CO-CREATE aimed to contribute to the evidence and infrastructure for local and national policy changes to make healthy choices the easiest, most appealing, and preferred choices for adolescents across Europe, thus reducing the burden of obesity and related non-communicable diseases, both now and in the future.
About the project
Childhood obesity is on the rise across Europe. By 2025, overweight and obesity is expected to affect one in every five children.
What we eat and how much we move are direct results of the many individual choices we make each day. Obesity prevention efforts have often focused on trying to influence such individual choices as if they were conscious and rational. However, a large and growing body of research shows that people’s nutrition and physical activity behaviours are influenced by complex sets of contextual elements, including unhealthy and unsupportive physical, social, cultural, economic, and political environments. To be successful in reducing the prevalence of overweight and obesity, we need to move towards comprehensive policies addressing the food and physical activity systems and environments surrounding us, reshaping the context to make healthy choices the easiest and most widely preferred.
To achieve the overall aim, the project was organised into 10 work packages (WP1 – WP10) - see the CO-CREATE project webpage for details as well as all the results from the project. The Public Health Nutrition group was involved in the activities in the following work packages; WP4, WP5 & WP6, and led WP7.
Sub-projects
- WP4: Obesity system mapping
- The overall objective of WP4 was to identify the key factors driving obesity in adolescents and generate system maps to identify the key opportunities for policy interventions to tackle the problem of adolescent obesity.
-
In the spring of 2019, four system mapping workshops were conducted with 16-18 year olds from upper secondary schools with vocational and academic training and in urban and rural settings. These maps were merged with the maps from the UK, the Netherlands, Poland and Portugal in the scientific article reporting on the results.
-
Across the countries the finding of mental health as a driver of obesity was the most surprising finding.
- WP5: Youth Alliances for overweight Prevention Policies
-
The overall objective of WP5 was to inform and develop novel, context specific and evidence based policy options for obesity prevention through involvement and participation of youth from diverse background in 3 youth alliances per country in Norway, the Netherlands, UK, Poland and Portugal.
-
In the school year 2019/2020 an alliance was run in a rural area in Norway and a digital alliance was started in collaboration with PRESS in the spring of 2020 during the COVID-19. These alliances resulted in five fully developed policy proposals. More details on how the alliances were organized in Norway is provided on the project web-page in Norwegian.
-
The youth formed a Youth Task Force across the five participating countries demanding 4 actions from policy makers to prevent obesity in the CO-CREATE Youth Declaration, and continued their engagement for the rest of the project.
-
- WP6: Dialogue forums
-
The overall objective of WP 6 was to bring together adolescents, policy makers and businesses to produce actionable commitments to enable healthy nutrition and physical activity habits for obesity prevention.
-
In Norway, we held one digital dialog on regulation of marketing of unhealthy food and one physical dialog with four groups discussing either marketing or implementing a national school meal. The results of these can be found in the report of the all the 20 dialogs conducted in CO-CREATE.
-
We also tested the use of the tool in collecting the views of younger children on the EU School Fruit, Vegetable and Milk Scheme.
-
Both dialog forum tools are available from partner EAT responsible for WP6.
-
- WP7: Evaluation of CO-CREATEd policy interventions and methodology
- The overall objective of WP7 was to evaluate the CO-CREATion, using process, output and impact data. This was achieve through three tasks: 1) Developing a system dynamics model to simulate the effect of the policy ideas 2) Evaluate the changes in participants in the alliances and the dialog forum 3) Develop implementation and evaluation plans for the youth policy ideas.
- There were two system dynamics models developed 1) Based on data from the Health Behavior Among School-aged Children showing that : "Out of 10 possible intervention points tested, exercise, fruit, life dissatisfaction, school pressure, and skipping breakfast were identified as the top five most influential ones across the 24 cases." 2) Based on a systematic review of system dynamics simulation models of obesity on youth, the system maps from WP4 as well as literature and dialog with experts, which can be developed further by system dynamics researchers or explored by youth. For this one, an interactive learning environment version aimed at youth was also developed.
- A questionnaire was developed to assess changes in readiness for action and attitudes towards obesity prevention policies in the youth and stakeholders participating in the youth alliances and the dialog fora. Due to COVID-19 the numbers of participants were lower than planned for, but the results were encouraging.
- Implementation and evaluation plans were made for one policy per country based on a protocol for writing these plans.
Financing
This project has received funding from the European Union's Horizon 2020 research and innovation programme (Work Programme 2016-2017: Food security, sustainable agriculture and forestry, marine and maritime and inland water research and the bioeconomy) under grant agreement No 774210.
Cooperation
The project is coordinated by the Norwegian Institute of Public Health and the whole list of collaborators can be found on the CO-CREATE webpage.
Start and Finnish
2018-2023