Evaluating Obesity Prevention Efforts A Plan for Measuring Progress (2013) / Chapter Skim
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1 Introduction
1 Introduction
Pages 15-42
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Committee on Evaluating Progress of Obesity Prevention efforts, is to develop a concise and actionable plan for measuring progress in obesity prevention efforts for the nation and adaptable guidelines for community assessments and evaluation. The Committee was tasked to 1 Overweight and obesity are defined in Appendix B
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The fields of evaluation, policy analysis, surveillance, and community health assessment are hardly new, and this background knowledge contributed greatly to the Committee's ability to anticipate issues, relate them to other prevention experience, and where necessary, differentiate the evaluation of obesity prevention from that experience. Evaluating Obesity Prevention compared to other prevention efforts The prevention field generally, and obesity prevention in particular, need to engage in surveillance of diseases and related conditions and assess the relative importance and trends in prevalence of factors associated with diseases and related conditions (see Chapters 3 through 8)
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Complex situations require a much better understanding of the community context of obesity prevention. Although community context is essential to understand in other prevention efforts, it is even more important for obesity prevention efforts because the risk factors related to eating and activity affect everyone.
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All of these forms of evaluation can apply to any combination of programs or components of programs, systems, 18 Evaluating Obesity Prevention Efforts
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For example, the 2004 IOM report Preventing Childhood Obesity: Health in the Balance grappled with the use of body mass index as the most common measure of overweight and obesity and evaluation of outcomes in obesity prevention efforts (IOM, 2004)
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Outputs • Short-term: Improved Evaluationa Capacity and Training • Core Indicators and Measures • Intermediate-term: Increased • Recommendations and Guidance Evaluationa Activities • Support for Implementation • Long-term: Enhanced Data Use FIGURE 1-1 Framework for evaluating progress of obesity prevention efforts. a Evaluation refers to assessment, monitoring, surveillance, and summative evaluation activities.
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, the main federal funders of evaluation of obesity prevention and the research that informs it, and agencies that need evaluation to accomplish their missions and objectives related to obesity prevention. existing objectives and strategies of Obesity prevention efforts The most recent among the several IOM obesity committee reports, referred to in this report as the APOP report (IOM, 2012a)
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The campaign includes 3 Strategies related to child care fall under physical activity, food and beverage, worksite, and health care environments. 22 Evaluating Obesity Prevention Efforts
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• Physical activity in child care centers • Science and practice of physical activity • Sugar-sweetened beverages • Nutritional standards for all food and beverages • Food and beverage retailing and distribution policies • Food literacy in schools Community • Enhancing the physical and built environments (citizens and civic • Physical activity-related community programs organization) • Sugar-sweetened beverages • Nutritional standards for all food and beverages • Food and beverage retailing and distribution policies • Social marketing program • Weight gain and breastfeeding Schools • Physical education and physical activity in schools (public sector)
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meta-analysis of 48 mass media health campaigns found an average effect size (mean of correlations, Mr) of only 0.09.
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Continuing cases measure success or failure of weight reduction treatment rather than prevention, or duration rather commencement of the problem. 26 Evaluating Obesity Prevention Efforts
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. The IOM report Bridging the Evidence Gap in Obesity Prevention identified ways to "locate, evaluate, and assemble evidence to inform decisions" for evidence-based practice while generating more practice-based evidence that would contribute to building a strong evidence base to identify, 5 Look AHEAD (Action for Health in Diabetes)
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Some aspects of evaluation remain necessarily incomplete or underdeveloped given the gaps in scientific knowledge of the determi nants of overweight and obesity and of the relative effectiveness of interventions for various population groups and settings. Some of the strategies for evaluating obesity prevention efforts considered, therefore, draw on the notable public health successes in the past (CDC, 2007; Isaacs and Schroeder, 2001; Ward and Warren, 2006)
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Monitoring Monitoring involves a phase of evaluation focused on the implementation of planned interventions, from the tracking of legislative proposals and policies to the adoption and the quality and extent of implementation of practices by government agencies and other organizations, or by their practitioners. Public health law and policy monitoring involves the "ongoing, systematic collection, analysis, interpretation, and dissemination of information about a given body of public health law and policy" such as state laws related to competitive food sales in schools, community zoning ordinances governing the availability of food outlets, state and school district policies governing physical education requirements, and state licensing requirements for health care providers (Chriqui et al., 2011, p.
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Second, the system must be integrated with public health activities (e.g., pro 7 In a community context, collecting baseline data of status is commonly referred to as an "assessment." Surveillance provides repeated or continuous assessments of progress or change over time. 30 Evaluating Obesity Prevention Efforts
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. Measuring Prevalence and Incidence of Obesity Today, numerous useful surveillance systems exist in the health sector for tracking obesity and obesity risk factors (e.g., diet, physical activity)
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Promoting Health Equity and Reducing Disparities Of particular concern to the Committee from the outset of its discussions was the growing recognition that evaluating progress for the nation as a whole, or even for regions of the United States, will need to pay special attention to the disparities that have accompanied the obesity epidemic. This central concern is driven in part by the commitment of the Healthy People 2020 disease prevention and health promotion objectives for the nation, which focus on the social determinants of health and the elimination of disparities in health a centerpiece (Koh et al., 2011b)
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Any solution to obesity will need to account for this com plex web of biological, behavioral, and environmental factors. Building on current evaluation methods, this systems science approach requires that evaluation planners consider the properties of a complex s ystem while evaluating obesity prevention efforts.
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and help to establish an infrastructure for monitoring progress of obesity prevention efforts at national, state, and community levels. This report answers the following questions: • Why?
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Chapter 9 offers a systems perspective for evaluating progress in obesity prevention. Measurement ideas for the HBO/IOM TWOTN campaign can be found in Chapters 6 (its national 36 Evaluating Obesity Prevention Efforts
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and are offered as examples of opportunities and challenges inherent in evaluation, considering the respective national and community obesity evaluation plans. Chapter 10 concludes the report by presenting recommended plans, action-oriented recommendations to support the implementation of the recommended plans, and measurement ideas for the HBO/IOM TWOTN campaign.
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:e47-e55. 38 Evaluating Obesity Prevention Efforts
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2009. Making evidence from research more relevant, use ful, and actionable in policy, program planning, and practice: Slips "twixt cup and lip." American Journal of Preventive Medicine 37(6 Suppl 1)
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New York: Klewer Academic/ Plenum Publishers. 40 Evaluating Obesity Prevention Efforts
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American Journal of Preventive Medicine 36(2 Suppl)
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:531-558. 42 Evaluating Obesity Prevention Efforts
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