Unpacking vertical and horizontal integration: childhood overweight/obesity programs and planning, a Canadian perspective.

BACKGROUND: Increasingly, multiple intervention programming is being understood and implemented as a key approach to developing public health initiatives and strategies. Using socio-ecological and population health perspectives, multiple intervention programming approaches are aimed at providing coordinated and strategic comprehensive programs operating over system levels and across sectors, allowing practitioners and decision makers to take advantage of synergistic effects. These approaches also require vertical and horizontal (v/h) integration of policy and practice in order to be maximally effective. DISCUSSION: This paper examines v/h integration of interventions for childhood overweight/obesity prevention and reduction from a Canadian perspective. It describes the implications of v/h integration for childhood overweight and obesity prevention, with examples of interventions where v/h integration has been implemented. An application of a conceptual framework for structuring v/h integration of an overweight/obesity prevention initiative is presented. The paper concludes with a discussion of the implications of vertical/horizontal integration for policy, research, and practice related to childhood overweight and obesity prevention multiple intervention programs. SUMMARY: Both v/h integration across sectors and over system levels are needed to fully support multiple intervention programs of the complexity and scope required by obesity issues. V/h integration requires attention to system structures and processes. A conceptual framework is needed to support policy alignment, multi-level evaluation, and ongoing coordination of people at the front lines of practice. Using such tools to achieve integration may enhance sustainability, increase effectiveness of prevention and reduction efforts, decrease stigmatization, and lead to new ways to relate the environment to people and people to the environment for better health for children.

Complexity and team dynamics in multiple intervention programmes: challenges and insights for public health psychology.

Psychologists engaged in public health research and intervention will become more involved in multiple intervention programming approaches. Managing innovation and complexity is a challenge when the team members come from different disciplines, organizational cultures and research perspectives. This report captures some of those challenges with a participatory, capacity-building, community-based intervention over research stages. We detail successful and less successful attempts to manage the challenges within changing public health contexts and end with concrete suggestions for teams with mixed intervention and research goals. Insights from this project should inform similar programmes with multi-level, participatory, community-based approaches.

Improving accuracy of transcripts in qualitative research.

Everyone who has worked with qualitative interview data has run into problems with transcription error, even if they do the transcribing themselves. A thoughtful, accurate, reliable, multilingual transcriptionist with a quick turnaround time is worth her or his weight in gold. In this article, the authors examine some transcription circumstances that seem to bring about their own consistent set of problems. Based on their experiences, the authors examine the following issues: use of voice recognition systems; notation choices; processing and active listening versus touch typing; transcriptionist effect; emotionally loaded audiotaped material; class and/or cultural differences among interviewee, interviewer, and transcriptionist; and some errors that arise when working in a second language. The authors offer suggestions for working with transcriptionists as part of the qualitative research team.