium wanted to further develop the CO-OP model in those communities, and to explore dissemination opportunities in four additional neighborhoods: Logan Square, North Lawndale, Roseland and South Chicago.

Community groups aiming to combat obesity in other cities had begun asking the consortium for technical assistance, and it wanted to help those organizations apply the consortium model.

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RWJF STRATEGY

RWJF has developed three integrated strategies to reverse the childhood obesity epidemic: evidence, action and advocacy.

Building the Evidence Base

Investments in building the evidence base will help ensure that the most promising efforts are replicated throughout the nation.

The Foundation's major research efforts in this area—Active Living Research, Healthy Eating Research and Bridging the Gap—are contributing to the nation's collective knowledge about the changes to policies and to community and school environments that are most effective in increasing physical activity and improving nutrition for kids. See Grant Results on Active Living Research for more information on that program.

Action

RWJF's action strategy for communities and schools focuses on engaging partners at the local level, building coalitions and promoting the most promising approaches.

  • The Foundation is working with The Food Trust, a Philadelphia-based advocacy organization whose mission is to ensure that everyone has access to affordable, nutritious food. The Food Trust has brought supermarkets back to underserved communities in Pennsylvania, and with RWJF support is working in New Orleans and in other states to replicate those results.
  • RWJF also works closely with the Alliance for a Healthier Generation (a partnership of the American Heart Association and William J. Clinton Foundation) to support its efforts to improve nutrition, physical activity and staff wellness in schools nationwide.
  • Healthy Kids, Healthy Communities, an RWJF national program, is developing policies and environmental strategies that support healthy eating and active living, especially among children who are at highest risk for obesity based on family income, race and/or ethnicity or where they live.

Advocacy

As staff learns from the evidence and action strategies, RWJF shares results by educating leaders and investing in advocacy, building a broad national constituency for childhood obesity prevention. For example:

  • RWJF supported the National Governors Association when Arkansas Gov. Mike Huckabee designated wellness in schools, homes and workplaces as his Chairman's Initiative for 2005–2006.
  • Through Leadership for Healthy Communities, RWJF works closely with national organizations that represent elected and appointed officials—such as the National Conference of State Legislatures, and the U.S. Conference of Mayors—to educate their members about successful approaches to increasing physical activity and healthy eating among kids. The goal is to support leaders and decision-makers in their efforts to create healthier states, counties and cities.
  • Communities Creating Healthy Environments, an RWJF national program, advocates for policies and environmental strategies that support healthy eating and active living, especially among children who are at highest risk for obesity based on family income, race and/or ethnicity or where they live.

This project fits within both the action and advocacy strategies.

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THE PROJECT

From March 2007 to February 2009, the Consortium to Lower Obesity in Chicago Children (CLOCC), housed within the Center for Obesity Management and Prevention at the Children's Memorial Research Center of Children's Memorial Hospital, disseminated its community-organizing CO-OP (Community Organizing for Obesity Prevention) model to neighborhoods, throughout Chicago. The model is designed to enlist local partners in combating childhood obesity. CLOCC staff also provided technical assistance to organizations in five other cities on applying their consortium model to prevent obesity.

The project entailed five key activities:

  • Providing technical assistance to enable neighborhoods to organize and implement programs to reduce childhood obesity, and to advocate for policy changes at the state and local level, such as in schools.
  • Expanding Muévete (Move) (culturally relevant aerobics classes for mothers), in Humboldt Park and establishing it in more neighborhoods.
  • Creating a community networker internship program. This entailed hiring local residents to work as part-time interns for 18 months in the four neighborhoods with which the consortium was forming new relationships.
  • Providing technical assistance to enable other cities to implement the consortium model.
  • Advocating at the city and state level for policy changes and interventions to prevent and address obesity. To expand these efforts, the consortium hired an advocacy program manager in 2007.

Related RWJF Grants

In December 2008, RWJF awarded two related grants targeting childhood obesity in Chicago:

  • A two-year $217,000 grant to Children's Memorial Hospital to support the Chicago Faith-Based Advocacy Initiative to Transform Health (FAITH). That grant enables two faith-based coalitions to promote policy and environmental changes in their neighborhoods to prevent childhood obesity (ID# 065331).
  • A four-year $400,000 grant under RWJF's national program Healthy Kids, Healthy Communities to Logan Square Neighborhood Association, which works to create healthy environments in and around public parks (ID# 065613). Logan Square is one of nine lead sites in the national program.

Challenges

Lack of funding prevented some targeted neighborhoods from implementing strategies for combating obesity. Project staff found that even when community organizations already had funding for such activities, they sometimes could not shift the funds to new projects.

Consortium staff also found it difficult to recruit and retain part-time, temporary community networkers, as they continued to search for full-time jobs.

Communications

After providing technical assistance to organizations in Kansas City, Project Director Adam B. Becker, Ph.D., M.P.H., collaborated with a leader of that initiative on an article in a special issue of Progress in Pediatric Cardiology on childhood obesity (see the Bibliography for details).

Project staff also gave a presentation on the CO-OP model at the 2007 annual meeting of the American Public Health Association.

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RESULTS

The consortium reported the following results in an April 2009 report to RWJF:

  • Consortium staff and members developed materials on the CO-OP model and used them to disseminate it. For example:
    • Staff and steering committee members in Humboldt Park developed a PowerPoint® presentation on the model, and used it to introduce the CO-OP approach to community organizations and residents of Lower West Side and Englewood.
    • Project staff created a brochure on the CO-OP model and disseminated it citywide, through community meetings, CLOCC quarterly meetings (attended by 125–200 people), and presentations to potential funders.
    • Project staff developed a video and manual illustrating Muévete (Move) (culturally relevant aerobics classes for mothers) and showing neighborhoods how to develop them. (See the Bibliography for details.)
  • Assisted by community networkers from the consortium, Englewood and Lower West Side began implementing the CO-OP model:
    • The neighborhoods organized steering committees, which began meeting monthly in August 2008, and created subcommittees to develop strategies to improve access to healthy food and safe opportunities for physical activity among children and families.
    • A community planning process in Englewood produced an action plan for promoting healthy eating and physical activity among local residents that helped to inform the emerging CO-OP strategy.
  • Project staff established partnerships in three of the four newly targeted neighborhoods and identified a lead organization to host the networking interns, who then cultivated more local partners.
    • For example, the intern in Logan Square helped establish a community advisory board for a local park and initiated partnerships with neighborhood schools to promote healthy eating and physical activity.
    • The consortium was unable to find a lead organization in Roseland to host an intern, so it used the funds to expand the work of the other three neighborhoods.
  • Five Chicago neighborhoods established or expanded Muévete (Move) and other physical activity programs. For example:
    • Community organizations in West Town, West Humboldt and Logan Square began Muévete programs, while twice-weekly classes in Humboldt Park grew from 30 to 40 participants.
    • Englewood's steering committee organized multi-generational walking clubs for middle-aged women and men three times a week.
  • Project staff provided technical assistance to organizations in five cities around the country to help them apply the consortium model in combating obesity. Project Director Adam B. Becker, Ph.D., M.P.H., who is also executive director of the consortium, and Katherine Kaufer Christoffel, M.D., M.P.H., who founded the consortium and is its medical and research director, conducted the site visits.

    They engaged with representatives of some 150 organizations in Dallas; Orlando, Fla.; Kansas City, Mo.; Raleigh/Wake County, N.C.; and East Chicago, Ind. The visits enabled coalitions tackling obesity in Dallas and Wake County to attract new partners and funders, according to Becker.
  • Project staff worked with partners to promote state and local policies to prevent childhood obesity:
    • The consortium convened and staffed Chicago's Inter-Departmental Task Force on Childhood Obesity, which includes participants from nine city agencies, such as health, children and youth, schools and parks. The task force completed a plan for a coordinated, citywide approach to tackling childhood obesity and presented the plan to the City Council. The plan was accepted and the task force has begun implementing it with the establishment of youth-focused fitness programs at local parks and a policy initiative geared towards improving nutrition and physical activity in childcare settings.
    • The advocacy program manager held training workshops on advocacy for the project's community networkers, and helped them complete advocacy assessments of their neighborhoods. The assessments led to advocacy plans that the neighborhoods sought to implement under their Healthy Kids, Healthy Communities projects, the Faith-Based Advocacy Initiative to Transform Health and other projects.
    • The advocacy program manager served as the consortium's liaison to the state Safe Routes to Schools network and participated in other obesity-related city and state policy meetings.
    • To support its advocacy work, project staff created a policy review protocol to enable staff and partner organizations to determine which state and local proposals to support.
  • The U.S. Surgeon General recognized the consortium as a Childhood Overweight and Obesity Prevention Champion in 2008.

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LESSONS LEARNED

  1. To make on-site technical assistance more effective, allow local organizations to describe and ask questions about their specific challenges. Such information can give consultants insight into how best to respond to a site's needs, and their responses can give locals cover in tackling politically sensitive problems. Including unstructured time for discussion is especially valuable in revealing local needs and challenges. (2009 report to RWJF)
  2. Provide seed funding to enable neighborhood organizations to launch specific initiatives to fight obesity, which can provide a base for further fundraising. Project staff found it easier to convince local groups to embrace the Community Organizing for Obesity Prevention (CO-OP) approach than to encourage them to launch concrete programs. Providing financial as well as technical assistance boosts the chances that neighborhoods can fully implement the CO-OP model in combating obesity. (2009 report to RWJF)
  3. Funding that encourages community organizations to forge connections with local and state officials can bring new voices to the policy-making table. While grantee groups cannot and did not use funds from RWJF and other foundations to lobby officials on specific legislation, the consortium did strengthen its relationships with government agencies and officials, helping it gain an "insider's view of policy and systems change." (2009 report to RWJF)

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AFTER THE GRANT

The consortium is continuing its efforts to prevent and combat childhood obesity in Chicago, and to provide technical assistance to other cities and organizations. For example, as of July 2009 the consortium was funding a full-time community networker in Logan Square while the neighborhood considered how to assume financial responsibility for the position.

Consortium staff partnered with Communities in Schools in Chicago to provide technical assistance on using public education to prevent obesity in Dallas, Milwaukee and Moore County, N.C. The executive director and the Chicago Commissioner of Public Health also gave a presentation on the City of Chicago Inter-Departmental Task Force on Childhood Obesity at the RWJF-funded Leadership for Healthy Communities Childhood Obesity Prevention Summit in May 2009.

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GRANT DETAILS & CONTACT INFORMATION

Project

Developing and disseminating community approaches to healthy lifestyle promotion for children and families

Grantee

Children's Memorial Hospital (Chicago,  IL)

  • Amount: $ 379,486
    Dates: March 2007 to August 2008
    ID#:  059631

Contact

Adam B. Becker, Ph.D., M.P.H.
(312) 573-7770
abbecker@childrensmemorial.org

Web Site

http://www.clocc.net

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Articles

Becker AB, Longjohn M and Christoffel KK. "Taking on Obesity in a Big City: Consortium to Lower Obesity in Chicago Children (CLOCC)." Progress in Pediatric Cardiology, 25(2): 199–206, 2008. Abstract available online.

Reports

Community Organizing for Obesity Prevention (CO-OP): A Model for Community Action to Prevent Childhood Obesity (brochure). Chicago: Consortium to Lower Obesity in Chicago's Children, 2008.

Movement for a Healthier Life—Muévete: A Manual for Establishing a Physical Activity Program in Your Community. Chicago: The Puerto Rican Cultural Center, 2008.

Audio-Visuals and Computer Software

Muévete. Chicago: Consortium to Lower Obesity in Chicago's Children.

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Report prepared by: Janet Heroux
Reviewed by: Sandra Hackman
Reviewed by: Molly McKaughan
Program Officer: John Govea