Commentary on “Improving community readiness among Iranian local communities to prevent childhood obesity”

Mar 17,2023 | Christopher M. Shea Commentary

What does it mean for a community to be “ready” to implement a new program, and what does it take to increase the readiness of communities? This study by Niknam et al. examines an intervention to increase the readiness of communities in Iran to engage in childhood obesity prevention programs in primary schools. According to the authors, the concept of community readiness (CR) was generally unknown within the Iranian population—which is multicultural, has unequal distribution of resources, and where misconceptions about childhood obesity are common—meaning that efforts to improve CR have potential to contribute to effective implementation of regional and national programs. The study’s intervention—Community Readiness Intervention for Tackling Childhood Obesity (CRITCO)—is guided by theory, aligning intervention activities to dimensions of community readiness. Niknam et al. describe multiple phases, including developing a socio-culturally adapted version of the community readiness tool, assessing the readiness of 12 communities from diverse districts of Tehran, developing an intervention package based on the readiness data, and assessing changes in the readiness of intervention and non-intervention communities. Their findings include fidelity assessment results showing that approximately 80% of the intervention package activities were performed and were assessed to be of reasonable quality (3.5 out of 5).  Girls’ schools in the sample had both higher fidelity and higher quality of performance compared to boys’ schools. Furthermore, findings suggest that the intervention was impactful, with overall readiness scores of intervention sites increasing significantly whereas readiness scores of control sites decreased. The authors indicate hope that their study will be “a spark for developing readiness-based childhood obesity prevention programs in Middle Eastern and other developing countries.” Although additional detail about some of the methods would have been useful to see, the authors should feel confident that they have provided a model for others who wish to follow that spark.


Niknam, M., Omidvar, N., Eini-Zinab, H., Kalantari, N., Olazadeh, K., & Amiri, P. (2023). Improving community readiness among Iranian local communities to prevent childhood obesity. BMC Public Health, 23(1), 344. doi:10.1186/s12889-023-15163-3