Accelerating Progress in Obesity Prevention Solving the Weight of the Nation (2012) / Chapter Skim
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Appendix B: Methodology: Development of the Committee's Recommendations
Appendix B: Methodology: Development of the Committee's Recommendations
Pages 407-426
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Complementary (and parallel) to the set of filtering criteria, an approach was used to help identify relationships and synergies among the recommendations with the most promise to accelerate progress in obesity prevention.
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The 2005 IOM report Preventing Childhood Obesity: Health in the Balance and the 2005 Transportation Research Board report Does the Built Environment Influence Physical Activity? demonstrated increasing recognition of the complex, multifaceted nature of the many factors that influence energy bal ance (IOM, 2005; TRB/IOM, 2005)
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Review and Filtering Each recommendation that met the above inclusion criteria was reviewed and coded on several dimensions based on the committee's guiding principles (see Chapter 4) so the committee could assess its promise for accelerating progress in obesity prevention over the next decade.
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The committee focused its searches by first seeking and using literature syntheses and updates, and if no recent syntheses were found, searched for evidence on the particular recommendation of interest and also reached out to states, communities, and localities that have implemented an intervention for implementation-related research. Accelerating Progress in Obesity Prevention 410
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As the committee gathered and reviewed prior recommendations, it became increasingly clear that to identify which recommendations were most likely to accelerate progress in obesity prevention, the committee needed to understand and map how the various recommendations would interact and reinforce or perhaps inhibit progress. To this end, it was necessary to understand that for each recommendation under consideration, there was a primary mechanism by which change would be effected and that each had a set of prerequisites, accelerants, and inhibitors that could potentially come into play during its implementation.
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The arrows are directional, indicating the flow of influence from one shape to another. An Accelerating Progress in Obesity Prevention 412
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impacts the strategy of food literacy in schools (a circle labeled 5 at the left and lower in the map) because a simplified nutrition labeling system makes it easier for students to act on the nutrition guidelines taught in schools.
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B-1.eps FIGURE B-1 Committee's systems map for understanding and visualizing the interconnectedness bitmap of its recommendations and strategies. Accelerating Progress in Obesity Prevention 414
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Coverage of and access to and incen tives for obesity prevention, screening, diagnosis, and treatment (18) Healthy eating and active living at work (19)
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Accelerating Progress in Obesity Prevention 416
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However, the systems map also shows that through its connection to strategy 6 (sugar-sweetened beverages) , strategy 14 also indirectly influences recommendation B (reduce unhealthy food and beverage options and increase healthier options)
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bitmap Accelerating Progress in Obesity Prevention 418
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, a two-step connection. It affects recommendation D by a slightly longer chain, from strategy 15→6→18 (healthy eating and active living at work)
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provided additional guidance on healthy eating for the committee. These guidelines are based on the latest scientific evi Accelerating Progress in Obesity Prevention 420
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The Physical Activity and Dietary Guidelines for Americans support the prevention of overweight and obesity through the overarching concept of maintaining calorie balance over time to achieve and sustain a healthy weight. To maintain calorie balance, the guidelines highlight that individuals should improve physical activity and eating behaviors, increase physical activity and reduce sedentary behavior, control total calorie intake, and maintain appropriate calorie balance over the life span.
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These guidelines provide a strong evidence base on how proper physical activity levels and a healthy diet help individuals maintain a healthy body weight and contribute to progress in obesity prevention. Key Physical Activity Guidelines and overarching concepts in the Dietary Guidelines include the following: 1.
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Recommendations for prevention of childhood obesity (Davis et al., 2007) Promising strategies for creating healthy eating and active living environments (Lee et al., 2008a)
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National physical activity plan for the United States (National Physical Activity Plan, 2010) Statement of policy, comprehensive obesity prevention (NACCHO, 2010)
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2011a. Early childhood obesity prevention policies.
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Washington, DC: Executive Office of the President of the United States. Accelerating Progress in Obesity Prevention 426
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