Choosing Approaches

The following examples illustrate how interventions designed for a single setting, such as schools, can differ based on the targeted individuals and groups.

High-risk Individuals

Individuals at greater risk of becoming obese, such as those who are overweight.

• National Association of School Nurses, SCOPE program
  School nurses receive training in the most recent assessment techniques for high risk students.
  Examples of organizations that have succeeded in reaching high risk individuals include:
  • Community health clinics
  • Regional offices of the USDA Cooperative Extension Service
  • Area Health Education Centers (AHEC)
  • Tribal councils
  • School-based health centers

Sub-groups of the Population that are at High Risk

Certain groups at greater risk of obesity and associated conditions than the rest of the population.

• Cherokee Choices: A Diabetes Prevention Program for American Indians
  A Native American community with high rates of childhood obesity and Type-2 diabetes implemented a school-based program to improve well-being and reduce the risk of diabetes. Paid community mentors worked with students and school staff to: increase awareness, promote physical activity, enhance knowledge of nutrition, teach stress-management skills, and develop teachers as role models.

Entire Population

All individuals within a population.

• California Project LEAN: Leaders Encouraging Activity and Nutrition
  A school district and its board work to enact policies elevating the importance of physical activity and physical education before, during, and after school. Interventions targeting entire populations differ from those targeting high-risk individuals or sub-groups in that they are designed to change policies, systems, and environments (PSE) rather than behavior. A mix of strategies is needed. While many evidence-based models target individual-level change, they have a high cost for every person reached.