Evaluating Obesity Prevention Efforts A Plan for Measuring Progress (2013) / Chapter Skim
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4 Indicators for the Evaluation Plans
4 Indicators for the Evaluation Plans
Pages 95-114
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T he Committee was charged to identify and develop indicators that could be used at the national and community levels for measuring progress of obesity prevention efforts. The Statement of Task called for the Committee to draw from the indicators included in the Institute of Medicine (IOM)
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An objective is a statement of movement in an indicator toward a quantita 96 Evaluating Obesity Prevention Efforts
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. Measurement over time will reflect results of action; that is, if action is taken, then tangible results will indicate improvements in various aspects of the 1 Leading Health Indicators are a subset of the Healthy People 2020 indicators selected for priority health issues (www.healthypeople.gov)
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goal 98 Evaluating Obesity Prevention Efforts
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(2009) recommendations for total and rate of weight gain based on pre-pregnancy BMI 11 Birth weight Increase the number of children with a birth weight that is appropriate for their gestational age 12 Maternal pre-pregnancy weight Reduce the proportion of women whose pre-pregnancy weight is considered obese or overweight 13 Maternal post-pregnancy weight Reduce the proportion of women who are considered obese or overweight post-pregnancy APOP GOAL AREA 1: PHYSICAL ACTIVITY ENVIRONMENT 14 Adult physical activity Increase the proportion of adults who meet current federal physical activity guidelines for aerobic physical activity and for muscle-strengthening activityb,c 15 Adolescent physical activity Increase the proportion of adolescents who meet current federal physical activity guidelines for aerobic physical activityb 16 Child and adolescent daily Increase the proportion of children aged 6-17 who engage in at least 20 minutes vigorous physical activity per day of vigorous physical activity Strategy 1-1: Enhance the physical and built environment 17 Joint/shared use of community Increase the proportion of the nation's public and private schools that provide facilities access to their physical activity spaces and facilities for all persons outside of normal school hours (i.e., before and after the school day, on weekends, and during summer and other vacations)
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or cognitive function who engage in light, moderate, or vigorous leisure-time physical activitiesb Strategy 1-2: Provide and support community programs designed to increase physical activity 26 Nonschool organized physical Increase the proportion of children aged 6-17 who participate in one or more activity–related activities organized physical activities outside of school, such as sports teams or lessons, clubs, or organizations Strategy 1-3: Adopt physical activity requirements for licensed child care providers 27 Physical activity requirements Increase the number of states with licensing regulations for physical activity in for licensed child care child care that require a number of minutes of physical activity per day or by length of time in care (physical activity is defined to include large muscle or gross motor activity, development, and/or equipment as well as vigorous or moderate physical activity) b APOP GOAL AREA 2: FOOD AND BEVERAGE ENVIRONMENT 28 Adult energy intake Reduce the mean calories consumed among adults to meet Dietary Guidelines for Americans recommendations for age, gender, and activity levels 29 Child and adolescent energy Reduce the mean calories consumed among children and adolescents aged 2-19 intake to meet Dietary Guidelines for Americans recommendations for age, gender, and activity levels Strategy 2-1: Adopt policies and implement practices to reduce overconsumption of sugar-sweetened beverages 30 Sugar-sweetened beverage States and school districts adopt policies that prohibit the sale of sugar-sweetened policies in schools beverages in schools and require that schools offer a variety of no- or low-calorie beverage options that are favorably pricedd 31 Sugar-sweetened beverage Reduce energy intake from consumption of sugar-sweetened beveragesd consumption 32 Price of low-fat milk Reduce the relative price of low-fat milk (compared to soda/sweetened beverages)
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APOP GOAL AREA 3: MESSAGING ENVIRONMENT Strategy 3-1: Develop and support a sustained, targeted physical activity and nutrition social marketing program 48 Funding for national social Federal funding for sustained, targeted physical activity and nutrition social marketing program marketing campaign, and designation of a lead federal agency to oversee itd Strategy 3-2: Implement common standards for marketing foods and beverages to children and adolescents 49 Television marketing of foods Increase the proportion of foods and beverages marketed to children and and beverages to children and adolescents that are recommended by the Dietary Guidelines for Americans and adolescents reduce the proportion of foods and beverages marketed that are not recommended by the Dietary Guidelines for Americans continued Indicators for the Evaluation Plans 101
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providing population-based primary prevention services in the following area: physical activityb 55 BMI measurement by physicians Increase the proportion of primary care physicians who regularly measure the body mass index of their patientsb 56 Nutrition and weight counseling Increase the proportion of physician office visits that include counseling or by physicians education related to nutrition or weightb 57 Physical activity-related Increase the proportion of physician office visits that include counseling or counseling by physicians education related to physical activity Strategy 4-2: Ensure coverage of, access to, and incentives for routine obesity prevention, screening, diagnosis, and treatment 58 Insurance incentives for Increase the number of health plans that include incentives for maintaining healthful lifestyles healthful lifestylesd 59 Obesity screening and promotion Increase the number of health plans that promote obesity screening and strategies offered by health plans preventiond 60 Obesity screening and Increase the number of health care plans that use innovative reimbursement prevention reimbursement strategies for screening and obesity prevention servicesd strategies offered by health plans 102 Evaluating Obesity Prevention Efforts
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hospitals with policies and practices to support breastfeedingd 67 Employer lactation-support Increase the proportion of employers that have worksite lactation-support programs programsb 68 Breastfeeding disparities Reduce disparities in breastfeeding initiation and maintenanced APOP GOAL AREA 5: SCHOOLS AND CHILD CARE ENVIRONMENTSe Strategy 5-1: Require quality physical education and opportunities for physical activity in schools 69 Daily school physical education Increase the proportion of adolescents who participate in daily school physical educationb 70 Daily school physical education Increase the proportion of public and private schools that require daily physical education for all studentsb 71 School recess -- state Increase the number of states that require regularly scheduled elementary school recessb 72 School recess -- school district Increase the proportion of school districts that require regularly scheduled elementary school recessb 73 School recess time Increase the proportion of school districts that require or recommend elementary school recess for an appropriate period of timeb Strategy 5-2: Ensure strong nutritional standards for all foods and beverages sold or provided through schools 74 Availability of healthy food Increase the proportion of school districts that require schools to make fruits or options in schools vegetables available whenever other food is offered or soldb 75 School Breakfast Program in Increase the proportion of schools with a School Breakfast Programb schools 76 Child dietary intake in school Increase the proportion of children and adolescents aged 5-18 who consume foods and beverages at school recommended by the Dietary Guidelines for Americansd continued Indicators for the Evaluation Plans 103
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as examples of indicators that could be used by independent evaluators who wish to design their own obesity prevention evaluation studies. The list of 104 Evaluating Obesity Prevention Efforts
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The Committee was not able to assess which indicators might be the "best" in every case or which combination(s) of indicators might be ideal for the national and/or community plans or for individual obesity prevention evaluation studies.
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3 Bridging the Gap (BTG) • Availability of healthy food options in • National, state schools • Daily school physical education • School Breakfast Program in schools • School policies to facilitate access to clean drinking water • School recess -- state • School recess -- school district • School recess time • Sugar-sweetened beverage policies in schools • Sugar-sweetened beverage taxation 4 Centers for Disease Control and • Policies that promote physical activity • State Prevention (CDC)
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• Gestational weight gain • Maternal post-pregnancy weight • Maternal pre-pregnancy weight 12 National Ambulatory Medical • Insurance incentives for healthy • National Care Survey (NAMCS) lifestyles • Nutrition and weight counseling by physicians • Obesity screening and prevention reimbursement strategies • Obesity screening and promotion strategies offered by health plans • Physical activity-related counseling by physicians 13 National College Health • College nutrition education • National Assessment (NCHA)
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20 National Immunization Survey • Breastfeeding disparities • National, state, selected (NIS) large urban areas 21 National Profile of Local Health • Community-based primary prevention • National Departments nutrition-related services • Community-based primary prevention physical activity–related services 22 National Resource Center for • Nutrition standards in child care • State Health and Safety in Child Care • Physical activity requirements for and Early Education -- State licensed child care Licensing Information 108 Evaluating Obesity Prevention Efforts
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physical activity Resources and Services • Child and adolescent physical activity– Administration (HRSA) related attitudes and perceptions region • Exclusive breastfeeding • Nonschool organized physical activity– related activities 24 National Survey of Employer- • Employee health promotion programs • National Sponsored Health Plans • Employee participation in health promotion programs 25 National Survey of Maternity • Hospital breastfeeding policies • National, state Practices in Infant Nutrition and Care (mPINC)
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schools large districts • Daily school physical education • Joint/shared use of community facilities • National Health Education Standards • Nutrition professional development for teachers • School Breakfast Program in schools • School policies to facilitate access to clean drinking water • School recess • Sugar-sweetened beverage policies in schools 33 School Nutrition Dietary • Availability of healthy food options in • National Assessment Study (SNDA) schools • Farm-to-School programs • Federal school meal standards • School Breakfast Program in schools • Sugar-sweetened beverage policies in schools 34 State Birth Registries/Birth • Birth weight • State Records Databases • Exclusive breastfeeding • Gestational weight gain (for states using 2003 revised live birth certificates)
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These obesity prevention–related indicators do not directly link to APOP topics, but they are important for the Committee's national and community plans, as well as for independent obesity prevention–related evaluation studies. Such broader, population health and prevention indicators would offer perspective to obesity prevention efforts and would help to relate grassroots priorities and action to achievement of community and national improvements in health outcomes.
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• Availability of free easily accessible potable water • Surveillance of local policies on sugar-sweetened beverages • Surveillance of local policies on nutrition standards for foods and beverages provided to preschool-aged children in child care 112 Evaluating Obesity Prevention Efforts
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Accelerating Progress in Obesity Prevention (IOM, 2012)
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:164-170. 114 Evaluating Obesity Prevention Efforts
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