UCLA

Results from recent research studies examining the direct effect of local health department obesity prevention efforts on county-level variations in obesity are inconclusive. Local health departments' inability to decrease the prevalence of obesity within their jurisdiction with existing public health resources will likely persist as a result of organizational inefficiencies and limited funding available to provide obesity risk reduction programs and services to communities most adversely affected by the epidemic. To broaden their impact despite these barriers, local health departments would do well to identify other strategies that improve their ability to deliver obesity prevention programs to diverse communities, such as using partnerships with community-based organizations that have relevant obesity prevention expertise.

This dissertation comprises two studies that examine the role of local health department organizational characteristics and area-level factors on the presence of local health department community-based partnerships and the effect of these partnerships on the percentage point change in county-level obesity prevalence. Multiple waves of data from the National Profile Survey of Local Health Departments, U.S. Census Bureau, and the obesity prevalence data from the Behavioral Risk Factor Surveillance System were analyzed using multinomial logistic regression and ordinary least squares regression modeling. Additionally, key informant interviews (n=4) with stakeholders from the Los Angeles County Department of Public Health complemented the secondary data analyses

Results indicated that local health departments are providing a substantial amount of obesity prevention programs through partnerships with other organizations in the local public health system. The probability of partnering to provide obesity prevention programs increased with the size of the population served. The benefit of local health department community-based partnerships for decreasing the county-level prevalence of obesity was not confirmed. Local health departments experience barriers to the formation of community-based partnerships, including the administrative burden associated with the processing of formal contracts.

Findings suggest that local health departments are interested in improving their obesity prevention efforts and value partnerships with community-based organizations. However there are other important agencies that local health departments must partner with for policy adoption and advocacy activities. Local health departments within larger jurisdictions can benefit from the economies of scale and improve their population-based obesity prevention programs. Results suggest that future obesity risk reduction research should continue assessing the benefits achieved from local health department partnerships with community-based organizations.