FIGURE 4-1 Framework for evaluating progress of obesity prevention efforts.

a Evaluation refers to assessment, monitoring, surveillance, and summative evaluation activities.


The Committee defined the terms environment, strategy, indicator, objective, and measure. Environment refers to the five environments emphasized in the APOP report (IOM, 2012): physical activity, food and beverage, messaging, health care and worksite, and school and child care (outside the home) (with child care added by this Committee). Strategy refers to the APOP report’s 20 recommended strategies related to policy, systems, and environmental changes across the five environments (IOM, 2012). Interventions refer to the specific combination of policy, educational, mass media, organizational, and economic changes being evaluated in relation to specific APOP strategies and intended impacts (see Figure 4-1). For this report, the Committee adapted more recent definitions provided by the IOM’s Committee on Leading Health Indicators for Healthy People 2020 (IOM, 2011). Herein, an indicator is defined as a measurement related to a criterion of success or standard of acceptability, for example, the prevalence of obesity or the proportion of states with strong nutritional standards for foods and beverages sold or provided in schools. An objective is a statement of movement in an indicator toward a quantita-

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