Lynne M. MacLean

‘Mom, I hate it when they weigh me’. These words were uttered by a child of one of the authors of this chapter. This quote was chosen as the title of this chapter on stigma and BMI screening in schools since it captured some of the experience of children made to feel different in a public setting because of their weight. School is a particularly important public setting, full of children striving for acceptance by their peers, as well as themselves, hoping perhaps to stand out in terms of achievement but not in terms of characteristics that will lead to ridicule and isolation. What role, if any, might Body Mass Index (BMI) screening in schools play in increasing stigmatization of the overweight/obese? Are there solid reasons justifying BMI screening in schools? Might other approaches provide us with the same information? This chapter explores some of these issues and offers some alternative paths for dealing with weight issues in the school setting.

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.

Given the rise in obesity rates in North America, concerns about obesity-related costs to the health care system are being stressed in both the popular media and the scientific literature. With such constant calls to action, care must be taken not to increase stigmatization of obese people, particularly of children. While there is much written about stigma and how it is exacerbated, there are few guidelines for public health managers and practitioners who are attempting to design and implement obesity prevention programs that minimize stigma. We examine stigmatization of obese people and the consequences of this social process, and discuss how stigma is manifest in health service provision. We give suggestions for designing non-stigmatizing obesity prevention public health programs. Implications for practice and policy are discussed.

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.