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Obesity Evaluation Toolkit: Resources for Evaluating Community-Level Obesity Prevention Efforts

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Title: Obesity Evaluation Toolkit: Resources for Evaluating Community-Level Obesity Prevention Efforts


1
Institute of Medicine
Obesity Evaluation Toolkit Resources for
Evaluating Community-Level Obesity Prevention
Efforts Webinar August 25, 2015
2
1. Introduction Leslie Sim, M.P.H. Institute
of Medicine of The National Academies of Science,
Engineering, and Medicine 2. Overview of
report, Evaluating Obesity Prevention Efforts A
Plan for Measuring Progress Lawrence W. Green,
Dr. P.H., M.P.H. University of California, San
Francisco
3
  • 3. Steps in evaluating community-level obesity
    prevention efforts
  • Stephen Fawcett, Ph.D.
  • Work Group for Community Health and Development,
    University of Kansas
  • 4. Web-based resources to support your efforts
  • Christina Holt, M.A.
  • Community Tool Box, Work Group for Community
    Health and Development, University of Kansas
  • 5. Questions

4
  • Submit questions - toolbox_at_ku.edu
  • Issues connecting? - 1-866-770-8162

5
Evaluating Obesity Prevention EffortsA Plan for
Measuring Progress
Lawrence W. Green, Chair and 13 members of The
Committee on Evaluating Progress of Obesity
Prevention Efforts
6
Committee on Evaluating Progress of Obesity
Prevention Efforts
  • Lawrence W. Green, Dr.P.H. (Chair)
  • University of California, San Francisco
  • Christina Bethell, Ph.D., M.P.H., M.B.A.
  • Johns Hopkins University
  • Ronette R. Briefel, Dr.P.H., R.D.
  • Mathematica Policy Research
  • Ross C. Brownson, Ph.D.
  • Washington University in St. Louis
  • Jamie F. Chriqui, Ph.D., M.H.S.
  • University of Illinois at Chicago
  • Stephen Fawcett, Ph.D.
  • University of Kansas
  • Brian R. Flay, D.Phil.

7
  • AN URGENT
  • NEED FOR
  • EVALUATION 

8
What we need to know from evaluation
  • Where are we in making progress and with whom?
    (current status)
  • How are we doing in making progress? (trends over
    time in assessing needs and implementation of
    policies and strategies)
  • What works in which populations?
  • What are the unintended consequences?

9
Committee on Evaluating Progress of Obesity
Prevention Efforts
  • Study Charge
  • to develop a concise and actionable plan for
    measuring progress in obesity prevention efforts
    for the nation and adaptable guidelines for
    community assessments and evaluation.

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The Concise and Actionable Plan
  • Enhanced Leadership
  • Enhanced Roadmap
  • Enhanced Capacity and Infrastructure
  • Included resources
  • Indicators for the evaluation plans
  • Tools and methods for assessing progress in
    populations at greater risk for obesity
  • Community health assessment, surveillance, and
    monitoring of interventions

12
Interdependence of National and Community Obesity
Evaluation Plans
Core indicators, Data sources, Resources,
Methodologies
Community Obesity Evaluation Plan
National Obesity Evaluation Plan
Contextual data, Feasibility, Local innovation
13
Recommendations
  1. Improve Leadership and Coordination
  2. Improve Data Collection
  3. Provide Common Guidance
  4. Improve Access to and Dissemination of
    Information
  5. Improve Workforce Capacity
  6. Address Disparities and Health Equity
  7. Support a Systems Approach

14
To access the full report and related
dissemination materials(url http//iom.nationala
cademies.org/Reports/2013/Evaluating-Obesity-Preve
ntion-Efforts-A-Plan-for-Measuring-Progress.aspx)
Interactive indicator widget
Pull-out summary of indicators
4-page report brief
15
Indicators of Progress (Excerpt from Table 4-1)
Indicator Topic Objective
OVERARCHING/SYSTEM-LEVEL INDICATORS OVERARCHING/SYSTEM-LEVEL INDICATORS
Obesity-adult Reduce the proportion of adults who are obese (body mass index (BMI) 30)
APOP GOAL AREA 1 PHYSICAL ACTIVITY ENVIRONMENT APOP GOAL AREA 1 PHYSICAL ACTIVITY ENVIRONMENT
Adult physical activity  Increase the proportion of adults who meet current federal physical activity guidelines for aerobic physical activity and for muscle-strengthening activity

16
National and State Level Indicators (excerpt,
Table 6-4)
Indicator Topica Data Source or Documentationb National Planc State Plansc WHO Proposed Indicatorsd
Overarching/System Level Overarching/System Level Overarching/System Level Overarching/System Level Overarching/System Level
Obesity-adult BRFSS NHANES     Core
2. Obesity-adolescent NHANES YRBSS     Core
3. Obesity-child NHANES     Core
Goal Area 2 Food and Beverage Environment  Goal Area 2 Food and Beverage Environment  Goal Area 2 Food and Beverage Environment  Goal Area 2 Food and Beverage Environment  Goal Area 2 Food and Beverage Environment 
28. Adult energy intake NHANES     Expanded
29. Child and adolescent energy intake NHANES     Expanded
30. Sugar-sweetened beverage policies in schools BTG CLASS SHPPS SNDA     Expanded
17
Community Level Indicators (excerpt, Table 7-2)
Indicator Topica Data Source Current Availability by Community Sizeb Current Availability by Community Sizeb
    Larger Smaller
Overarching/System-Level      
Obesity-adult BRFSS  
Overweight-adult BRFSS    
Obesity-adolescent YRBSS, School reports    
Goal Area 2 Food and Beverage Environment      
Sugar-sweetened beverage policies in schools (school district) SHPPS    
Sugar-sweetened beverage consumption YRBSS (adolescent)    
School policies to facilitate access to clean drinking water SHPPS    
Note Larger population gt50,000 Smaller
population lt 50,000
18
Some Steps in Evaluating Community-Level Obesity
Prevention EffortsStephen Fawcett, Work Group
for Community Health and Development, University
of Kansas
19
Vision for IOM Report
  • Assure collection and analysis oftimely and
    meaningful datato inform and improve
    obesityprevention efforts at national,
    state,and community levels

20
CONTEXT for Evaluation
  • Multi-component, multi-sector, and multi-level
    interventions
  • Indicators/measures of varying quality utility
  • Varying capacity, capabilities, leadership, and
    resources

21
ACTIVITIES Develop Resources for Training,
Technical Assistance, and Dissemination
  • Products/protocols/templates
  • Web-based support training
  • Curricula
  • Clearinghouses for measures
  • Communications

22
Steps/Components of a Community Evaluation Plan
(Box 8-1)
  1. Design stakeholder involvement.
  2. Identify resources for the monitoring and
    summative evaluation.
  3. Describe the interventions framework, logic
    model, or theory of change.
  4. Focus the monitoring and summative evaluation
    plan.
  5. Plan for credible methods.
  6. Synthesize and generalize.

23
1. Design stakeholder involvement
  • Identify stakeholders
  • Consider the extent of stakeholder involvement
  • Assess desired outcomes of monitoring and
    summative evaluation
  • Define stakeholder roles in the monitoring and
    summative evaluation

24
Participatory Evaluation (CBPR)
25
2. Identify resources for monitoring and
summative evaluation
  • Person-power resources
  • Data collection resources

26
Some Web-Based Data Sources(Table 7-5)
  • Community Commons CHNA.org
  • County Health Rankings
  • USDA Food Atlas
  • CDC Diabetes Interactive Atlas
  • Census ACS and County/Zip Business Patterns
  • HHS Community Health Status Indicators

27
What indicators available at local level?
  • Available for all/ many communities
  • Adult obesity/overweight
  • Activity Active transport by walking, bicycling,
    density of recreational facilities, leisure-time
    PA
  • Nutrition Adult F/V, food outlet density,
    farmers market density, food deserts, SNAP/WIC
    store density
  • Some larger communities also have
  • Youth obesity/overweight
  • Activity Youth PA, screen time, school PA
    participation
  • Nutrition SSB consumption, youth F/V

28
Data Availability (Table 7-2 Example)
29
3. Describe the interventions framework or logic
model, or theory of change.
  • Purpose or mission
  • Context or conditions
  • Inputs resources and barriers
  • Activities or interventions
  • Outputs of activities
  • Intended effects or outcomes

30
Generic logic model for community obesity
prevention (Figure 8-1, adapted).
31
4. Focus the monitoring and summative evaluation
plan.
  • Purpose or uses What does the monitoring and
    summative evaluation aim to accomplish?
  • Set priorities by end-user questions, resources,
    context
  • What questions will the monitoring and summative
    evaluation answer?
  • Ethical implications (benefit outweighs risk)

32
End-User Focused Evaluation QuestionsSome
examples
  • How fully was intervention implemented?
  • Did the intervention have desired effects?
  • What was the impact on participants/ population?
  • With whom?
  • Under what conditions?

33
5. Plan for credible methods.
  • Stakeholder agreement on methods
  • Indicators of success
  • Credibility of evidence

34
Some Emerging Methods forData Collection
  • Environmental change data
  • Documentation of initiatives
  • Unobtrusive observations
  • Secondary data (e.g., GIS)
  • Policy change data
  • Documentation of initiatives
  • Surveillance
  • Systems change data
  • Mapping changing relationships

35
Indicators of Success
  • Translate expected effects (logic model) into
    specific measurable units
  • Examples include
  • Program Outputsunits of activities delivered
  • Intermediate Outcomeschanges in communities and
    systems (program, policy, environment)
  • Behavioral Outcomeschanges in diet and physical
    activity
  • Population-level Outcomesreduced prevalence of
    obesity

36
Evaluation Designs Match to Goal/Context
Qualitative methods interviews, focus groups,
photo-voice, etc.
37
6. Synthesize and generalize.
  • Disseminating and compiling studies
  • Learning more from implementation
  • Ways to assist generalization
  • Shared sense-making and cultural competence
  • Disentangling effects of interventions

38
Logic Model Design and Shared Sensemaking
39
Obesity Evaluation ToolkitWeb-based Resources
for Community Evaluation
  • CONTEXT Distributed evaluation workforce
  • People we will never see
  • In places we will never be
  • TOOLKIT Just-in-time resources for
  • Training
  • Technical Assistance

40
Web-based resources to support your
efforts Christina Holt, M.A. Community Tool Box,
Work Group for Community Health and Development,
University of Kansas
41
Navigating to the Toolkit
  • The Obesity Evaluation Toolkit is available
    online
  • http//iom.nationalacademies.org/activities/nutrit
    ion/obesityprevprogress/resources-evaluating-commu
    nity-level-obesity-prevention-efforts

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What you will find
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Evaluation Toolkit
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Community Tool Box Example Resource
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Troubleshooting Guide
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