Abstract

Although progress has been made in the development and large-scale implementation of effective childhood obesity interventions, challenges remain significant. Our objective was to understand the causes of success in the United States and Latin American countries in implementing policies and programs (PAPs)against obesity and to identify opportunities for improvement by applying implementation science principles. We selected three case comparison studies: (1) front-of-package food labeling (Mexico and Chile), (2) open streets and streets for play programs (Colombia and the United States), and (3) the Baby Friendly Hospital Initiative (BFHI) (Brazil and the United States). We summarized information obtained from various sources (scientific publications, grey literature and key informant interviews) to describe the barriers, enablers and progress of PAPs in all dimensions of the RE-AIM framework. An evidence-based advocacy campaign, together with the willingness of policy makers and evidence on their impact and on the possibility of implementing them on a larger scale, were the keys to the successful launch and implementation of PAPs. Their design and implementation had to be adapted to different contexts. More powerful tools are needed to monitor and evaluate processes and their outcomes, as well as to track equity indicators to maximize the population benefits of PAPs. Implementation science offers an important contribution to fill knowledge gaps and open a dialogue to improve anti-obesity policies. It will also help to transfer lessons learned to the rest of the continent so that they can be used for research and evaluation purposes both during the development phase of PAPs and during their implementation and maintenance.