Introduction

Obesity is one of the most topical health problems, which endangers the population of the US. This issue deteriorates the quality of life and reduces the possibility of having a long and healthy life without restrictions of activity or a diet. Unfortunately, one of the age groups, which suffer from obesity specifically, are children and adolescents. Their weakness is caused by the lack of resistance to advertisements of various sweets, lack of physical activity, and unhealthy lifestyle overall. This paper introduces a program for mitigating the problem of obesity in children living in Miami, Florida. Its framework meets the guidelines proposed by Healthy People 2020 initiative and applies the MAP-IT approach of pursuing efficient change of lifestyle of children. Therefore, the application of the proposed interventions would allow combating the causes of obesity in children, reducing the development of negative factors associated with the problem and enhancing the knowledge of the issue.

The Analysis of the Issue

It is critical to clearly define the problem before attempting to introduce particular methods of mitigation. Thus, obesity and excessive weight have become the most discussed issues because of their high incidence in population. Scholars argue that childhood excessive weight and obesity has increased worldwide (Lobstein et al., 2015), which means that the problem is relevant not only for the developed but developing countries. Moreover, the problem is especially evident in the US where the average weight of a child has risen by more than 5 kg within three decades, to a point where a third of the country's children are overweight or obese (Lobstein et al., 2015). Similarly, researchers claim that in 2011-2012, 8.1% of infants had high weight, along with the similar diagnosis for 16.9% of individuals aged from 2 to 19 years (Ogden et al., 2014). The overall obesity incidence in children in the US has an increasing trend leading to the fact that almost whole population may suffer from obesity in the long-term perspective. The analysis of the issue for a period of over 12 years demonstrated that there is a significant increase in obesity prevalence in males aged from 2 to 19 years of age (Ogden et al., 2012). The tendency of the increase of obesity incidence in children is partially associated with the increase of body weight of a child earlier in life. Thus, Cunningham, Kramer, and Venkat Narayan (2014) claim that incident obesity in children aged from 5 through 14 was more likely to have occurred in younger ages, especially in those who had entered preschool overweight. Therefore, it is important to introduce changes addressing the causes of childhood obesity and excessive weight allowing mitigating them and improving the well-being of the nation.

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The analysis of factors provoking the increase of childhood obesity incidence demonstrates that despite having different sources their total contribution results in a stable negative tendency. For instance, the research Costa-Font and Gil (2013) conducted in Spain allows stating that, Income and parental influences are the central determinants of obesity among children. This reason may also be relevant for Americans because of the poor quality of cheap foods, which may have increased the amount of calories. Moreover, experts argue that, The shared environment created by parents affects childrens choices and eventually their body weight outcomes (Papoutsi, Drichoutis, & Nayga, 2012). Among other causes, they mention the increased consumption of calories, the lack of physical activity, and food advertising that targets children modifying their food choices (Papoutsi, Drichoutis, & Nayga, 2012). Consequently, the proposed community transformation project has to consider these factors increasing the validity and relevance of the suggested intervention.

Healthy People 2020 MAP-IT Approach as the Framework of the Proposed Community Transformation Project

The proposed community transformation project goes along with the requirement of Healthy People 2020 program in order to increase the access to the resource pools directed towards the expected social change. The program itself is a result of a comprehensive work of different institutions ranging from political to medical ones pursuing a single aim of making the nation healthier. It claims that they offer specific, important areas of emphasis where action must be taken if the United States is to achieve better health by the year 2020 (Framework, n. d.). One of the instruments proposed by this program for improving community health is MAP-IT (Mobilize, Assess, Plan, Implement, Track) (Section 14. MAP-IT: A model for implementing Healthy People 2020, 2015). This method offers a systematic plan, which allows mobilizing human and organizational resources, assessing the most relevant community needs, planning the approach of the change, implementing it, and tracking its progress. The benefits of this approach are the involvement of all stakeholders, the analysis of assets and needs, the increased relevance of the analysis, production of a specific valid community plan and evaluation of its efficacy (Section 14. MAP-IT: A model for implementing Healthy People 2020, 2015). Gradual application of the described stages allows focusing on the needs of the community of Miami, Florida regarding the issue of obesity in children.

Mobilize

The first stage of the selected methodology is mobilizing the key resources responsible for the required change in the community. These resources include various organizations and individuals, who should be unitized in a coalition working on the rest of the stages. The creation of such a coalition is a substantial step in combating childhood obesity rates in Miami, FL, because it allows addressing a unified scope of resources to especially relevant domains increasing the efficacy of interventions. The program suggests that the mayor of Miami as well as the governor, congressmen, and representatives of the state are among the influential individuals. Moreover, they may include various specialists on children in the spheres of psychology, pedagogy, social connections, nutrition, sports programs, and other. The organizations are important because of their contribution to the implementation of the program one may name Division of Community Health, the Alliance for a Healthier Generation, Obesity Action Coalition. Similarly, they include all local hospitals, educational facilities, facilities responsible for sports, and local Internet resources.

Furthermore, it is critical to distribute the responsibilities among the selected stakeholders and create a vision of the coalition. The suggested vision is preventing obesity incidence in children of Miami and their protection from negative factors, which provoke them towards unhealthy lifestyles, leading to excessive weight. Along with it, the responsibilities of the stakeholders should be developed according to their domain of work. For instance, the congressmen and representatives are responsible for introducing acts, which would reduce the incidence of children-targeted advertising. Similarly, educational and sports facilities are responsible for educating children on the basics of healthy lifestyle Medical institutions should monitor childrens health, reveal obesity tendencies, and other. Lastly, it is important to optimize the work of the participants by means of establishing a leader or leaders, deciding upon meetings and their agenda, rewarding success, etc. Consequently, the proposed initiatives allow creating an efficient coalition named Miami Coalition Fighting against Children Obesity (MCFCO), which would directly address the problem of childhood obesity in Miami, Florida. It is expected to reduce the obesity rates by 50% within a period of two years, by 2018.

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The next stage of the program is the assessment of community needs and resources, which is important in efficiently utilizing the selected resources for the management of relevant issues. The community of Florida has a great problem, which is one in four children in the state is overweight or obese (Florida, n. d.). Similarly, this issue is relevant for Miami, which is why the community of Miami requires mitigation of the problem of children obesity. Realistically, this means that the children of Miami require creation of the informational space, which would allow increasing their knowledge about the causes of obesity. Additionally, it is expected that the program would thoroughly monitor their health and modify the aspects of their lifestyle including eating habits, exercising, and mind patterns associated with the advertisements. Therefore, the creation of the identified framework requires specific policies, which would allow to regulate the social factors of the community, improve health services, and modify individual behaviors of children. Similarly, MCFCO has to collect the statistical information regarding the factors associated with childhood obesity in Miami.

Moreover, the implementation of the proposed initiatives requires the support of informational resources, legislators, infrastructure, experts as well as institutions and organizations of the community. Therefore, MCFCO identifies such objectives as regulation of the space of children-targeted advertisements in media and the Internet; modification of childrens lifestyle habits (diet and exercising); and the increase of the childrens awareness of the causes and threats of obesity and excessive weight. The risk factors of the focus of the program are children-targeted advertisements, childrens unhealthy diet, lack of daily exercising, and lack of knowledge about human nutrition and physiology.

Plan

It is evident that every community change program requires a plan of action in order to assure its efficacy. The suggested plan has such stages as action steps, assignment of responsibility, information collection, and a feasible timeline (Section 14. MAP-IT: A model for implementing Healthy People 2020, 2015). Action steps include the statistical assessment of actual children obesity ratio in Florida during the period of latest five years. The obtained data would allow tracing the dynamics of the incidence of obesity in children. Furthermore, the stakeholders should reveal the factors associated with the incidence of obesity in children in Florida and the degree of their influence. After that, MCFCO will select the stakeholders responsible for each factor within a particular domain. Furthermore, the stakeholders should stark working in order to achieve the defined goals regarding their domain of activity. It is expected that the first phases of the plan have to take a month in order to assure the latest long phase of implementation of the changes. Along with it, the last month of 2018 should be devoted to statistical calculations allowing revealing the most effectively working stakeholders and their methods, as well as assessing the overall efficacy of the program.

Implement

The phase of implementation of the proposed interventions is important for the program, because it impacts the community and has a direct effect towards the achievement of the defined goals. Thus, MCFCO has to establish the Office of MCFCO responsible for tracking the progress of the proposed interventions. Its staff is responsible for coalition building, goal setting, statistic calculations, and control. Along with it, it cooperates with the city and state legal executives supporting the proposed initiatives in the Congress. Moreover, it has to create a communication plan, which would allow initiating various interventions by means of communication with the responsible stakeholders. Similarly, its task is to create partnerships with the stakeholders from other states and cities in order to share the experience of the most effective interventions. Consequently, the identified aspect of the implementation of the program allows it to be relative to the needs of the local community of Miami, FL.

Track

The last step of the created program is tracking the activities, interventions, and their results, which is important for assuring of their validity. It is important to create regular evaluations, because adequate tracking of the progress of interventions allows fixing them in case of mistakes. In order to increase the adequacy of interventions it is important to standardize the procedures of data collection, analysis, and interpretation. Similarly, it is necessary to introduce limitations on self-reported information and assure the existence of data accessibility. The program expects the calculations to be performed with the assistance of statistical software. However, the assessment of the overall efficacy of the program will be performed in 2018, whereas the achievements of reach goals are assessed on a monthly basis. The member of the coalition should assess the efficacy of the program and the achievement of each goal as predictably achieved, not likely to be achieved, achieved, not achieved, and uncertain. Therefore, the proposed interventions would allow MCFCO reducing the incidence of children obesity in Miami by 50% by 2018.

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Expected Outcomes of the Project and Possible Problems

The analysis of the proposed initiative and the relevant evidence allows stating that the implementation of the community project would be associated with positive outcomes. Veciana-Suarez (2014) reports that hospital programs for children, which included dietary and exercising interventions, allowed reaching significant body weight reduction within a period of 12 weeks. Similarly, the community may use the assistance of social networking initiatives combating obesity with the aim of boosting the effect of weight reduction initiatives (Shin et al., 2014). Such an effect is possible to achieve by increasing the knowledge of obesity related factors in the local population. Moreover, the focus on technology, academic and industrial resources allows creating a stronger effect in the community (Tate et al., 2013). Such cooperation allows bypassing possible negative factors like parent unawareness of the problem lack of knowledge and produce a direct impact on children. Lastly, it is advised to improve family ecology and relationships in order to boost the regulatory processes of children obesity (Fiese & Bost, 2016). Therefore, the program is efficient in a long-term perspective, but considering the aforementioned issues would allow bypassing possible problems and increasing the timely efficacy of the interventions.

In conclusion, the paper suggests that the community transformation project allows establishing Miami Coalition Fighting against Children Obesity, which would effectively mitigate the problems of childhood obesity in Miami, Florida by 2018. The analysis of the issue demonstrated that obesity and excessive weight in Florida and Miami in particular are increasing, which creates a problem for the local population. The evaluation of the causes of this demonstrated a number of critical factors, which require mitigation. Among them is children-targeted advertising, lack of physical activity, bad nutrition habits, and the lack of knowledge of ones physiology. The usage of the MAP-IT framework proposed by Healthy People 2020 allows creating MCFCO, which includes various influential stakeholders capable of reaching the defined goals of the proposed program. The procedures of mobilization of resources, assessment of the problems, planning, as well as the procedures of implementation and tracking allows predicting reduction of childhood obesity in Miami by 50% by 2018. Other states and cities may use the example of this program to establish coalitions effectively managing similar or different community problems.

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