ORIGINAL PAPER Pediatric Obesity Community Programs: Barriers & Facilitators Toward Sustainability Eli K. Po’e • Sabina B. Gesell • T. Lynne Caples • Juan Escarfuller • Shari L. Barkin Published online: 30 March 2010 Ó Springer Science+Business Media, LLC 2010 Abstract Our current generation of young people could become the first generation to live shorter lives than their parents. Families need resources in their community to address this issue. Identifying barriers and facilitators of community organizations to offer obesity-related services is a first step in understanding sustainable community programs. The objective of this study is to identify com- mon barriers and facilitators in community organizational programs designed to prevent or reduce pediatric obesity. We conducted an exploratory qualitative research study based on grounded theory. Thirty-six community organi- zations were identified based on self-descriptions of goals involving pediatric obesity. Semi-structured, systematic, face-to-face interviews among program directors (n = 24) were recorded, transcribed, and coded for recurrent themes. Relevant themes were abstracted from interviews by a standardized iterative process by two independent review- ers between December 2007 and November 2008. Theme discordance was reconciled by a third reviewer. Seventy percent of organizations indicated that obesity prevention/ treatment was their explicit goal with remaining groups indicating healthy lifestyles as a more general goal. Facilitators to provision of these programs included: pro- grammatic enhancements such as improved curriculums (73%), community involvement such as volunteers (62.5%), and partnerships with other programs (54.2%). Barriers that threatened sustainability included lack of consistent funding (43.8%), lack of consistent participation from the target population (41.7%) and lack of support staff (20.8%). New approaches in fostering partnerships between organizations need to be developed. Building coalitions and engaging community members in develop- ing community based programs may be a helpful strategy to strengthen community-based programs to address the pediatric obesity epidemic. Keywords Community health Á Community-based organizations Á Pediatric obesity Á Childhood overweight Introduction Our current generation of young people could become the first generation to live shorter lives than their parents [1, 2]. Recent reports indicate that, nationally, one in four children are overweight or obese [3]. Overall trend data have clearly indicated childhood obesity rates increasing dramatically since the 1970’s [4]. In a recent Robert Wood Johnson Report, no state has reached the Healthy People 2010 goal of reducing obesity to 15% [5]. In fact, almost two-thirds of states have obesity rates above 25% [5]. Although many attempts have been made to address pediatric obesity on the individual level, effective and sustainable interventions on the population level remains to be elusive [6, 7]. A number of recent studies suggest that the next-gener- ation of interventions must involve the community or sys- temic societal changes [8–10]. In a recent article, Huang et al. argue that a systems-oriented multilevel framework must be established given the complexity of the obesity epidemic, suggesting that structural modifications to mul- tilevel interventions must be in place in order to effectively address pediatric obesity [9]. A couple studies demonstrated E. K. Po’e (&) Á S. B. Gesell Á T. Lynne Caples Á J. Escarfuller Á S. L. Barkin Division of General Pediatrics, Pediatric Clinical and Translational Research, Vanderbilt University Medical Center, S0119 MCN, Nashville, TN 37232, USA e-mail: eli.poe@vanderbilt.edu 123 J Community Health (2010) 35:348–354 DOI 10.1007/s10900-010-9262-5