Healthy Kids, Healthy Cuba: findings from a group model building process in the rural Southwest.

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BACKGROUND: Healthy Kids, Healthy Cuba (HKHCuba) is 1 of 49 community partnerships that participated in the national Healthy Kids, Healthy Communities program of the Robert Wood Johnson Foundation. One method of evaluation was to introduce systems thinking at the community level by identifying the essential parts of the HKHCuba system and how it influences policy and environmental changes to promote healthy eating and active living as well as to prevent childhood obesity in this unique, triethnic, rural community in New Mexico.

METHODS: In this cross-sectional design, 12 HKHCuba partners participated in a group model building (GMB) session to develop behavior over time graphs and a causal loop diagram.

RESULTS: Twenty-seven influences identified in the behavior over time graphs emerged as feedback loops and 5 subsystems emerged within the causal loop diagram. In addition to specific strategy-related influences (eg, access to healthy food, participation in community gardens), sense of cultural pride, sense of community, and social engagement, particularly among youth, were highly salient topics.

CONCLUSIONS: The GMB process provided participants with the opportunity to explore the connections across their specific areas of work and make connections between policy and environmental influences on healthy eating and active living behaviors. The GMB processes and systems thinking approaches were new to the majority of participants, received positively, and perhaps should have been introduced earlier in the project period.