Implementing a stakeholder-driven community diffusion-informed intervention to create healthier, more equitable systems: a community case study in Greenville County, South Carolina.

This case study describes the application of a theory-informed, stakeholder-driven intervention with a group of 19 multi-sector stakeholders from an existing coalition to promote whole-of-community change that supports childhood obesity prevention. The intervention applied community-based system dynamics to design and implement activities that promoted insights into the systems driving childhood obesity prevalence and helped participants prioritize actions to influence those systems. This led to three new priority areas for the coalition: addressing food insecurity; building power among historically marginalized voices within the community; and supporting advocacy efforts to promote community-wide change beyond the coalition's previous focus on organizational-level policy, systems and environment change.

Impacts of a medical-legal partnership on clinical capacity to address social determinants of health.

Background: Social determinants of health (SDOHs) impacts on an individual's health outcomes have become more evident, and clinical providers are vital in helping patients address those needs. Providers are experiencing high-stress levels related to patient care, resulting in a diminished capacity to address these SDOHs. This study examines the impact of a medical-legal partnership (MLP) on the clinical capacity to assist providers with addressing SDOH needs and reducing clinician stress.

Development of a Community Coalition to Influence Nutrition and Physical Activity in Early Childhood Education.

Background: Recognizing insufficient support for healthy eating and physical activity in early childhood education centers in Greenville, South Carolina, a group of stakeholders formed a workgroup as an organizing structure. Members developed and implemented a 2-year community-based participatory research initiative aimed at nutrition and physical activity policy, systems and environment change in 10 early childhood education centers.

Objectives: This article 1) describes engagement efforts and partnerships leading to formation of the workgroup and initiative, 2) presents data on Workgroup members' knowledge and engagement, and 3) shares lessons learned.

LiveWell in early childhood: results from a two-year pilot intervention to improve nutrition and physical activity policies, systems and environments among early childhood education programs in South Carolina.

Background: Early childhood education (ECE) settings are critical intervention targets for obesity prevention. This study evaluated a pilot two-year community-based participatory research (CBPR) project designed to assist ECE center directors and caregivers in policy, systems and environmental (PSE) change for improving healthy eating (HE) and physical activity (PA).

Methods: A two-year CBPR study was conducted in 10 licensed ECE centers in Greenville, South Carolina.

Exploring Dietary Behavior Differences among Children by Race/Ethnicity and Socioeconomic Status.

Background: In Spartanburg County, SC, nearly 33.7% of children are overweight or obese. The purpose of this study was to investigate differences in eating behavior of youth by race/ethnicity and socioeconomic status.

Promoting Healthy Environments In Afterschool Settings: The LiveWell Greenville Afterschool Initiative.

Introduction: LiveWell Greenville, a multi-organization community coalition, launched an initiative in 2011 to help afterschool programs promote environments that decrease the risk of obesity among children and adolescents. The objective of this study was to describe changes in nutrition and physical activity environments, policies, and practices among 37 afterschool programs after their participation in the LiveWell Greenville Afterschool Initiative.

Methods: The study used a nonexperimental, pre- and postsurvey design.

Examining the Relationship between Park Neighborhoods, Features, Cleanliness, and Condition with Observed Weekday Park Usage and Physical Activity: A Case Study.

Background: Little research has comprehensively explored how park features, quality indicators, and neighborhood environments are associated with observed park usage and physical activity (PA). This case study examined whether weekday park usage and PA differ by neighborhood type, across numerous categories of park features, and according to park feature condition and cleanliness.

Methods: Direct observation was used to capture the number of users and PA levels within 143 park features in 6 parks (3 urban, 3 suburban) over the course of six weeks.

'We need a safe, walkable way to connect our sisters and brothers': a qualitative study of opportunities and challenges for neighborhood-based physical activity among residents of low-income African-American communities.

Objective: The purpose of this study was to explore perceptions of the benefits of and influencing factors for neighborhood-based physical activity (PA), and elicit suggestions for increasing neighborhood-based PA among primarily Black residents living in lower income neighborhoods.

Design: Eight focus groups were conducted in low-income, predominantly Black neighborhoods (n = 8) in Greenville, SC during Spring 2014. Using a semi-structured focus group guide with open-ended questions, residents were asked to describe benefits of PA, neighborhood factors associated with PA, and ways to increase PA within their neighborhoods.

An Initiative to Facilitate Park Usage, Discovery, and Physical Activity Among Children and Adolescents in Greenville County, South Carolina, 2014.

Introduction: Parks are important settings for increasing population-level physical activity (PA). The objective of this study was to evaluate Park Hop, an incentivized scavenger-hunt-style intervention designed to influence park usage, discovery, park-based PA, and perceptions of parks among children and adolescents in Greenville County, South Carolina.

Methods: We used 2 data collection methods: matched preintervention and postintervention parent-completed surveys and in-park observations during 4 days near the midpoint of the intervention.