Lessons from the field: How successful community-based coalitions on obesity, choose and prioritize interventions to improve health policy, health behaviors, and health outcomes

Background: Community-based coalitions could be mechanisms to foster individual and systems change in their communities in order to reduce the burden of obesity. Coalitions can increase the likelihood of reducing obesity by selecting and implementing effective interventions. Community-based coalitions are challenged with selecting effective interventions due to the multiple and interacting determinants of obesity and the substantial amount of untested recommendations. This investigation sought to identify best practices in decision-making processes used to select obesity interventions. Methods: Three exemplar community-based obesity coalitions were investigated using a multiple case study design. Data from twenty seven coalition member interviews were analyzed using methods based in Grounded Theory in order to identify practices in decision-making processes related to intervention selection. Findings: Nine shared practices related to decision-making processes were found among the three exemplar coalitions: setting a vision and objectives that include determinants of obesity; physical activity and healthy eating throughout the community environment, obtaining grants that support the objectives, defining an organizational structure that maximizes collaboration and shared decision-making, gathering information from the community, sharing information with the community and coalition members, leaders guiding and simplifying the process, aligning community-based information with objectives, making final selections by consensus, and building momentum with objectives. Conclusions: Successful community-based obesity coalitions combine information from subject matter experts in the community, expert agency recommendations, local community needs, assets and interest, and coalition member interest in order to select the obesity interventions for their communities.