it remains to be determined how many communities have recognized that community stakeholders need to take additional actions.
It is important to emphasize the short-term and intermediate outcomes that can be examined in evaluating changes at the community level. It is not realistic for each community program to reduce children’s BMI levels in a short time frame, nor is this expected; instead, the focus should be on assessing progress toward short-term outcomes (e.g., changing institutional, local, or state policies to support obesity prevention) and intermediate outcomes such as increasing the proportion of children or youth involved in physical activity on a daily basis, increasing the percentage of physical education or recess periods that children or youth spend in moderate or vigorous physical activity, increasing the number of miles of bicycle and walking trails, and increasing access to affordable fresh fruits and vegetables for families (e.g., through the provision of farmers markets in low-income communities and community or school gardens).
Furthermore, communities need to take full advantage of their racial/ ethnic diversity and cultural assets by developing programs and opportunities culturally relevant to the children and adolescents in their communities. Sports activities, dance, foods, and beverages all have distinct cultural relevance that reflect community strength and provide an infrastructure for promoting healthful eating and active living.
The committee identified several important elements in assessing progress in childhood obesity prevention in communities:
Collect, analyze, and present specific data for the community to make the case for action to local decision makers. Challenges include knowing how and from where to gather community-level data.
Assess interventions that have evidence of effectiveness, and select promising initiatives that can be implemented by programs in the community.
Identify funding sources for a new intervention or program; and have the time and the knowledge to identify, apply, and manage the required reporting for external grants.
Design an evaluation plan and have sufficient numbers of knowledgeable staff with the skills and time available to measure and document the outcomes of an intervention.
Sustain the intervention, particularly after external grant funding has ended.
The evaluation framework introduced in Chapter 2 can be used to evaluate community policies and interventions. Two examples of the use of