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Bridging the Evidence Gap in Obesity Prevention: A Framework to Inform Decision Making
at any phase of the evidence review or decision-making process. The L.E.A.D. framework guides the generation of evidence related to “What,” “Why,” and “How” questions and supports the use of multiple forms of evidence and research designs from a variety of disciplines. In obesity prevention–related research, the generation of evi dence from evaluation of ongoing and emerging initiatives is a particular priority.
Researchers, decision makers, and intermediaries working on obesity prevention and other complex multifactorial public health problems are the primary audiences for communicating and disseminating the L.E.A.D. framework. With sufficient information, they can apply the framework as a guide for generating needed evidence and supporting decision making. It is important to understand the settings, communication channels, and activities of these key audiences to engage and educate them effectively on the purpose and adoption of the framework. To support the development of a communication and dissemination plan, it is critical to create partnerships, make use of existing activities and networks, and tailor the messages and approaches to each target audience.
As the target audiences begin to use the framework, assessing its use in selected settings will be essential so it can be improved and refined. Evaluation of the impact of the L.E.A.D. framework is also important for determining its relevance to current evidence-generation and decision-making processes. To this end, key outcome measures—utilization, adoption, acceptance, maintenance, and impact—should be defined and data collected on these measures. It will be important to develop or adopt data collection tools and utilize methods and existing initiatives that will best serve this purpose, as well as to systematically integrate the feedback thus obtained to sustain and improve the framework’s applicability and utilization.
The United States has made progress toward translating science into practice in the brief time since the obesity epidemic was officially recognized. But the pace of this translation has been slow relative to the scope and urgency of the problem and the associated harms and costs. As discussed above, moreover, the evidence emerging from applied research on obesity prevention can be inconclusive, incomplete, and inconsistent. A systematic process is needed to improve the use of available evidence and increase and enhance the evidence base to inform decisions on obesity prevention and other complex public health problems. Commitment to such a process is needed from both decision makers and those involved in generating evidence, including public and private policy makers and their advisors, scientific and policy think tanks, advocacy groups and stakeholders, program planners, practitioners in public health and other sectors, program evaluators, public health researchers and research scientists, journal editors, and funders. With this in mind, the committee makes the following recom-