Progress in Preventing Childhood Obesity How Do We Measure Up? (2007) / Chapter Skim
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report, Preventing Childhood Obesity: Health in the Balance. Following the release of the Health in the Balance report, the Robert Wood Johnson Foundation asked the IOM to assess progress in childhood obesity prevention actions across a variety of sectors and also to engage in a dissemination effort that would promote the implementation of the 2005 report's findings and recommendations through three regional symposia.
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The crosscutting themes that emerged from all three symposia to support childhood obesity prevention efforts were to forge strategic partnerships, educate stakeholders, increase resources, and empower local schools, communities, and neighborhoods. This report, Progress in Preventing Childhood Obesity: How Do We Measure Up?
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The committee emphasizes the need for a collective commitment to evaluation by those responsible for funding, planning, implementing, and monitoring childhood obesity prevention efforts. Although resources are limited, evaluation should be incorporated as an essential component of the program planning and implementation process rather than as an optional activity.
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The translation of evaluation and research findings into promising practices constitutes the primary means for accelerating national efforts to reverse the childhood obesity epidemic. Since the need for effective evaluation is ongoing, both the capacity and quality of evaluation will be positively influenced by a steadfast national commitment to support obesity prevention efforts and the rapid translation and dissemination of evaluation and research findings -- across the geographical landscape -- to stakeholders involved in obesity prevention efforts in states and communities.
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. The evaluation framework also illustrates the range of inputs and outcomes while giving careful consideration to the following factors: • The interconnections and quality of interactions within and among the multiple sectors involved in childhood obesity prevention initiatives.
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6 OUTCOMES RESOURCES & INPUTS STRATEGIES & SECTORS ACTIONS • Programs Structural, Leadership Health Cognitive • Policies Institutional, Strategic Planning Outcomes and Social • Surveillance Systemic Government Political Commitment Outcomes Reduce BMI and Monitoring Outcomes Industry Levels in • Research Communities the • Education Schools Population • Partnerships Home Behavioral Adequate Funding and • Coalitions Reduce Outcomes Environmental Capacity Development • Coordination Obesity Outcomes • Dietary • Collaboration Prevalence • Physical • Communication Activity Reduce • Marketing Obesity and Promotion Related • Product Morbidity Development • New Technologies Crosscutting Factors that Influence the Evaluation of Policies and Interventions Age; sex; socioeconomic status; race and ethnicity; culture; immigration status and acculturation; biobehavioral and gene-environment interactions; psychosocial status; social, political, and historical contexts. FIGURE S-1 Evaluation framework for childhood obesity prevention policies and interventions.
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All of these factors should be taken into account when designing, monitoring, and evaluating obesity prevention initiatives as depicted in Figure S-1. The committee has identified several relevant criteria that can be used to judge the design and quality of interventions and encourages funders and program planners to consider the following actions: • Include diverse perspectives and attend to the sub-populations in the greatest need of prevention actions -- particularly underserved, low income, and high-risk populations that experience health disparities; • Use relevant empirical evidence relevant to the specific context when designing and implementing the intervention; • Identify similar or potentially synergistic efforts and make important cross-sectoral linkages and sustained collaborations; and • Link structural, environmental, and behavioral changes in individu als and populations relevant to childhood obesity prevention.
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4. Evaluation serves to foster collective learning, accountability, responsibility, and cost-effectiveness to guide improvements in childhood obesity prevention policies and programs.
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Recommendation 2: Policy makers, program planners, program imple menters, and other interested stakeholders -- within and across relevant sectors -- should evaluate all childhood obesity prevention efforts, strengthen the evaluation capacity, and develop quality interventions that take into account diverse perspectives, that use culturally relevant approaches, and that meet the needs of diverse populations and contexts. • Federal and state government departments and agencies should consistently evaluate the effects of all actions taken to prevent childhood obesity and strengthen the evaluation capacity, paying particular attention to culturally relevant evaluation approaches.
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• Community stakeholders and relevant partners should expand the capacity for local-level surveillance and applied research and should develop tools for community self-assessment to support childhood obesity prevention efforts. • Schools and school districts should conduct self-assessments to enhance and sustain a healthy school environment, and mecha nisms for examining links between changes in the school environ ment and behavioral and health outcomes should be explored.
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• Industry should collaborate with the public sector and other rel evant stakeholders to develop a mechanism for sharing propri etary data and a sustainable funding strategy that can inform and support childhood obesity prevention interventions. • Community stakeholders should partner with foundations, gov ernment agencies, faith-based organizations, and youth-related organizations to publish and widely disseminate the evaluation results of community-based childhood obesity prevention efforts.
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The purpose of the task force would be to ensure coordinated budgets, policies, and requirements for obesity prevention programs and to establish effective interdepartmental collaboration and priorities for action. Furthermore, the federal government should provide a sustained commitment and long-term investment in childhood obesity prevention initiatives found to be effective (such as the VERB™ campaign)
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Communities Communities vary widely in the extent and nature of the resources available to be used in changing the built and social environments to facilitate physical activity and access to foods and beverages that contribute to a healthful diet. A number of state and local governments, foundations, nonprofit and youth-related organizations, faith-based organizations, and community coalitions are demonstrating innovative and collaborative approaches to childhood obesity prevention.
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As is true for community efforts, wide variations in the extent of the efforts and resources available for investment in obesity prevention by individual schools, school districts, and state agencies are observed. Federal law requires that schools receiving federal funds for school meals must develop school wellness policies by the fall of 2006, which has stimulated school-based health promotion and obesity prevention efforts across the country.
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Incremental changes are valuable and signal that progress is occurring. Conclusion A succinct assessment of the nation's progress in preventing childhood obesity is not feasible given the diverse and varied nature of America's communities and population.
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