Evaluating Obesity Prevention Efforts A Plan for Measuring Progress (2013) / Chapter Skim
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5 Evaluating Progress in Promoting Health Equity: A Review of Methods and Tools for Measurement
5 Evaluating Progress in Promoting Health Equity: A Review of Methods and Tools for Measurement
Pages 115-132
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What: What can be done through evaluation to promote health equity? To address these challenges, mea surement tools and research methods for assessing individual, diet, physical activity, and the environments should be culturally appropriate and include variables characterizing social advantage and disadvantage.
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. Achieving health equity is critical to addressing obesity disparities insofar as it assures that every one has a fair opportunity to attain their full health potential with equal access to available care and community resources for equal need, equal utilization for equal need, and equal quality of care for all (Braveman et al., 2011a,c; Whitehead and Popay, 2010)
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This chapter offers a compilation of tools and methods available for use, with particular attention paid to obesity disparities, and calls attention to the opportunities that exist with the NCCOR-R to encourage the use of common tools research methods and the gaps that remain. Defining who, what, and where: essential definitions The pathways for addressing modifiable factors across environments targeted for obesity prevention require an understanding of two important concepts: robust measurement tools and research methods appropriate for disadvantaged populations, and knowledge of the multiple social influences on obesityrelated disparities (Braveman et al., 2011c; Lovasi et al., 2009)
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. Among children grades 3-5 in seven American Indian communities, 26.8 percent of American Indian boys and 30.5 percent of American Indian girls were found to be obese (Caballero et 118 Evaluating Obesity Prevention Efforts
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Braveman and colleagues pointed to upstream dimensions that characterize social advantage and disadvantage, and have particular relevance in assessing and understanding obesity disparities among high-risk populations (Braveman et al., Evaluating Progress in Promoting Health Equity 119
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. Sociocultural and socioeconomic influences, living and working conditions, and timing or life course exposure to disadvantage, described below and represented in Figure 5-1, are important to opera tionalize and to measure if they are to explain accurately the behavioral pathways to obesity disparities such as differential food consumption and physical activity patterns.
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Physical Activity Environment Identification of any inequitable distortion of resources that may be promoting disparities in physical activity requires tools and research methods to measure the physical environment and is important for public policy (Gordon-Larsen et al., 2006)
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School and Early Child Care Environments Schools and early child care settings provide venues for reaching nearly all children across the coun try. Structuring these educational environments to assure access to healthy food and adequate physical activity is crucial to preventing and controlling childhood obesity among high-risk populations (Gittelsohn and Rowan, 2011)
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Evaluating Progress in Promoting Health Equity 123
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Exclusionary/Inclusionary criteria for identifying tools and methods within NCCOR-R target ing populations with health disparities: exclusionary criteria included individual tools and methods of dietary intake or physical activity (e.g., 24-hour dietary recalls, food frequency tools and methods, or actigraph) and surveillance tools and methods because Accelerating Progress in Obesity Prevention (APOP)
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Evaluating Progress in Promoting Health Equity 125
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This inconsistency in what to measure, and how to measure, further complicates and confuses interpretation of findings relevant to understanding and assessing prog ress in obesity disparities. Systematic inclusion of consistently defined variables is needed to better identify tools and methods, interpret findings, and understand the pathways to preventing disparities and achiev ing health equity.
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:392-397. Evaluating Progress in Promoting Health Equity 127
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2006. Health disparities and health equity: Concepts and measurement.
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:348-354. Evaluating Progress in Promoting Health Equity 129
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American Journal of Preventive Medicine 36(4 Suppl)
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:1852-1859. Evaluating Progress in Promoting Health Equity 131
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