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      Participatory evaluation of municipal obesity prevention clubs in Tehran city: Strengths, challenges, and future direction

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          Abstract

          Background and aim

          Community-based initiatives are important for obesity prevention. This study aimed to evaluate the activities of municipal obesity prevention clubs (OBCs) in Tehran, Iran, using a participatory approach.

          Methods

          The evaluation team was formed, and the members identified the OBC's strengths, and challenges and provided suggestions for change through a participatory workshop, observation, focus group discussions, reviewing relevant documents ( n = 97), and 35 interviews with involved stakeholders. The MAXQDA software was used for data analysis.

          Results

          An empowerment training program for volunteers was identified as one of the strengths of OBCs. Despite the obesity prevention efforts of OBCs through public exercise sessions, healthy food festivals, and educational sessions, several challenges were identified that hinder participation in OBCs. These challenges included poor marketing strategies, poor training approaches in participatory planning, insufficient motivational support for volunteers, low perceived recognition of volunteers by the community, volunteers' low food and nutrition literacy, poor educational services in the communities, and limited funding for health promotion activities.

          Conclusion

          Weaknesses in all stages of community participation, including information, consultation, collaboration, and empowerment, in OBCs were detected. Facilitating a more enabling environment for informing and involving citizens, expanding neighborhood social capital, and involving health volunteers, academia, and all potential governmental sectors to collaborate for obesity prevention is recommended.

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          Most cited references38

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          Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

          Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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            The value and challenges of participatory research: strengthening its practice.

            The increasing use of participatory research (PR) approaches to address pressing public health issues reflects PR's potential for bridging gaps between research and practice, addressing social and environmental justice and enabling people to gain control over determinants of their health. Our critical review of the PR literature culminates in the development of an integrative practice framework that features five essential domains and provides a structured process for developing and maintaining PR partnerships, designing and implementing PR efforts, and evaluating the intermediate and long-term outcomes of descriptive, etiological, and intervention PR studies. We review the empirical and nonempirical literature in the context of this practice framework to distill the key challenges and added value of PR. Advances to the practice of PR over the next decade will require establishing the effectiveness of PR in achieving health outcomes and linking PR practices, processes, and core elements to health outcomes.
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              Lessons from community participation in health programmes: a review of the post Alma-Ata experience.

              The year 2008 marked the 30 year anniversary of Primary Health Care, the health policy of all member nations of the WHO. Community participation was one of the key principles of this policy. This article reviews the experiences of and lessons learned by policy makers, planners and programme managers in attempting to integrate community participation into their health programmes. The lessons, identified in an earlier article by the author, are still relevant today. They help to identify three reasons why integrating community participation into health programmes is so difficult. These reasons are: (1) the dominance of the bio-medical paradigm as the main planning tool for programmes, leading to the view of community participation as an intervention; (2) the lack of in-depth analysis of the perceptions of community members regarding the use of community health workers; and (3) the propensity to use a framework that limits investigation into what works, why and how in community participation in health programmes. Despite these challenges, evidence suggests that community participation has contributed to health improvements at the local level, particularly in poor communities, and will continue to be relevant to programme professionals.
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                Author and article information

                Contributors
                Journal
                Front Public Health
                Front Public Health
                Front. Public Health
                Frontiers in Public Health
                Frontiers Media S.A.
                2296-2565
                16 February 2023
                2023
                : 11
                : 1055210
                Affiliations
                [1] 1Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences , Tehran, Iran
                [2] 2Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran
                [3] 3Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran
                [4] 4Health Equity Research Centre, Tehran University of Medical Sciences , Tehran, Iran
                [5] 5Department of Social and Cultural Affairs of Tehran Municipality, Health Department, The Tehran Municipality's Organization, 15th District , Tehran, Iran
                [6] 6Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences , Tehran, Iran
                [7] 7Community-Based Participatory Research Center, Tehran University of Medical Sciences , Tehran, Iran
                [8] 8Knowledge Utilization Research Center, Tehran University of Medical Sciences , Tehran, Iran
                [9] 9School of Public Health, Tehran University of Medical Sciences , Tehran, Iran
                Author notes

                Edited by: Paolo Zucca, Central Directorate for Health, Social Policies and Disabilities, Italy

                Reviewed by: Alessandra Galmonte, University of Trieste, Italy; Valentina Cardi, University of Padua, Italy

                *Correspondence: Nasrin Omidvar ✉ omidvar.nasrin@ 123456gmail.com

                This article was submitted to Public Health Education and Promotion, a section of the journal Frontiers in Public Health

                Article
                10.3389/fpubh.2023.1055210
                9978347
                36875369
                2d90262a-15b6-4211-89da-0dfa2ccf6956
                Copyright © 2023 Edalati, Omidvar, Takian, Rasam, Ghodsi and Majdzadeh.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 28 September 2022
                : 23 January 2023
                Page count
                Figures: 4, Tables: 4, Equations: 0, References: 48, Pages: 15, Words: 10727
                Funding
                This article is part of a Ph.D., thesis in food and nutrition policy by SE, who was funded and supported by the Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran.
                Categories
                Public Health
                Original Research

                obesity,obesity prevention,community-based program,evaluation,participatory evaluation,program evaluation,community-based organization (cbo)

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