Evaluating Obesity Prevention Efforts A Plan for Measuring Progress (2013) / Chapter Skim
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9 Systems and Evaluation: Placing a Systems Approach in Context
9 Systems and Evaluation: Placing a Systems Approach in Context
Pages 255-272
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A systems approach to obesity prevention evaluation efforts can build on current evaluation methods and improve our understanding on the relationships and their impact among the Accelerating Progress in Obesity Prevention (IOM, 2012a) report strategies, outcomes, and stakeholders across a variety of settings.
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The "what happened" question context is representative of a static, i ndependent, linear situation that potentially describes some combination of what has happened, when it 256 Evaluating Obesity Prevention Efforts
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. A systems approach to taking action demands respecting the characteristics of systems noted above and considering leverage points that may influence change within a complex system -- attempting to identify the "best choice" for action.
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. 258 Evaluating Obesity Prevention Efforts
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Their partici pation in building systems maps tends to unearth causal loops that experts and others from outside the community would not anticipate. Systems and Evaluation: Placing a Systems Approach in Context 259
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. Properties to consider include the following: 260 Evaluating Obesity Prevention Efforts
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• Resource allocation that addresses obesity prevention is related to other areas competing for the same resources. With all of these properties to consider, using a systems perspective for evaluating obesity prevention efforts is challenging.
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, the combined and coordinated set of activities implemented at the individual, com TABLE 9-1 Places to Intervene in a Complex System and the Associated Evaluation Objectives Level Definition/Description Evaluation Objective Structural elements Subsystems, actors, and the physical structure Assess level of coherence among the components of the system of the system Feedback and delays Self-regulation, self-reinforcement, and Assess degree to which the system operates in adaptation of the system. Reinforcing loops a continuous manner, and assess the likelihood for driving growth and balancing loops for that the system will or will not grow constraining goals Structure Enhancing connections across most of the Assess degree to which interdependent elements system as a whole in a network work together Goals What the system is trying to achieve Evaluate how well the system adapts to its environment Paradigm A system's deepest belief Understand the degree to which the system acts as a learning environment SOURCES: Adapted from Finegood, 2011; Malhi et al., 2009; and Meadows, 2008.
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Simple rules and system levels can be used to identify opportunities to take action and may be r egarded as a fundamentally different way of thinking about how to approach complex problems, such as obesity. Using a Systems Perspective to Address Population Health: A Review of Prior IOM Reports Previous IOM consensus committees have applied systems thinking to identify the types of evidence and research needed to guide decision making around obesity prevention; to identify promising strategies and actions; to anticipate the effects and unanticipated consequences of actions; and to explore different pathways through which interventions can lead to changes -- for better or worse -- in population behavior and health outcomes.
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, which use data-driven assumptions to guide their predictions (Levy et al., 264 Evaluating Obesity Prevention Efforts
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. The ReThink Health dynamics simulation model was designed to help planners to test different quantitatively estimated effects of scenarios by tracking changes in health status, utilization, costs, and equity following different intervention options (ReThink Health, 2012)
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, one real izes that complex social networks serve as an example of a systems approach to evaluation that includes Inputs: Stakeholders' needs/goals; current context for systems-oriented evaluations; need for systems-oriented evaluation Vision: Networks and Impacts: Multi-sector/multi-level Activities: Need for identifying multi-level feedback loops that partnerships; improved physical, policy, process-oriented indicators; develop the include individuals, and social systems; reduction of plan to monitor/evaluate; and develop families, peers, geographic (spatial) disparities resources for technical assistance communities, regions, states, and the nation Outputs: Recommended set of core environmental change indicators and measures leveraging networks, identifying Outcomes: Improved evaluation/surveillance capacity and leaders, and enabling continuous learning infrastructure; activities; and data use and pooling of findings and best practices; with a systems lens protocols and guidance for systems evaluations; participatory evaluation to engage stakeholders FIGURE 9-3 Examples of how various systems approaches to evaluation may be applied to obesity prevention efforts in the context of the Committee's evaluation framework.
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These researchers compared the results of a projected impact of taxing caloric sweetened beverages on obesity prevalence based on the extrapola tion of a static weight loss prediction model to the results of a dynamic simulation model. The static model, presented in a report by the U.S.
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" when taking 268 Evaluating Obesity Prevention Efforts
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Finally, the chapter considers how systems may be applied to the Committee's proposed evaluation framework. A systems approach may be useful to describe interrelationships among the many variables and elements that are involved in obesity and prevention efforts.
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:139-154. 270 Evaluating Obesity Prevention Efforts
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2012. Summary of the ReThink Health dynamics simulation model.
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