tions within the community are important, as is concerted involvement in community coalition efforts. Health care organizations can also demonstrate leadership by serving as organizational role models for physical activity and healthful eating practices, which include expanding the availability of low-calorie and high-nutrient foods in worksite vending machines and cafeterias as well as creating incentives for employees to engage in physical activity.

Efforts are under way to consider the types of information that clinicians and other stakeholders need to effectively address childhood obesity (Public Health Informatics Institute, 2005). An example is the All Kids Count program, a national technical assistance program to improve child health and the delivery of immunizations and preventive services through the development of integrated health information systems (Saarlas et al., 2004). Furthermore, regional health networks and electronic health records, which are increasingly being used, may provide sources of data relevant to childhood obesity that would also protect patient confidentiality. For example, western North Carolina Health Network’s Data Link Project provides access to electronic health information for health care providers caring for the same patients across multiple health care institutions. Although this system is not being designed to provide regional aggregate health data search capabilities, such capabilities could be incorporated into the network’s data linkages with the agreement of the participating entities.

Few mechanisms exist to provide accountability for the various components of the health care system in obesity prevention efforts. The committee encourages health care providers and organizations to provide greater leadership in addressing issues related to promoting healthful eating and regular physical activity. The National Initiative for Children’s Healthcare Quality is in the process of developing a national program for recognizing promising clinical practices and clinical partnerships whose efforts have contributed to reducing childhood obesity (NICHQ, 2006).

APPLYING THE EVALUATION FRAMEWORK TO COMMUNITIES

What Constitutes Progress for Communities?

Individual communities across the nation are at different stages of engagement and action in addressing childhood obesity. The committee recognizes that it is not possible to obtain an accurate and systematic assessment of how many communities are fully engaged, how many are only beginning to initiate changes, how many recognize the problem but have not begun to address it comprehensively, and how many have not yet prioritized this issue. It is likely that the attention that childhood obesity is being paid in schools has alerted most communities to this issue. However,



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