through the following activities: (1) increase local data collection with an emphasis on differential exposures (e.g., access to healthful foods), vulnerabilities, and consequences; (2) adapt measures to allow for culturally appropriate foods, activities, and health-promoting environments; and (3) use methods for small-area analysis to examine associations between differential exposures/vulnerabilities and associated health disparities.

•   The Secretary of HHS in collaboration with other federal agencies should (1) develop common conceptual and operational language, domain (i.e., individual dietary behavior, food environment, individual physical activity behavior, physical activity environment), and definitions to understand influences on disparities and health equity in obesity, taking into account expertise from multiple disciplines; (2) identify common tools (both qualitative and quantitative) for all target populations most at risk for obesity disparities across all levels of impact (e.g., individual, community, society); and (3) emphasize the quality of these recommended tools and methods for adapting them to specific contexts and systems.

•   The National Collaborative on Child Obesity Research, a public-private partnership, should (1) identify best practices for both participatory and culturally competent evaluation; (2) expand the capability of its Registry to house and provide regular updates on core tools and methodologies to measure disparities and equity and improve the accessibility, utility, and dissemination of these tools; and (3) consider expanding the core tools and methodologies to include adults.

Support a Systems Approach in Evaluation

Recommendation 7: Evaluators, government, and private funders should incorporate a systems approach to evaluating obesity prevention efforts into their research-related activities through leadership, funding, and training support.

To implement this recommendation,

•   Evaluators should embrace a systems approach—reflecting interactions among strategies in and across multiple sectors and levels—to guide their methods of research and evaluation of obesity prevention efforts.

•   Government agencies should examine what combination(s) of indicators is most appropriate for evaluating progress in obesity prevention, focusing on categories of indicators that relate to the systems framework recommended in the APOP report.

•   Government agencies and private organizations funding obesity prevention research and evaluation should (1) stimulate the use of systems science by integrating it into requests for proposals of research designed to address multi-sectoral, multi-level, and multi-component issues; (2) create requests for proposals that focus on systems science–based research in obesity prevention; and (3) stimulate research on the value proposition of a systems approach to obesity evaluation by creating calls for research that include numerous domains and elements to identify the “value” of community-based interventions (based on the recommendations of the Committee on Valuing Community-Based, Non-Clinical Prevention Policies and Wellness Strategies).

•   Relevant federal agencies funding obesity prevention work (e.g., CDC, National Institutes of Health, Agency for Healthcare Research and Quality) should encourage and promote partner-



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