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2 Improving the Usefulness of Obesity Evaluation Information to Potential Users
Pages 43-72

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From page 43...
... , federal and state government agency staff that manage programs and resources, nongovernmental organizations at all levels, advocates of policy changes at all levels, opponents of such advocacy, local coalitions, local officials and local program managers, researchers and evaluators, employers, and health care providers and insurers. Table 2-1 summarizes the roles and needs of the users of obesity evaluation information that are detailed in this chapter.
From page 44...
... TABLE 2-1  Users of Obesity Evaluation Information and Their Roles and Needs Evaluation User Role Needs Community • provide differing perspectives and • to know why it is important to take action on partners or priorities obesity prevention compared to other problems coalitions • efforts depend on partnerships for • knowledge of which strategies are effective for their sustainability specific situation • information about implementation and lessons learned from other places • clear communication strategies to convey information effectively • to know options for action • often require some guidance about how to implement options Local decision • may lead or be part of formal • to track progress to know when to apply course makers and community coalitions corrections, manage implementation, and emphasize managers • often are drivers for change or de-emphasize a course of action • innovate and share information • timely and accessible data at the local level about how to institute and • a good sense of "what works" implement relevant policies • assess strategies recommended by decision makers to determine whether the strategies are feasible, acceptable, and likely effective • be responsive and accountable to constituents and external funders Health care • health care providers: opportunity • health care providers: better information on "what providers and to guide patients about healthful works" for them to recommend, in the specific health insurance diet and physical activity context of their communities and health care plans • health insurance plans: interest settings in the evaluation to manage the • nonprofit hospitals: knowledge of "what works" at financial risk related to health a community level to assure good use of resources consequences of excess weight • health insurance plans: cost-effectiveness of various strategies for building the business case for employers and consumers • health insurance plans: standardized data collection • health insurance plans: information on community program resources • health insurance plans: data to target and refine communication Employers • control access to the workplace, • confidence that wellness programs will reduce not an important and pervasive setting only health care costs, but also absenteeism and for health promotion health-related productivity losses • knowledge to create the best program for their workforce 44 Evaluating Obesity Prevention Efforts
From page 45...
... TABLE 2-1 Continued Evaluation User Role Needs Federal and state • power to greatly influence obesity • comparative effectiveness of alternative strategies policy makers prevention in government, along with cost and cost-effectiveness business, and nonprofit • geopolitical jurisdiction comparisons organizations • best way to define issues • make and administer policy at • funder organizations: need to hold grantee federal and state levels organizations accountable for the use of funds • clear and easily digestible information to help frame choices and correctly interpret evidence Advocates • essential to the policy • be visible and persistent development process, particularly • decide on which prevention strategies to focus for public health • information from the research community • often serve as knowledge brokers to support claims about "what works" and applicability to the populations at greatest risk • information on what similar communities and states are doing • knowledge of whether specific advocacy appeals or framing of the issues and stratagems work in different contexts • information on policy progress and the needs for improvement Federal and • oversee accountability and • a variety of data elements that are not always state agency reporting requirements for funds available administrators distributed to state and local levels • indicators such as changes in programs, policies, for initiatives or environments for planning and mid-course • dissemination, translation, and corrections local implementation • best available evidence of effectiveness • external validity and generalizability Funder • keep the policy conversation going • see indicators of progress on the way to health and Organizations • champion continued social and social changes system changes • tangible signs of progress both in interventions and • educate to encourage advocacy for outcomes to retain the interest of leadership and change at all levels boards of trustees • publicize progress • evidence about what works in community-level initiatives to invest resources Improving the Usefulness of Obesity Evaluation Information to Potential Users 45
From page 46...
... According to our interviews, once community partners or coalitions are motivated to do some thing about obesity prevention, they need to know which strategies are effective and what they should do in their specific situation, given the strengths and limitations revealed by the community assessments 46 Evaluating Obesity Prevention Efforts
From page 47...
... Now that guided tools and specific data such as GIS and community assessments are required activities for health departments and nonprofit hospitals, they offer opportunities for community leaders and community coalitions to focus their obesity prevention efforts. However, no one knows how much these tools are used.
From page 48...
... . Yet, in New York State, researchers piloting and field-testing an evalua tion instrument had difficulty identifying community stakeholders outside of health departments who were knowledgeable about community assessments (Myers and Stoto, 2006; Stoto et al., 2009)
From page 49...
... These approaches include community-based par Improving the Usefulness of Obesity Evaluation Information to Potential Users 49
From page 50...
... Such knowledge brokers at the community level can include the staff of health departments, universities or colleges, and nonprofit organizations that are organized for this purpose. State health departments and the more than 2,800 community health depart ments in the United States have the potential to play a special and sustainable role in implementing com munity obesity prevention, and in particular in the conduct and use of community obesity prevention evaluations (Blanck and Kim, 2012)
From page 51...
... . Recent data from the National Survey of Energy Balance Related Care among Primary Care Physicians indicates that knowledge levels of energy balance guidelines (i.e., physical activity, diet, and weight)
From page 52...
... . With passage of the Patient Protection and Affordable Care Act, wellness programs are likely to expand further as more employers start to self-insure and begin to see pre vention savings accrue directly to their bottom line.
From page 53...
... Policy makers fill essential roles in government, business, and nonprofit organizations and have power to greatly influence obesity prevention. An example of the pervasive importance of federal agency Improving the Usefulness of Obesity Evaluation Information to Potential Users 53
From page 54...
... For example, the YMCA and accred iting and licensing bodies like the National Association for Family Child Care set standards for physical activity in their programs based on best evidence and what is feasible (National Association for Family Child Care, 2013; YMCA, 2011)
From page 55...
... . For obesity prevention and physical activity, the Community Preventive Services Task Force BOX 2-2 Policy Evaluation Improves Foods Sold and Served in Schools Research and evaluation have long helped to shape policy for the federally funded child nutrition programs.
From page 56...
... . Examples include the state-by-state childhood obesity report cards developed to inform policy makers at the state level using data from the National Survey of Children's Health in combination with state policy summaries (Childhood Obesity Action Network, 2009)
From page 57...
... " The Committee's interviews and workshops also indicated that political opposition to many of the suggested strategies demands that advocates rely on the research community to be able to support claims about "what works" and their particular applicability to the populations at great Improving the Usefulness of Obesity Evaluation Information to Potential Users 57
From page 58...
... Recognizing the need for such support, knowledge brokers such as the Data Resource Center for Child and Adolescent Health provide hands-on consultation to family advocates who want to integrate data findings quickly into their efforts around childhood obesity and related topics (The Child and Adolescent Health Measurement Initiative, 2012)
From page 59...
... . They are well positioned to offer technical assistance and to leverage resources for prevention Improving the Usefulness of Obesity Evaluation Information to Potential Users 59
From page 60...
... . Some state health departments, however, suffer from the same evaluation capacity problems seen among community coalitions and decision makers.
From page 61...
... Yet the legitimate BOX 2-6 Use of the Community Dashboard by the Healthy Kids, Healthy Communities Program Healthy Kids, Healthy Communities is funded by the Robert Wood Johnson Foundation (RWJF) to support policy and environmental changes in 49 communities nationwide.
From page 62...
... , CTG by the Patient Protection and Affordable Care Act's Prevention and Public Health Fund (CDC, 2013b) , Racial and Ethnic Approaches to Community Health (REACH)
From page 63...
... Improving the Usefulness of Obesity Evaluation Information to Potential Users 63
From page 64...
... ," (2) "What works to prevent 64 Evaluating Obesity Prevention Efforts
From page 65...
... Evaluation users operate at federal, state, and community levels, and in at least three contexts: the policy-making process (Dunn, 2011; Kingdon, 2011) ; dissemination and diffusion of obesity prevention strategies (Brownson et al., 2012; Rogers, 2003)
From page 66...
... 2010. The Kaiser Permanente Community Health Initiative: Overview and evaluation design.
From page 67...
... 2007. Research to study and disseminate evidence of effective community health assessments.
From page 68...
... Washington, DC: The National Academies Press. 68 Evaluating Obesity Prevention Efforts
From page 69...
... Oxford: Elsevier. Improving the Usefulness of Obesity Evaluation Information to Potential Users 69
From page 70...
... 70 Evaluating Obesity Prevention Efforts
From page 71...
... :33-40. Improving the Usefulness of Obesity Evaluation Information to Potential Users 71
From page 72...
... . 72 Evaluating Obesity Prevention Efforts


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