Evaluating Obesity Prevention Efforts A Plan for Measuring Progress (2013) / Chapter Skim
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10 Taking Action: Recommendations for Evaluating Progress of Obesity Prevention Efforts
10 Taking Action: Recommendations for Evaluating Progress of Obesity Prevention Efforts
Pages 273-296
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Even modest improvement in evaluation has the potential to provide clarity and refined direction in addressing the obesity epidemic. This report provides flexible evaluation plans for the national, state, and community levels (including indicators of status and progress)
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. Obesity Evaluation Plans Evaluation plans (for assessment, monitoring, surveillance, and summative evaluation activities)
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a Community Obesity Evaluation Plan, and it recommends seven actions to support the implementation of the recommended plans. In the final part of the chapter the Committee identified measurement ideas for determining the impact of the HBO/IOM TWOTN campaign.
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Indicators of Progress One clear gap in evaluation efforts is the identification of a set of core indicators to use at the national and community levels for measuring progress in obesity prevention efforts. As a key first step in identifying this core set, the Committee identified a list of indicators that currently exist.
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Although the Committee identified important strengths of the current monitoring, surveillance, and summative evaluation data systems, limitations of current national evaluation efforts exist, the following needs resulting in: • coordinating leadership, integration, and accountability of evaluation efforts across federal agencies, within and between departments, across federal, state, and local governments, and with the nongovernmental and private sectors; • maximizing and coordinating the use of data already being collected; • identifying and prioritizing indicators at the national and community levels and developing new indicators where necessary; • improving surveillance capacity and frequency, especially for policies and environmental factors, and evaluation capacity/leadership; • improving training and support for monitoring, surveillance, and evaluation; • improving access to and dissemination of data, findings from analysis, and other information for the consumer; • collecting additional longitudinal data, including national incidence trends and local prevalence trends for obesity; • tracking and monitoring disparities and their social determinants (i.e., differential exposures/ opportunities, vulnerabilities/capabilities, and consequences) ; and • using best practices of evaluation design, including monitoring and feedback on progress on intermediate outcomes (i.e., community/system changes such as new policies, expanded pro grams, and environmental changes)
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The National Obesity Evaluation Plan is designed to organize the planning, implementa tion, and evaluation of the impact of obesity prevention interventions recommended in the APOP report at a national level. It is important to note here that the APOP report frames obesity prevention efforts in terms of policy, systems-level, and environmental approaches, which require new evaluation approaches, indicators, and measures.
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: 1. Designate a federal obesity evaluation task force or entity to oversee the implementation of the National Obesity Evaluation Plan and coordinate with relevant federal, state, local, and private-sector entities.
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, Early Head Start, and Head Start into the National Obesity Evaluation Plan j. Expand current monitoring and surveillance structures into existing data-collection systems at the national or state levels 3.
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Ensure that evaluation plans in federally funded obesity-related grants and programs include common indicators and measures that can be aggregated across communities and inform the plan.
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. Box 10-4 identifies key components to develop and implement a Community-Level Obesity Intervention Monitoring and Summative Evaluation Plan.
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. continued Taking Action 283
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NOTE: Steps are further detailed in Chapter 7. BOX 10-4 Components of a Community-Level Obesity Intervention Monitoring and Summative Evaluation Plan Purpose: To guide local action and to inform national choices about the most effective and cost-effective strategies identified in the Accelerating Progress in Obesity Prevention (APOP)
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Intended effects or outcomes 4. Focus the monitoring and summative evaluation plan.
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Recommended actions to support the development of local infrastructure and capacities for community-level intervention monitoring and summative evaluation are posited in a later section of this chapter. Finally, the National Obesity Evaluation Plan and the Community Obesity Evaluation Plan are interdependent.
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The Committee believes that one or a combination of these would be the best option for overseeing and implementing the National Obesity Evaluation Plan and for reporting to whatever agency is leading these efforts. Alternatively, the appointment of a new task force could also successfully address the need for improved leadership of evaluation of obesity prevention efforts, but the committee does not view it as necessary.
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• Create an ongoing timeline for implementation of the activities outlined in the National Obesity Evaluation Plan • Establish a process for accountability, prioritization, and adaptation by agencies reporting p eriodically to the task force/entity on their activities, and the task force/entity reporting annu ally to the agency that is leading these efforts on coordination efforts, gaps in monitoring, r ecommendations for new measures and evaluations, and progress toward meeting goals. Improve Data Collection for Evaluation Recommendation 2: Using the recommended indicators and gaps identified in this report as guides (i.e., related to Accelerating Progress in Obesity Prevention report strategies)
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and state and local health departments, in c ollaboration with nonfederal partners, should standardize the collection and analysis of data, including common indicators, measures, methods, and outcomes used for assessment, monitoring, surveillance, and summative evaluation to assure aggregation among localities and back to the National Obesity Evaluation Plan. To guide the implementation of this recommendation, potential actions to standardize the use of common indicators and measures include the following: • Promote the use of sets of core indicators for assessment at the national, state, large community, and small community levels that, at a minimum, include indicators of obesity prevalence, physi cal activity, and nutrition to assess environmental and policy changes as recommended in the APOP report (see recommended indicators in Chapter 6, Table 6-3, for national- and state-level indicators and Chapter 7, Table 7-2, for large and small communities)
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r • Promote the use of best practice templates for community-level monitoring and summative evaluations of obesity prevention efforts (see Box 10-4 and Chapter 8) , including the use of practical participatory engagement and use of a strong methodological study design and analy ses.
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Department of Agriculture, through the National Collaborative on Child Obesity Research and other nongovernmental and professional organizations, should build on their existing evaluation resources to assure support for the diverse and inter-disciplinary workforce engaged in conducting assessments, surveillance, monitoring, and summative evaluation activities. To guide the implementation of this recommendation, potential actions to improve workforce capacity include the following: • Provide standardized training on planning and designing assessments, surveillance, monitoring, and summative evaluations for policy and environmental interventions, including the use of common indicators, measurement protocols, data collection methods, and the use of qualitative methods.
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. • CDC, as well as state and local health departments, should strengthen assessment and monitor ing of environmental conditions and systems relationships among them that produce disparities 292 Evaluating Obesity Prevention Efforts
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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 leader hip, funding, s 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.
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Current community summative evaluation efforts by Prevention Research Centers (through University of North Carolina Chapel Hill) and Kaiser Permanente will provide indicators of local dosage or reach for TWOTN.
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Key activities identified in the evaluation framework and provided in this report include obesity evaluation plans at the national and community levels that provide a tool for guiding the planning, implementation, and evaluation of obesity prevention efforts. A second key activity identified in the evaluation framework is a list of indicators and sources of data and provide a source of baseline data to begin to comprehensively assess obesity prevention actions already being implemented across the country.
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