WASHINGTON -- The United States lags behind other international plans to evaluate obesity prevention efforts, and the country needs to know whether these efforts are having their intended impact, says a new report from the Institute of Medicine. The committee that wrote the report concluded that more systematic and routine evaluations could help determine how well obesity prevention programs and policies are being implemented and which interventions work best. The committee also recommended specific national and community plans for evaluation of obesity prevention efforts.
Investment in obesity program and policy evaluation is too sporadic, presenting serious barriers to understanding the impact of interventions and the need for future investments, the committee said. Moreover, current data monitoring systems inadequately track progress of some programs, and such monitoring is needed at both the national and community levels. Although many monitoring systems exist, the national systems lack adequate leadership, coordination, infrastructure, guidance, accountability, and capacity. Furthermore, local communities do not have the necessary guidance, capacity, data, and resources for assessing the status of obesity, identifying prevention needs, monitoring obesity prevention actions, evaluating their short-term outcomes, and tracking their long-term effects on obesity reduction.
To guide future efforts to inform and improve obesity prevention at the national, state, and community levels, the committee designed separate but interdependent national and community obesity evaluation plans that prioritize activities and leverage existing resources. The plans provide frameworks for obtaining end-user input, choosing indicators and measures for data collection and analysis, and improving the evaluation structure -- specifically the success of policy and environmental strategies recommended in the 2012 IOM report Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation.
Evaluation efforts lack an agreed-upon set of core indicators that could be used at the national and community levels for measuring and comparing progress in obesity prevention. As a starting point for developing the core set, the committee identified 83 indicators about which data are currently collected that could be incorporated into the national and community evaluation plans and provide guidance to improve the infrastructure and capacities of longer-term evaluations.
The evaluation plans outlined in the report will not be fully realized, however, without coordinated changes across multiple federal, state, and local government agencies and departments in collaboration with other nongovernmental partners responsible for obesity prevention-related activities, the committee said. It recommended the creation of an obesity task force or other entity to oversee and lead the implementation of the national plan and provide support to the community plan. In addition, relevant federal agencies, state and local health departments, and other pertinent organizations should enhance evaluation efforts through improved data collection, common guidance, access to and dissemination of data, work-force ability, capacity to address disparities and health equity, and integration of a systems approach in evaluation efforts.
The study was sponsored by the Michael & Susan Dell Foundation. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies. A committee roster follows.
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Indicators for Measuring Progress in Obesity Prevention
Table - Measuring Progress in Obesity Prevention: Indicators and Data Sources
Pre-publication copies of Evaluating Obesity Prevention Efforts: A Plan for Measuring Progress are available from the National Academies Press on the Internet at http://www.
INSTITUTE OF MEDICINE
Food and Nutrition Board
Committee on Evaluating Progress of Obesity Prevention Efforts
Lawrence W. Green, Dr.P.H., M.P.H. (chair)
Department of Epidemiology and Biostatistics
School of Medicine
University of California
Christina Bethell, Ph.D.
Professor of Pediatrics
School of Medicine, and
Child and Adolescent Health Measurement Initiative
National Data Resource Center for Child and Adolescent Health
Oregon Health & Science University
Ronette R. Briefel, Dr.P.H.
Mathematica Policy Research Inc.
Ross C. Brownson, Ph.D.
Professor of Epidemiology
Brown School of Social Work and School of Medicine
Jamie F. Chriqui, Ph.D.
Senior Research Scientist
Health Policy Center
Institute for Health Research and Policy
University of Illinois
Stephen Fawcett, Ph.D.
Kansas Health Foundation Distinguished Professor
Department of Applied Behavioral Science, and
Work Group for Community Health and Development
University of Kansas
Brian R. Flay, Ph.D.
Department of Public Health, and
Promise Neighborhoods Research Consortium
Oregon State University
Deanna M. Hoelscher, Ph.D.
Professor and Director
Michael & Susan Dell Center for Healthy Living
School of Public Health
University of Texas
James W. Krieger, M.P.H., M.D.
Chronic Disease and Injury Prevention
Public Health - Seattle & King County
Laura C. Leviton, Ph.D.
Senior Adviser for Evaluation
Robert Wood Johnson Foundation
K.M. Venkat Narayan, M.D.
Hubert Professor of Global Health and Epidemiology, and Professor of Medicine
Division of Biological and Biomedical Sciences
Rollins School of Public Health
Nico P. Pronk, Ph.D.
Vice President, and
Health Science Officer
Lorrene Ritchie, Ph.D.
Director of Research
Atkins Center for Weight and Health
University of California
Elsie Taveras, M.P.H.
Division of General Pediatrics, and
Pediatric Population Health Management
Massachusetts General Hospital, and
Department of Pediatrics and Population Medicine
Harvard Medical School
Leslie J. Sim