A systems-based typological framework for understanding the sustainability, scalability, and reach of childhood obesity interventions

Terry T K Huang, Brandon L Grimm, Ross A. Hammond

Research output: Contribution to journalArticle

11 Scopus citations


This article proposes a systems-based framework to examine 3 structural dimensions of childhood obesity interventions that can impact intervention sustainability, scalability, and reach. These 3 dimensions are the locus of intervention drivers (top-down vs. bottom-up), the locus of change effected (policy vs. individual behavior), and the public versus private sector. Interventions focused on individual behavior change often rely on bottom-up approaches and have generally been less sustainable than policy interventions. However, top-down (government or industry) support can lead to better funding and shifts in social norms. In the public sector, top-down efforts targeting individual behavior are generally also more scalable and have wider reach to diverse communities. In the private sector, behavior-change interventions tend to have greater resources and are sustained over longer periods, even when efficacy is in question; they may also be quite scalable. In a systems approach, a combination of approaches that encompass the structural dimensions in systems space will likely be needed to significantly impact childhood obesity. Next-generation childhood obesity interventions should be able to demonstrate sustainability, scalability, and reach as benchmarks of plausible success and criteria for investment.

Original languageEnglish (US)
Pages (from-to)253-266
Number of pages14
JournalChildren's Health Care
Issue number3
StatePublished - Jul 1 2011


ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Clinical Psychology

Cite this