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Implementing and Evaluating a Stakeholder-Driven Community Diffusion–Informed Early Childhood Intervention to Prevent Obesity, Cuyahoga County, Ohio, 2018–2020


The systems map has been used to communicate the interconnectedness of factors that drive and are affected by early childhood obesity in Cuyahoga County, Ohio. The 81 variables are grouped into 8 color-coded subsystems: healthy diet, engagement, political will, health care, physical activity, social emotional health, funding, and health and wellness in early childhood education settings.

Systems map developed and refined by the Early Ages Healthy Stages Action Building Committee, 2019. Arrows indicate a connection between variables; plus signs indicate a connection in which change in one direction (eg, an increase or decrease) in the first variable results in a change in the same direction in the connected variable; minus signs indicate a connection in which a change in one direction in the first variable results in a change in the opposite direction in the connected variable. Abbreviations: ACEs, adverse childhood experiences; CACFP, Child and Adult Care Food Program; ECE, early childhood education; OHP, Ohio Healthy Programs; SNAP, Supplemental Nutrition Assistance Program; WIC, Special Supplemental Nutrition Program for Women, Infants, and Children.

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Page last reviewed: January 20, 2022