tion that would allow communication among the various stakeholders and reduce this reliance on a single community site leader. Often policy experts, funders, evaluators, and site leaders fail to communicate with one another. As a result, information is not available to those who need it, and goals are set and strategies implemented without the input of important stakeholders. A number of site leaders suggested that regular forums involving all stakeholders would be helpful in addressing this concern.
Site leaders acknowledged the important role of evaluation in childhood obesity prevention programs. However, a number of them also expressed frustration with evaluation on several fronts. Sustainable, multifaceted changes to the community environment take time, especially given the nature of working with local city planners, councils, and neighborhoods, among other stakeholders. The initiation of projects and the achievement of progress often require agreement and action by multiple parties at the community level. Yet evaluations are commonly conducted in a short time frame.
Several site leaders suggested the need to develop evaluation methods that can capture a community’s interim gains toward childhood obesity prevention instead of just ultimate outcomes. They described working in low-income communities where a significant proportion of children are struggling with being overweight or obese, and where the local environment poses several obstacles to children’s engaging in healthful eating and physical activity. In such a context, an exclusive focus on measuring outcomes could be problematic. For example, as discussed earlier, a community’s obesity rate may be so high that it is infeasible to achieve measurable positive changes in a relatively short time frame. Several site leaders emphasized that progress in environmental change is difficult to achieve but is a necessary step in obesity prevention. Typical evaluations fall short in capturing this important point. As one site leader suggested, the key is determining how to measure change, not necessarily an end point; evaluations of childhood obesity prevention programs are always, in a sense, process evaluations because communities are never going to complete the improvements they are seeking to effect. Site leaders proposed that discussion and development of progress measures for childhood obesity prevention programs would be a positive step and that they could be helpful if called upon to contribute to such efforts.