Process evaluation of a community-based intervention program: Healthy Youth Healthy Communities, an adolescent obesity prevention project in Fiji

Abstract: Nearly one-half of the adult population in Fiji between the ages of 15–64 years is either
overweight or obese; and rates amongst school children have, on average, doubled during the last
decade. There is an urgent need to scale up the promotion of healthy behaviors and environments
using a multi-sectoral approach. The Healthy Youth Healthy Community (HYHC) project in Fiji used
a settings approach in secondary schools and faith-based organizations to increase the capacity of the
whole community, including churches, mosques and temples, to promote healthy eating and regular
physical activity, and to prevent unhealthy weight gain in adolescents aged 13–18 years. The team
consisted of a study manager, project coordinator and four research assistants (RAs) committed to
planning, designing and facilitating the implementation of intervention programs in collaboration
with other stakeholders, such as the wider school communities, government and non-governmental
organizations and business partners. Process data were collected on all intervention activities and
analyzed by dose, frequency and reach for each specific strategy. The Fiji Action Plan included nine
objectives for the school settings; four were based on nutrition and two on physical activity in schools,
plus three general objectives, namely capacity building, social marketing and evaluation. Long-term
change in nutritional behavior was difficult to achieve; a key contributor to this was the unhealthy
food served in the school canteens. Whilst capacity-building proved to be one of the best mechanisms
for intervening, it is important to consider the cultural and social factors influencing health behaviors
and affecting specific groups. (Global Health Promotion, 2014; 20(4): 23–34).