Concept Mapping Analysis of Sustainability Factors and Strategies for Childhood Obesity Prevention Programs

This study aimed to identify and prioritize sustainability factors and strategies and to explore their relationships based on expert-informed concept mapping analysis. Three rounds of consultation were conducted sequentially among a total sample of 44 experienced experts in childhood obesity intervention. Experts first rated the importance and feasibility of factors and strategies related to program sustainability and then completed a card sorting task to group factors and strategies according to whether the same strategies could address them. Inter-rater agreement was assessed using the Average Deviation index. A go-zone plot was generated to visualize strategy priorities by importance and feasibility. Multidimensional scaling and hierarchical cluster analysis were used to identify clusters of sustainability factors and strategies. The results showed that "matching stakeholders' perceived needs" was rated as the most important factor, and 12 strategies were rated as both highly important and feasible in the go-zone plot. Six clusters of sustainability factors and strategies emerged: (1) alignment and collaboration, (2) workforce engagement, (3) capacity building, (4) resource security, (5) sustainability-focused enhancement, and (6) streamlining and optimization. This assessment and categorization of factors and strategies can help practitioners prioritize practices based on their specific needs and contextual conditions to sustain childhood obesity prevention programs.