Activities In terms of logic models, the actions necessary to achieve desired outcomes. For this report, activities to improve evaluation efforts include reviewing indicators and measures, developing plans and infrastructure, and enhancing resources.
Assessment An effort in which data on the community or other jurisdiction characterizes the problem, its distribution, and describes efforts to address it.
Body mass index (BMI) A ratio of weight in kilograms to the square of height in meters. BMI is used as a screening tool to identify possible weight problems and is considered a fairly reliable indicator of body fatness.
Causal loop diagram A diagram that links elements in a system by positive or negative feed-back mechanisms. Also known as a systems map.
Community People sharing a common place (e.g., city, neighborhood); they may also share a common experience (e.g., living in a neighborhood with few grocery stores or parks or living in poverty) or interest (e.g., working together to promote better nutrition or active living).
Community level Activities conducted by local governmental units (e.g., cities, counties), school districts, quasi-governmental bodies (e.g., regional planning authorities, housing authorities, etc.) and private-sector organizations (e.g., hospitals, businesses, child care providers, voluntary health associations, etc.).
Complex adaptive system A system composed of many unrelated pieces that interact in subtle or nonlinear ways to strongly influence the overall behavior of the system.
Complexity The study of complex adaptive systems (see Complex adaptive system).
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B Glossary Activities In terms of logic models, the actions necessary to achieve desired outcomes. For this report, activities to improve evaluation efforts include reviewing indicators and measures, developing plans and infrastructure, and enhancing resources. Assessment An effort in which data on the community or other jurisdiction characterizes the problem, its distribution, and describes efforts to address it. Body mass index (BMI) A ratio of weight in kilograms to the square of height in meters. BMI is used as a screening tool to identify possible weight problems and is considered a fairly reliable indicator of body fatness. Causal loop diagram A diagram that links elements in a system by positive or negative feed-back mecha- nisms. Also known as a systems map. Community People sharing a common place (e.g., city, neighborhood); they may also share a common experience (e.g., living in a neighborhood with few grocery stores or parks or living in poverty) or interest (e.g., working together to promote better nutrition or active living). Community level Activities conducted by local governmental units (e.g., cities, counties), school districts, quasi-governmental bodies (e.g., regional planning authorities, housing authorities, etc.) and private-sector organizations (e.g., hospitals, businesses, child care providers, voluntary health associations, etc.). Complex adaptive system A system composed of many unrelated pieces that interact in subtle or nonlin- ear ways to strongly influence the overall behavior of the system. Complexity The study of complex adaptive systems (see Complex adaptive system). 303
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Concept mapping A process to enable conceptualizing and describing ideas on a topic and visually rep- resenting these ideas in a map. Context The set of factors or circumstances that surrounds a situation or event and that gives meaning to its interpretation; the broader environment in which a program operates. Cross-sectional The observation of a defined population at a single point in time or time interval. Delays In terms of systems science, the length of time relative to the rate of system change. Diffusion of innovations The diffusion of innovations theory was proposed by Rogers1 to explain the processes and factors influencing the spread and adoption of new innovations through certain channels over time. Key components of the diffusion theory are (1) perceived attributes of the innovation, (2) inno- vativeness of the adopter, (3) social system, (4) individual adoption process, and (5) diffusion system. Dynamics In terms of systems science, the behavior over time of a system or any of its components. Emergence In terms of systems science, the arising of novel and coherent structures, patterns, and p roperties during the process of self-organization in complex systems. End users See Evaluation users. Environmental audit Identification of interventions being implemented in a particular area. Evaluation users Those with an interest in obesity prevention and its results, also known as stakehold- ers. Can refer to policy makers, government agency staff, nongovernmental organizations at all levels, advocates, opponents, local coalitions, researchers and evaluators, businesses, media, or the public. Feedback loop In terms of systems science, the mechanism (rule or information flow or signal) that allows a change in a value of an asset at a point in time to affect a flow into or out of that same asset. Formative evaluation Identifies needs and track changes to guide and facilitate program improvement while the program activities are in progress. In terms of the Committee’s evaluation framework, formative evaluation includes the needs, inputs, resources, and activities. Geographic information system (GIS) A system of computer hardware, software, and special data used to capture, manage, analyze, and display geographically referenced information. Group model building A participatory method for including stakeholders in the process of developing a system dynamics model. 1 Rogers, E. M. 2003. Diffusion of innovations. 5th ed. New York: Free Press. 304 Evaluating Obesity Prevention Efforts
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Health disparities The population-specific differences in the presence of disease, health outcomes, or access to health care across racial, ethnic, and socioeconomic groups. Impacts In terms of logic models, the population-level changes and improvements that can result from widespread implementation of evidence-based interventions to prevent obesity. Incidence The frequency of new cases of a condition or disease within a defined time period. Incidence is commonly measured in new cases per 1,000 (or 100,000) population at risk per year. Indicator A source of data or evidence that can be used to assess the status or trend of a person or pop- ulation. Aggregates of raw and processed data that are used to measure social, economic, and health out- comes such as obesity rates, morbidity, and life expectancy. In this report examples of indicators include the prevalence of obesity or the proportion of states with strong nutritional standards for foods and bev- erages sold or provided in schools. Inputs In terms of logic models, the type and level of considerations or resources required to support, implement, and accomplish a set of activities and considerations influencing the choice of interventions or activities. In this report examples of inputs include user needs, existing objectives and strategies, and cur- rent context. Interventions Programs, systems, policies, environmental changes, services, products, or any combina- tion of these multi-faceted initiatives. Knowledge brokers Organizations or individuals that provide staffing, knowledge, and/or expertise in assessing and interpreting evidence facilitating interaction between research and decision makers. Leverage point The place to intervene in a system. Logic model A tool used to present a graphic depiction of how a program is supposed to work along with the relationships between the inputs, activities, outputs, and outcomes. Longitudinal Examines the specific characteristics of individuals, subgroups, or populations over time. Measure The actual survey item or set of items, assessment method, or observational technique that is used to quantify an indicator (data or evidence). Monitoring Tracking of the implementation of interventions (see Interventions) compared to standards of performance. Natural experiment Naturally occurring circumstances in which different populations are exposed or not exposed to a potential causal factor or intervention such that the circumstances resemble a true exper- iment in which study participants may be assigned to exposed or unexposed groups. Appendix B 305
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Obesity In adults, a body mass index (BMI) of 30 or greater is considered obese. Among those who are obese, the increasing health risks at higher levels of BMI are sometimes indicated by further classification into grades of increasing severity: grade 1 obesity is defined as a BMI of 30 to 34.9, grade 2 is a BMI of 35.0 to 39.9, and grade 3 is a BMI of 40 or greater. In this report, obesity in children and adolescents refers to age- and sex-specific BMIs that are equal to or greater than the 95th percentile of the Centers for Disease Control and Prevention’s BMI growth charts. Objective A statement of movement in an indicator toward a quantitative target usually by a specified time. Outcomes The changes that result from inputs, activities, and outputs to support evaluation efforts. Depending on the nature of the activities and outputs achieved, an outcome can be short term, intermedi- ate term, or long term. In this report outcomes include improved evaluation and surveillance capacities needed to understand and improve progress in obesity prevention and improved population health and equity. Outputs The direct products of activities; usually a tangible deliverable produced as a result of an a ctivity. In this report, outputs related to improved evaluation and surveillance include identification of core objectives and measures and recommendation and guidance on methods and protocols for surveil- lance and evaluation. Overweight In adults overweight is defined as a body mass index (BMI) of 25 to 29.9. In this report, overweight in children and adolescent refers to age- and sex-specific BMIs at or above the 85th percentile of the Centers for Disease Control and Prevention’s BMI growth charts. Policy monitoring (policy health law) The ongoing, systematic collection, analysis, interpretation, and dissemination of information about a given body of public health law and policy. Policy surveillance Reports on individual policy measures without linking to prior policy action. Population dose The product of penetration (reach divided by the size of the target population) and effect size (relative change in behavior for each person exposed). Prevalence The number of instances of a condition or a disease in a population at a designated point of time; usually expressed as a percentage of the total population. Simple rules In systems science, simple rules provide guidance for “decisions” about how best to adapt to changes in the environment. Simple rules are used to look retrospectively and to plan prospectively for increasing cohesiveness across an organization or among a group of individuals. Stakeholders See Evaluation users. 306 Evaluating Obesity Prevention Efforts
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Summative evaluation The effort (experimental or quasi-experimental controls or designs) to detect changes in output, outcomes, and impacts associated with interventions and attribute those changes to the interventions. Surveillance The ongoing systematic collection, analysis, and interpretation of data tracked over time to detect patterns, disparities, and changes that may be associated with interventions. System A set of elements or parts that is coherently organized and interconnected in a pattern or struc- ture that produces a characteristic set of behaviors, often classified as its “function” or “purpose.” Systems approach An approach that views a phenomenon and its components in its entirety, not just a single element, and that emphasizes the interactions and connectedness of the components to understand the entire system. A systems approach involves awareness of the wider context, an appreciation for inter- actions among different components, and transdisciplinary thinking. It acknowledges that individuals and families are embedded within broader social, political, and economic systems that shape behaviors and constrain access to resources necessary to maintain health. Systems map See Causal loop diagram. Systems perspective See Systems approach. Systems science Research related to systems theory that offers insight into the nature of the whole sys- tem that often cannot be gained by studying the system’s components in isolation. Systems theory An interdisciplinary theory that requires a merging of multiple perspectives and sources of information and deals with complex systems in technology, society, and science. Systems thinking An iterative learning process in which one takes a broad, holistic, long-term perspec- tive on the world and examines the linkages and interactions among its elements. Appendix B 307
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