As described in Chapter 1, there are a wide variety of decision scenarios related to obesity prevention policies and programs. A decision maker may be faced with a decision about a specific, populationwide policy change with a potential direct impact on physical activity or other weight-related behavior of adults or children. For example, a school board member may ask staff to assist in deciding whether to vote for a measure to send parents reports of their children’s BMI levels based on annual weight and height screening. Or a decision maker may need to undertake or retain a specific program aimed at increasing access to food or physical activity options in a community. Or the director of a youth service organization may ask staff to help select a family-oriented nutrition and fitness program for nationwide implementation. Finally, a decision maker may need to select one of a set of potential interventions that would decrease obesity-promoting environmental influences; for instance, an employer may ask staff to help determine which wellness services should be included in the employee benefit package next year.

Identifying the question posed by the decision maker is the essential first step in producing the evidence report. This question informs what approach is taken to selecting, implementing, and evaluating interventions; why an intervention is needed; what should be done; how the intervention can work in the given context; and how changes in well-established policies and practices can be justified.