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      “An Ounce of Prevention is Worth a Pound of Cure”: Proposal for a Social Prescribing Strategy for Obesity Prevention and Improvement in Health and Well-being

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          Abstract

          Background

          Social and behavioral determinants of health are increasingly recognized as central to effective person-centered intervention in clinical practice, disease management, and public health. Accordingly, social prescribing (SP) has received increased attention in recent times. The rampant global prevalence of obesity indicates that the customary, reductionistic, and disease-oriented biomedical approach to health service delivery is inadequate/ineffective at arresting the spread and mitigating the damaging consequences of the condition. There is an urgent need to shift the focus from reactive downstream disease-based treatments to more proactive, upstream, preventive action. In essence, this requires more effort to affect the paradigm shift from the traditional “biomedical approach of care” to a “biopsychosocial model” required to arrest the increasing prevalence of obesity. To this end, an SP approach, anchored in systems thinking, could be an effective means of moderating prevalence and consequences of obesity at a community level.

          Objective

          The proposed SP intervention has the following three key objectives: (1) build a sustainable program for Circular Head based on SP, peer education, and health screening to minimize the incidence of obesity and related lifestyle diseases; (2) increase service and workforce connectivity and collaboration and initiate the introduction of new services and activities for obesity prevention and community health promotion; and (3) enhance health and well-being and minimize preventable adverse health outcomes of obesity and related lifestyle diseases through enhancement of food literacy and better nutrition, enhancement of physical literacy and habitual personal activity levels, and improvement of mental health, community connectedness, and reduction of social isolation.

          Methods

          This paper describes a prospective SP strategy aimed at obesity prevention in Circular Head, a local government area in Northwest (NW) Tasmania. SP is a prominent strategy used in the Critical Age Periods Impacting the Trajectory of Obesogenic Lifestyles Project, which is an initiative based in NW Tasmania focused on assessing obesity prevention capacity. A social prescription model that facilitates the linkage of primary health screening with essential health care, education, and community resources through a dedicated “navigator” will be implemented. Four interlinked work packages will be implemented as part of the initial plan with each either building on existing resources or developing new initiatives.

          Results

          A multimethod approach to triangulate insights from quantitative and qualitative research that enables the assessment of impact on individuals, community groups, and the health care system will be implemented within the initial pilot phase of the project.

          Conclusions

          Literature is replete with rhetoric advocating complex system approaches to curtail obesity. However, real-life examples of whole-of-systems interventions operationalized in ways that generate relevant evidence or effective policies are rare. The diverse approach for primary prevention of obesity-related lifestyle diseases and strategies for improvement of health and well-being described in this instance will contribute toward closing this evidence gap.

          International Registered Report Identifier (IRRID)

          PRR1-10.2196/41280

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          Most cited references65

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          Health Effects of Overweight and Obesity in 195 Countries over 25 Years.

          Background While the rising pandemic of obesity has received significant attention in many countries, the effect of this attention on trends and the disease burden of obesity remains uncertain. Methods We analyzed data from 67.8 million individuals to assess the trends in obesity and overweight prevalence among children and adults between 1980 and 2015. Using the Global Burden of Disease study data and methods, we also quantified the burden of disease related to high body mass index (BMI), by age, sex, cause, and BMI level in 195 countries between 1990 and 2015. Results In 2015, obesity affected 107.7 million (98.7-118.4) children and 603.7 million (588.2- 619.8) adults worldwide. Obesity prevalence has doubled since 1980 in more than 70 countries and continuously increased in most other countries. Although the prevalence of obesity among children has been lower than adults, the rate of increase in childhood obesity in many countries was greater than the rate of increase in adult obesity. High BMI accounted for 4.0 million (2.7- 5.3) deaths globally, nearly 40% of which occurred among non-obese. More than two-thirds of deaths related to high BMI were due to cardiovascular disease. The disease burden of high BMI has increased since 1990; however, the rate of this increase has been attenuated due to decreases in underlying cardiovascular disease death rates. Conclusions The rapid increase in prevalence and disease burden of elevated BMI highlights the need for continued focus on surveillance of BMI and identification, implementation, and evaluation of evidence-based interventions to address this problem.
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            The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report

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              The need for a complex systems model of evidence for public health

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                Author and article information

                Contributors
                Journal
                JMIR Res Protoc
                JMIR Res Protoc
                ResProt
                JMIR Research Protocols
                JMIR Publications (Toronto, Canada )
                1929-0748
                2023
                17 February 2023
                : 12
                : e41280
                Affiliations
                [1 ] School of Health Sciences College of Health and Medicine University of Tasmania Launceston Australia
                [2 ] College of Arts, Law and Education University of Tasmania Launceston Australia
                [3 ] School of Health Sciences Swinburne University of Technology Melbourne Australia
                Author notes
                Corresponding Author: Sisitha Jayasinghe Sisitha.Jayasinghe@ 123456utas.edu.au
                Author information
                https://orcid.org/0000-0001-8805-385X
                https://orcid.org/0000-0002-2021-9291
                https://orcid.org/0000-0001-6080-7111
                https://orcid.org/0000-0003-0663-4154
                https://orcid.org/0000-0002-0323-4692
                https://orcid.org/0000-0003-4470-5814
                https://orcid.org/0000-0002-2261-7840
                https://orcid.org/0000-0002-5811-7960
                https://orcid.org/0000-0001-5310-6640
                https://orcid.org/0000-0002-7787-7201
                Article
                v12i1e41280
                10.2196/41280
                9985003
                36800232
                45bf93da-e78b-456f-a2ba-6da23fb6946e
                ©Sisitha Jayasinghe, Timothy P Holloway, Robert Soward, Kira A E Patterson, Kiran D K Ahuja, Lisa Dalton, Sandra Murray, Roger Hughes, Nuala M Byrne, Andrew P Hills. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 17.02.2023.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on https://www.researchprotocols.org, as well as this copyright and license information must be included.

                History
                : 20 July 2022
                : 28 November 2022
                : 1 December 2022
                : 5 December 2022
                Categories
                Proposal
                Proposal

                capacity building,community development,determinants of health,health care delivery,health care management,obese,obesity,patient education,peer education,prevention,screening,service delivery,social prescribing,social prescription,weight

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