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Suggested Citation:"Front Matter." Institute of Medicine. 2009. Community Perspectives on Obesity Prevention in Children: Workshop Summaries. Washington, DC: The National Academies Press. doi: 10.17226/12705.
×

COMMUNITY PERSPECTIVES ON OBESITY PREVENTION IN CHILDREN

Workshop Summaries

Paula Tarnapol Whitacre, Annina Catherine Burns, Cathy Liverman, and Lynn Parker, Rapporteurs

Food and Nutrition Board

INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

Washington, D.C.
www.nap.edu

Suggested Citation:"Front Matter." Institute of Medicine. 2009. Community Perspectives on Obesity Prevention in Children: Workshop Summaries. Washington, DC: The National Academies Press. doi: 10.17226/12705.
×

THE NATIONAL ACADEMIES PRESS

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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This study was supported by Contract No. OPVT-8390 between the National Academy of Sciences and The California Endowment. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

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Suggested citation: IOM (Institute of Medicine). 2009. Community Perspectives on Obesity Prevention in Children: Workshop Summaries. Washington, DC: The National Academies Press.

Suggested Citation:"Front Matter." Institute of Medicine. 2009. Community Perspectives on Obesity Prevention in Children: Workshop Summaries. Washington, DC: The National Academies Press. doi: 10.17226/12705.
×

“Knowing is not enough; we must apply.

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—Goethe

INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES


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Suggested Citation:"Front Matter." Institute of Medicine. 2009. Community Perspectives on Obesity Prevention in Children: Workshop Summaries. Washington, DC: The National Academies Press. doi: 10.17226/12705.
×

THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering, and Medicine


The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.


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Suggested Citation:"Front Matter." Institute of Medicine. 2009. Community Perspectives on Obesity Prevention in Children: Workshop Summaries. Washington, DC: The National Academies Press. doi: 10.17226/12705.
×

PLANNING COMMITTEE FOR COMMUNITY PERSPECTIVES ON OBESITY PREVENTION*

PATRICIA CRAWFORD (Chair),

School of Public Health and Department of Nutritional Sciences and Toxicology, University of California, Berkeley

SARAH SAMUELS,

Samuels and Associates, Oakland, California

MARY T. STORY,

Department of Pediatrics, School of Medicine at the University of Minnesota

Study Staff

ANNINA CATHERINE BURNS, Study Director

LYNN PARKER, Scholar

NICOLE FERRING, Research Associate

MATTHEW B. SPEAR, Senior Program Assistant

PAULA TARNAPOL WHITACRE, Consultant Science Writer

CATHY LIVERMAN, Scholar

ANTON L. BANDY, Financial Associate

GERALDINE KENNEDO, Administrative Assistant

LINDA D. MEYERS, Director, Food and Nutrition Board

*

Institute of Medicine (IOM) planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.

Suggested Citation:"Front Matter." Institute of Medicine. 2009. Community Perspectives on Obesity Prevention in Children: Workshop Summaries. Washington, DC: The National Academies Press. doi: 10.17226/12705.
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Suggested Citation:"Front Matter." Institute of Medicine. 2009. Community Perspectives on Obesity Prevention in Children: Workshop Summaries. Washington, DC: The National Academies Press. doi: 10.17226/12705.
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Reviewers

JUNE 2008 WORKSHOP SUMMARY

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this report:

TRACY A. FOX, Food, Nutrition & Policy Consultants, LLC, Washington, DC

ESMERALDA GONZALEZ, Stanislaus County Health Services Agency, Modesto, California

GAIL G. HARRISON, University of California, Los Angeles Center for Health Policy Research

SARAH SAMUELS, Samuels & Associates, Oakland, California

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the final draft of the report before its release. The review of this report was overseen by CATHERINE ROSS, Department of Nutritional Sciences, The Pennsylvania

Page viii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2009. Community Perspectives on Obesity Prevention in Children: Workshop Summaries. Washington, DC: The National Academies Press. doi: 10.17226/12705.
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State University. Appointed by the Institute of Medicine, she was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authors and the institution.

Suggested Citation:"Front Matter." Institute of Medicine. 2009. Community Perspectives on Obesity Prevention in Children: Workshop Summaries. Washington, DC: The National Academies Press. doi: 10.17226/12705.
×

Reviewers

MAY 2009 WORKSHOP SUMMARY

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this report:

LEANN L. BIRCH, Center for Childhood Obesity Research, Pennsylvania State University, State College, Pennsylvania

TRACY A. FOX, Food, Nutrition & Policy Consultants, LLC, Washington, DC

LESLIE MIKKELSEN, Prevention Institute, Oakland, California

EDUARDO J. SANCHEZ, Blue Cross and Blue Shield of Texas, Richardson, Texas

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the final draft of the report before its release. The review of this report was overseen by HUGH TILSON, School of Public Health, University of North Carolina. Appointed

Suggested Citation:"Front Matter." Institute of Medicine. 2009. Community Perspectives on Obesity Prevention in Children: Workshop Summaries. Washington, DC: The National Academies Press. doi: 10.17226/12705.
×

by the Institute of Medicine, he was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authors and the institution.

Suggested Citation:"Front Matter." Institute of Medicine. 2009. Community Perspectives on Obesity Prevention in Children: Workshop Summaries. Washington, DC: The National Academies Press. doi: 10.17226/12705.
×

Preface

Obesity among the nation’s children has increased dramatically over the past several decades. Recent statistics show that nearly one-third of U.S. children and adolescents are overweight or obese, which puts their physical and emotional health at risk, severely compromises their future well-being, and adds significant costs to the country’s already massive health care expenditures. As the public health threat of childhood obesity has become clear, the issue has become the focus of local, state, and national initiatives. Many of these efforts are centered on the community environment in recognition of the role of environmental factors in individual behaviors related to food and physical activity.

These efforts have shown that the seemingly simple formula for preventing obesity of consuming fewer calories than expended must take into account the social, environmental, and policy-related factors that affect eating and physical activity. Otherwise, success is almost impossible to sustain over the long term. In many communities, for example, fresh produce is not available or affordable, streets and parks are not amenable to exercise, and policies and economic choices make fast food cheaper and more convenient than healthier alternatives. Addressing such factors can have an impact on obesity rates across communities by creating conditions that facilitate healthier options for children and their families. In the past few years, recognizing the consequences of inaction, a growing number of nonprofit organizations, government agencies, policy makers, and others have stepped up their efforts to combat the obesity epidemic. Carried out in diverse settings and with diverse populations, these efforts have resulted in

Suggested Citation:"Front Matter." Institute of Medicine. 2009. Community Perspectives on Obesity Prevention in Children: Workshop Summaries. Washington, DC: The National Academies Press. doi: 10.17226/12705.
×

many promising approaches that encompass the community context rather than focusing solely on individual weight-loss programs.

These community efforts vary in scope and scale; overall, however, they remain fragmented, and little is known about their effectiveness. At the local level, communities are struggling to determine which obesity prevention programs to initiate and how to evaluate their impact. Recommendations presented in recent Institute of Medicine (IOM) reports on prevention of childhood obesity1,2 include actions that can be taken by multiple stakeholders and all sectors to improve children’s nutrition, increase their physical activity, and decrease their sedentary time. According to the 2005 IOM report Preventing Childhood Obesity: Health in the Balance:

Given that obesity is a serious health risk, preventive actions should be taken even if there is as-yet-incomplete scientific evidence on the interventions to address specific causes and correlates of obesity. However, there is an obligation to accumulate appropriate evidence not only to justify a course of action but to assess whether it has made a difference. As childhood obesity is a serious public health problem calling for immediate reductions in obesity prevalence and in its health and social consequences, the committee strongly believes that actions should be based on the best available evidence—as opposed to waiting for the best possible evidence. (p. 3)

In this context, the IOM’s Food and Nutrition Board held two workshops—in June 2008 and May 2009—funded by The California Endowment. The purpose of the workshops was to inform the IOM’s current work on obesity prevention in children through input from individuals who are actively engaged in community- and policy-based obesity prevention programs. Community perspectives were elicited on the challenges involved in undertaking policy and programmatic interventions aimed at preventing childhood obesity, and on approaches to program implementation and evaluation that have shown promise. Highlights of the workshop presentations and discussions are presented in this volume.

1

 IOM (Institute of Medicine). 2005. Preventing Childhood Obesity: Health in the Balance. Washington, DC: The National Academies Press.

2

IOM. 2007. Progress in Preventing Childhood Obesity: How Do We Measure Up? Washington, DC: The National Academies Press.

Suggested Citation:"Front Matter." Institute of Medicine. 2009. Community Perspectives on Obesity Prevention in Children: Workshop Summaries. Washington, DC: The National Academies Press. doi: 10.17226/12705.
×

SUMMARY OF WORKSHOP 2: MAY 2009

 

 

 

 

SUMMARY

 

19

4

 

INTRODUCTION

 

25

   

 Workshop Themes,

 

25

   

 Community Voices and Evidence,

 

27

   

 Report Organization,

 

28

5

 

COMMUNITY-BASED PROGRAMS: HOW DOES INFORMATION HELP THEM ACHIEVE THEIR GOALS?

 

29

   

 Providing Opportunities for Recreation in Densely Populated Santa Ana, California,

 

31

   

 Developing a Citywide Blueprint for Health in Baltimore,

 

34

   

 Collaborating on a Regional Level in Central California,

 

38

   

 Focusing on an Underserved Ward in Washington, DC,

 

40

   

 Discussion,

 

44

6

 

RESEARCH AND ADVOCACY GROUPS: HOW DOES EVIDENCE INFORM POLICY?

 

47

   

 Understanding Challenges to Advocacy for Obesity Prevention,

 

48

   

 Establishing the Burden of Evidence,

 

51

   

 Connecting Research and Action,

 

54

   

 Organizing the Community in Support of Obesity Prevention,

 

58

   

 Discussion,

 

60

7

 

DECISION MAKERS: HOW DO COMMUNITY PERSPECTIVES INFLUENCE POLICY?

 

63

   

 Support for Recreation and Open Space in Fairfax City, Virginia,

 

64

   

 Rigor of Evidence in New York Food Policy,

 

66

   

 “Culture of Fitness” in Arlington, Virginia,

 

68

   

 Efforts to Speak Out on Obesity Prevention in Montgomery County, Maryland,

 

69

   

 Evidence in Minnesota Health Policy Decisions,

 

70

   

 Reframing of the Conversation in Washington, DC,

 

72

   

 Discussion,

 

73

8

 

CLOSING REMARKS

 

75

   

 Diversity of Efforts,

 

75

   

 A Movement Versus Discrete Policies and Programs,

 

75

   

 Communication Is Key,

 

76

   

 Core Data,

 

76

   

 Community Knowledge,

 

77

Suggested Citation:"Front Matter." Institute of Medicine. 2009. Community Perspectives on Obesity Prevention in Children: Workshop Summaries. Washington, DC: The National Academies Press. doi: 10.17226/12705.
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 REFERENCES

 

79

 

 

APPENDIXES

 

 

A

 

Workshop Agendas

 

81

B

 

Biographical Sketches

 

85

C

 

Workshop Attendees

 

93

Suggested Citation:"Front Matter." Institute of Medicine. 2009. Community Perspectives on Obesity Prevention in Children: Workshop Summaries. Washington, DC: The National Academies Press. doi: 10.17226/12705.
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As the public health threat of childhood obesity has become clear, the issue has become the focus of local, state, and national initiatives. Many of these efforts are centered on the community environment in recognition of the role of environmental factors in individual behaviors related to food and physical activity. In many communities, for example, fresh produce is not available or affordable, streets and parks are not amenable to exercise, and policies and economic choices make fast food cheaper and more convenient than healthier alternatives.

Community efforts to combat obesity vary in scope and scale; overall, however, they remain fragmented, and little is known about their effectiveness. At the local level, communities are struggling to determine which obesity prevention programs to initiate and how to evaluate their impact.

In this context, the Institute of Medicine held two workshops to inform current work on obesity prevention in children through input from individuals who are actively engaged in community- and policy-based obesity prevention programs. Community perspectives were elicited on the challenges involved in undertaking policy and programmatic interventions aimed at preventing childhood obesity, and on approaches to program implementation and evaluation that have shown promise. Highlights of the workshop presentations and discussions are presented in this volume.

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