CO-CREATE's new Supplement drives forward tools & methods to prevent childhood obesity
Since its conception, the CO-CREATE research consortium has wanted to challenge reductionist attitudes to obesity interventions by advancing a more ‘systems approach’ while also addressing the observation that, when it comes to addressing obesity in young people, researchers and policy makers do not spend enough time asking young people themselves what they think should be the priorities for action.
Almost five years since its kick-off meeting, CO-CREATE has published a series of papers in the prestigious journal Obesity Reviews, outlining how the consortium has pioneered new methods and tools to ensure the voices of young people can be heard in obesity policy formation. In addition, the Supplement papers outline some of the new tools that have been developed for benchmarking nutrition and physical activity policies across Europe.
The supplement is a must-read, particularly for researchers, civil society and policymakers interested in engaging young people in their work! We discuss some of the key findings below.
Pioneering approaches to engage young people in research
While projects that encourage research subjects to participate in the design of research are not new, CO-CREATE is the first project to actively involve adolescents in obesity policy. The project has engaged young people at a number of research stages, including for building systems maps, setting up Youth Alliances and developing a Dialogue Forum Tool to aid dialogue between young people and decision makers. In the latest supplement, some of the methodological approaches are described.
Youth Alliances and generating policy ideas
Throughout the project, 200 European youth in the age-range of 15-19 have been engaged through novel Youth Alliances, providing a concrete example of how to engage youth in public health, in a manner that seeks to be participatory, transformative, and inquiry-based. The Youth Alliances, established across five countries in Europe, are an example of Participatory Action Research, and provided a forum for young people to discuss the topic of obesity prevention and develop policy solutions relevant to their own lives and communities. The policy ideas that have emerged from the Alliances provide insights into the lives of young people, and where policies and interventions may be best placed and well-received by the target group. Complementary to this are insights on the knowledge and readiness for action among young people, based on a questionnaire developed as part of the CO-CREATE project which is also reported on in the supplement.
A systems approach to understanding obesity
A ‘systems approach’ is becoming increasingly important to addressing the complex issue of obesity, challenging the limitations and failures that the largely reductionist approach to date has had. With this as a central pillar to the CO-CREATE project, a process called Group Model Building has been utilised to build systems maps in collaboration with young people in six countries, providing an opportunity for them to share their own experiences and concerns regarding their environments which in turn can help inform policy development to reflect young people’s views. The maps that have been created have informed other aspects of the project, including the Youth Alliances and systems model which looks at the impact of one or more policy actions (interventions) on obesity.
Ethical and power balance considerations
When engaging young people, there are several ethical considerations that need to be overcome. The CO-CREATE project has been sensitive to these issues, as described in two of the papers, power balances and ethics. Some of the specific considerations that have been addressed throughout the project include voluntary participation, protection from stigma, respect of time, data privacy and confidentiality, power balance and equal opportunities. The paper on power balances explores how youth engagement has been a core element of the project, as it reflects on the process of establishing conflict of interest and power balance frameworks within the Dialogue Forum Tool.
Benchmarking EU nutrition and physical activity policies
When looking to address obesity in children and adolescents across Europe, we cannot forget the policies themselves and the different levels of action that has been taken across the EU to date. To complement the existing NOURISHING framework and database focused on nutrition policies, hosted by World Cancer Research Fund International, the CO-CREATE project has developed the MOVING framework and database focused on physical activity policies. In addition, a novel set of benchmarking tools and a policy index have been developed to help track and score national action on nutrition and physical activity across Europe. Insights provided by these tools can help identify examples of best practice, policy gaps and support advocates, including adolescents, to champion strong nutrition, physical activity and obesity prevention policies at a national level.
What to look out for next
With the methods in place, and a vast amount of data and insights now collected, attention within the CO-CREATE team has turned to assessing results and recommendations that are emerging from the various work areas. As we enter the final phases of the project, you can expect to see more research papers, policy recommendations, toolkits, translated materials and briefings, amongst others.