Including climate change in community-based obesity prevention interventions: a qualitative exploration of the perspectives of Australian funders

Abstract Background Community-based obesity prevention interventions (CBOPIs) demonstrate promise as effective, cost-effective approaches to prevent obesity. Whilst CBOPI actions often focus on obesity-related outcomes, they may also have positive impacts on climate change. Actions that simultaneously address obesity and climate change are known as double-duty actions. For example, switching to active modes of transport benefits individual health, while also reducing emissions from vehicle use. Support from CBOPI funding decision-makers is crucial for intervention success; the factors influencing funding decisions are currently not well understood. This study aimed to identify factors that influence funding decisions within organisations, to determine whether funders recognise double-duty actions in CBOPIs, and which double-duty actions are preferred. Methods Potential participants with CBOPI funding decision-making roles were purposively sampled and invited to participate. Potential interview participants from government and non-government organisations were identified by search engine (Google) and invited via email to partake in an interview. Sixty-five invites were emailed and seven interviews with eight participants were conducted between April–May 2023. The participating stakeholders all had health roles; four State-wide and four local government. Semi-structured interviews with eight participants were conducted over Zoom between February-May 2023. Interviews were transcribed using Zoom Transcription and analysed with the assistance of NVivo. Reflexive Thematic Analysis underpinned the data analysis and the Social Ecological Model was used to further develop the theory. Results Results suggested that participants recognised double-duty actions and believed inclusion of climate change action in CBOPIs would improve both intervention outcomes and participant acceptability. However, participants believed that stringent funding models limit flexibility to include climate change action. This could be mitigated by incorporating climate change into strategic health plans. Community partnerships may also be an effective tool to enhance double-duty actions in CBOPIs, as they allow participants to tailor interventions to community concerns including climate change. Conclusion CBOPIs that use double-duty actions to intentionally target obesity prevention and climate change action may play an important role in addressing two critical public health issues at the community level. Whilst CBOPI funders are supportive of double-duty actions, modifications from strategy and partnerships may be required to realise the successful implementation.