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Bridging the Evidence Gap in Obesity Prevention: A Framework to Inform Decision Making
Index
A
ACE-Obesity. See Assessing Cost-Effectiveness in Obesity Study
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Index
A
ACE-Obesity. See Assessing Cost-Effectiveness in Obesity Study
Adaptability, 122, 168, 295
defined, 209
Adoption, 141, 145
Advocacy groups, 201
African Americans. See Ethnicity
Alternative study designs to randomized experiments, 172–181, 277–296.
See also Research designs
how well do alternative designs work?, 180–181
American Indians. See Ethnicity
Applicability. See Generalizability
Appraisals
defining, 57, 227
Archival studies
as sources of evidence, 101
Arkansas framework for combating childhood and adolescent obesity, with national recommendations for action, 97
Assembling evidence and informing decisions, 8–9, 133–157
guidance for assembling the evidence, 135–144
knowledge integration, 154–155
the L.E.A.D. framework for obesity prevention decision making, 134
a template for summarizing the evidence, 144, 146–154
tools for assembling evidence, 145–146
Assessing Cost-Effectiveness in Obesity Study, 98
Assessment, 93–94, 97, 144.
See also Evaluating evidence
Audiences. See Target audiences
Average causal effect, 177
B
Body mass index (BMI), 23
changes in the distribution of, 24
lowering, 36, 39–40
screening in schools, 75
Building a resource base
recommendations concerning, 12–13, 203–204
C
Caloric balance. See Energy-balance equation
Campbell Collaboration, 123
Campbell perspective, 174–177, 279, 281–282, 284, 288
design elements used in constructing quasi-experiments, 178–179
Canadian Task Force on the Periodic Health Examination, 121
Cancer. See Diseases related to obesity
Cardiovascular disease. See Diseases related to obesity
Case-comparison studies. See Case-control studies
Case-control studies
as sources of evidence, 100–102
Case study research
as sources of evidence, 103–104, 109
Causal pathways, 63, 93
Causality, 27, 174–180.
See also Average causal effect;
Mapping
perspectives on, 174–180
CBO. See Congressional Budget Office
CBPR. See Community-based participatory research
CDC. See U.S. Centers for Disease Control and Prevention
Certainty.
See also Internal validity;
Level of certainty
Clarity, 8, 144.
See also Assembling evidence and informing decisions
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Cluster randomization design, 172–173
Cochrane Collaboration of Systematic Reviews, 59, 121, 138, 225
COCOMO. See Common Community Measures for Obesity Prevention
Cohort studies, 215
as sources of evidence, 100–101
Committee on an Evidence Framework for Obesity Prevention Decision Making, 2, 17, 19–22, 197
Common Community Measures for Obesity Prevention, 110, 224
Communicating and disseminating the framework, 188–193
channels, 190–191
implementation and monitoring, 192–193
messages and materials, 192
objectives, 188
partnerships, 191–192
recommendations concerning, 14–15, 205–206
target audiences, 188–190
Communities and neighborhoods
approaches designed to foster changes in, 27, 43–44
Community assessment (needs assessment), 91–93, 135
Community-based participatory research, 295
Community Preventive Services Task Force, 123
Comorbidities. See Diseases related to obesity
Comparative effectiveness research, 118–120
as areas of evidence needed, 93–94
Comparative experiments
as areas of evidence needed, 93–94
Comprehensive approach for preventing and addressing childhood obesity, 29
Conceptual frameworks for evidence selection
lack of, 57–58
Conclusions, of the L.E.A.D. framework for obesity prevention decision making, 198–201
Congressional Budget Office, 162
Consensus views. See Expert knowledge
Consolidated Standards of Reporting Trials, 121
Content analysis, 61
as sources of evidence, 104–108
Context, 5, 138
evaluating, 7–8, 115–123
influencing interventions, 63–64
from a systems perspective/rationale, 71–87, 151–152
Continuous quality assessment, of ongoing programs, 171
Coordinated Approach to Child Health program, 49
Cost/benefit analysis
as areas of evidence needed, 95–96
Cost-effectiveness analysis
as areas of evidence needed, 95–96
Cost-feasibility analysis
as areas of evidence needed, 95
Cost-minimization analysis
as areas of evidence needed, 95
Cost-utility analysis
as areas of evidence needed, 95
Cross-cutting factors, 39–40
Cross-sectional studies
as sources of evidence, 100–102
D
Decision makers, 3, 27, 201
See also Target audiences
defined, 211
and intermediaries, 22, 188–189
Decision making
comprehensive approach for preventing and addressing childhood obesity, 29
context of, 138
evidence-informed, 2
obesity prevention, and evidence needs, 26–30
physical, social, and emotional health consequences of obesity in adults, children, and youth, 27
relative risk of health problems associated with obesity in adults, 27
Defining the problem, 71–87.
See also Systems perspective
application and future directions, 83–84
relation to the L.E.A.D. framework, 83
understanding a systems approach, 72–74
uses of systems thinking, approaches, mapping, and modeling, 75–83
Delphi Method, 126–127
Design elements
that strengthen causal inferences in observational studies, 285
used in constructing quasi-experiments in Campbell’s perspective, 178–179
Desired outcomes, 194.
See also Evaluating and refining the L.E.A.D. framework
Diabetes. See Diseases related to obesity
Dietary Guidelines for Americans, 40, 46
Diseases related to obesity, 21, 26–27, 36–37
Disparities, 38–39
Dissemination
of the L.E.A.D. framework, 10, 188–193
“Downstream” approaches, 39
E
EBM. See Evidence-based medicine
EBPH. See Evidence-based public health
EBPP. See Evidence-based public policy
Ecological models, 28–29, 41–42, 72
Economic cost analysis, 288–290
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as sources of evidence, 101
Editors. See Journals and journal editors
Effectiveness research, 98, 123, 133–142, 149.
See also Generalizability;
Impact
as areas of evidence needed, 93–94
as sources of evidence, 106, 108–109
Effects,
size of, 106,
Efficacy. See Level of certainty
Energy-balance equation, 6, 18, 22–23, 37–38
Ethnicity, 24–25, 96, 173
Ethnographic studies, 103
Evaluability assessment
of emerging innovations, 170–171, 200
Evaluating and refining the L.E.A.D. framework, 193–195
adoption and utilization of, 193
data collection methods and opportunities, 194–195
desired outcomes, 194
integration of evaluation findings into the L.E.A.D. framework, 195
objectives, 193–194
recommendations concerning, 14–15, 205–206
Evaluating evidence, 7–8, 115–131, 224
approaches to, 62
criteria for assessing quality of evidence, 125–126
existing approaches to evaluating evidence, 121, 123–124
generalizability and contextual considerations, 120–122
identification of appropriate outcomes, 118–120
the L.E.A.D. framework for obesity prevention decision making, 116
a proposed approach to evaluating the quality of scientific evidence, 124–128
a user’s perspective, 117–118
when scientific evidence is not a perfect fit—trade-offs to consider, 128
Evaluating interventions.
See also Assembling evidence and informing decisions
effectiveness, 137–139
impact, 141–142
Evaluation framework
for childhood obesity prevention policies and interventions, 39
for government efforts to support capacity development for preventing childhood obesity, 119
for industry efforts to develop low-calorie and nutrient-dense beverages and promote their consumption by children and youth, 120
Evidence. See Assembling evidence and informing decisions;
Evaluating evidence;
Gaps in evidence;
Locating evidence;
Opportunities to generate evidence;
Sources of evidence;
Status of the current evidence base
Evidence-based decision making, 2, 28
in public health, 1, 60–61
Evidence-based medicine, 2, 59–60, 171
Evidence-based public health, 60–61
Evidence-based public policy, 61
Evidence-related projects, 223–226
evaluation, 224
guidelines, 223
measures, 224
systematic reviews, 224–225
uses of, 226
Evidence synthesis, 105–108, 125, 136, 139, 213
meta-analyses, 106–107
mixed-method evidence synthesis, 107–108
as sources of evidence, 105–108
syntheses of qualitative research, 107
systematic reviews, 105–106
types of evidence synthesis methods and examples of their uses, 106
Evidence tables, 149–151.
See also Assembling evidence and informing decisions
template for, 150
Existing evidence needs, 161–163
considerations for increasing evaluation of obesity prevention initiatives, 162
selected recommendations for research in childhood obesity prevention, 163
Existing tools for assembling evidence, 144–146.
See also Assembling evidence and informing decisions
Experimental and quasi-experimental studies, 101, 103, 125
types of experimental and quasi-experimental evidence and examples of their uses, 103
Experimental designs, 60, 175
Expert knowledge, 123, 126
as sources of evidence, 109–110
types of expert knowledge and examples of their uses, 110
External validity. See Generalizability
F
FCC. See Federal Communications Commission
Federal Communications Commission, 281, 283
Fidelity, 142–143
Focus groups, 65, 103
Foresight Tackling Obesities: Future Choices Project, 80–83
Form components, 143.
See also Generalizability
Foundations, 12–13, 190, 203–204.
See also Target audiences
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Framework.
See also L.E.A.D. framework
conclusions regarding, 198–201
defining, 21–22
need for, 3
objectives regarding, 193–194
Frequency, 92
Functional components, 143.
See also Generalizability
Funders. See Research funders;
Resources needed
G
Gaps in evidence, 26–30, 56–59
ways to fill, 169–171
Gathering evidence, 110–111.
See also Information sources for locating evidence
Generalizability, 7–9, 58, 62, 95–96, 116–118, 143, 166, 200
and contextual considerations, 120–123
defined, 213
evaluating, 13
limitations in the way evidence is reported in scientific journals, 166–169
quality rating criteria for external validity, 122
recommendations concerning, 13–14, 204–205
Generating evidence. See Opportunities to generate evidence
recommendations concerning, 13–14, 204–205
Geographic mapping, 102
Government, as an evidence source, 272
Grading of Recommendations Assessment, Development, and Evaluation, 144–145
Graph theoretic approach, 180
Grey and unpublished literature
as evidence sources, 271
Guidance for assembling the evidence, 135–144.
See also Assembling evidence and informing decisions
existing tools for assembling evidence, 144–146
how do we implement this information for our situation?, 142–144
what specifically should we do about this problem?, 136–142
why should we do something about this problem in our situation?, 135–136
Guidelines
other evidence projects, 223
H
Harm, 7, 28, 83
Head Start program, 279
HEALCP. See Healthy Eating Active Living Convergence Partnership
Health Canada, 145
Health communication and social marketing approaches, to obesity prevention, 44–45
Health consequences of obesity, physical, social and emotional, 27
Health disparities, 92.
See also Disparities
Health Forecasting, 127
Health impact assessment, 94, 127
Healthy Eating Active Living Convergence Partnership, 189, 191–192
HEALTHY study, 96
HHS. See U.S. Department of Health and Human Services
High-risk populations, 163
evidence to identify, 91–93
HIV. See Human immunodeficiency virus
“How” questions, 6–7, 95–96, 98–99
how do we implement this information for our situation?, 142–144, 149–150, 153–154
areas of concerns and examples of evidence needed, 95
posing “Why,” “What,” and “How” questions after a policy or program is in place, 96–98
Human immunodeficiency virus programs to prevent, 293
Hypertension. See Diseases related to obesity
I
Identification of appropriate outcomes, 118–120
evaluation framework for government efforts to support capacity development for preventing childhood obesity, 119
evaluation framework for industry efforts to develop low-calorie and nutrient-dense beverages and promote their consumption by children and youth, 120
Identifying and locating evidence
evidence synthesis methods, 105–108
an expanded view, 89–114
experimental and quasi-experimental studies, 101, 103
expert knowledge, 109–110
gathering the evidence, 110–111
the L.E.A.D. framework for obesity prevention decision making, 90
mixed-method studies, 104–105
nonexperimental or observational studies, 100–102
parallel evidence, 108–109
potentially useful, 100–110
qualitative research, 103–104
specifying questions—an evidence typology for the L.E.A.D. framework, 91–100
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Impact
of interventions, 93–94, 136–142, 149, 151–153
of the L.E.A.D. framework, 193–194
Impact evaluation (or assessment), 127
as areas of evidence needed, 93–94
Implementation, 141, 168, 192–193
of interventions, 95–96, 122, 142–144
of the L.E.A.D. framework, 192–193
Incorporating systems thinking
recommendations concerning, 12, 203
Indicated interventions, 37–38, 141, 153
Information sources for locating evidence, 269–275
government, 272
Grey and unpublished literature, 271
policies and programs, 273–275
scientific literature databases, 269–270
surveys, polls, and rankings, 272
Initiative on the Study and Implementation of Systems, 78
Institute of Medicine, 18–19, 124, 135, 161, 197
Institutionalization, of an intervention or program, 122, 168.
See also Quality rating criteria for external validity
Integration
of evaluation findings into the L.E.A.D. framework, 187, 195
of the L.E.A.D. framework into public health decision making and related research, 188, 194, 195
of relevant evidence and knowledge into systems, 154
Interdisciplinary integration, 84
Internal validity.
See also Level of certainty
key assumptions/threats to, and example remedies for randomized controlled trials and alternatives, 176
International Obesity Task Force, 65, 91
Interrupted time series analysis, 174, 176, 180, 277–278, 281–283
as sources of evidence, 101, 103–105
Interventions
defined, 215
IOM. See Institute of Medicine
IOTF. See International Obesity Task Force
ISIS. See Initiative on the Study and Implementation of Systems
Iterative steps, in system dynamics modeling, 79
ITS. See Interrupted time series analysis
J
Journals and journal editors, 11–12, 14, 15, 20, 57, 65, 110, 111, 160, 166, 190–191, 193, 200–201, 203, 205, 206, 293.
See also Target audiences
K
Kaiser Permanente, 20, 197
Knowledge integration, 134, 154, 200
defined, 215
L
L.E.A.D. framework, 5, 66–68
communication and dissemination of, 187–193
conclusions regarding, 199, 201
evaluation and refinement of, 187, 193–195
fundamental evidence concepts in, 59–65
implementing fully, 111
key assumptions guiding use of, 11, 202
and new opportunities for research, 3
for obesity prevention decision making, 67, 73
and population health problems, 55
rationale for and overview of, 55–70, 149
recommendations concerning, 14–15, 205–206
using the L.E.A.D. framework, 4–10
Level of certainty, 7, 8, 11, 59, 62, 64, 115, 118, 121, 123, 124, 127, 138, 149, 152, 161, 172, 174–176, 200, 202, 283–284, 287–288, 294.
See also Internal validity
key assumptions/threats to internal validity and example remedies for randomized controlled trials and alternatives, 176
Locate Evidence, Evaluate Evidence, Assemble Evidence, Inform Decisions. See L.E.A.D. framework
Locating evidence, 7
information sources for, 269–275
strategies for, 89–114, 148–149
Logic models/modeling, 28, 65, 135–136, 151, 294
for obesity prevention, 39–41, 119
as sources of evidence, 103–104
Longitudinal studies, 100, 102, 118, 282, 289
as sources of evidence, 100, 102
Low-income
as a risk factor for obesity, 24, 26, 163
M
Maintenance, 141, 168, 187, 201, 224
assessing the extent of for an intervention, 118
as a dimension of generalizability, 52, 122
as part of RE-AIM, 144–145
Managed care programs, 45
Mapping, 84, 104, 139, 141, 146, 293–294,
See also Matching, mapping, pooling, and patching
defined, 215
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of obesity causality in the United States, 79–81
systems, 12, 74, 203
the obesity “system”—a broad causal map, 81
MATCH. See Multilevel Approach to Community Health
Matched cohort studies
as sources of evidence, 101, 103
Matching, 139, 146, 177, 290–292, 294.
See also Matching, mapping, pooling, and patching
the Multilevel Approach to Community Health model used to align the source of evidence with the targets of an intervention, plan and evaluate programs, and integrate knowledge for community partnering, 292
Matching, mapping, pooling, and patching, 139, 160, 290–296
as tools for assembling evidence, 146
Measurement
approaches to, 64–65
of BMI in schools, 75
Menu-labeling case study, 99
Meta-analyses, 57, 105–107, 138–139, 145, 167, 171, 180, 227
Mexican Americans. See Ethnicity
Military readiness, effect of obesity on, 26
Mixed-method evidence synthesis
as sources of evidence, 107–108
Mixed-method studies, 104–105, 125,
as sources of evidence, 104–105
types of mixed-method evidence and examples of their uses, 104–105
Monitoring, the L.E.A.D. framework, 192–193
Multilevel, multisector obesity prevention approaches, 46–49
example of a multilevel approach—childhood obesity prevention in Texas, 47–49
multilevel, multisector approach to childhood obesity prevention in Texas, 48
need for, 46–47
Multilevel Approach to Community Health, 291–292
Multisite designs, 172–173.
See also Randomized controlled trials
N
National Chronic Disease Directors, 190
National Collaborative on Childhood Obesity Research, 191–192
National Health and Nutrition Examination Surveys, 1, 22–24, 45, 272
National Health Examination Survey, 22
National Health Interview Survey, 105
National Institutes of Health, 45, 127, 154, 162, 165
Native Hawaiians. See Ethnicity
Natural experiments, 9, 159, 163, 169, 200
defined, 216
NCCOR. See National Collaborative on Childhood Obesity Research
Needs assessment, 150, 216
as areas of evidence needed, 96
New York City Department of Health, 43–44, 137
Next steps, in communicating, disseminating, evaluating and refining the L.E.A.D. framework, 10, 187–195.
See also L.E.A.D. framework
communicating and disseminating the framework, 188–193
communication and dissemination plan, 187
conclusions regarding, 201
evaluating and refining the framework, 193–195
evaluation and refinement plan, 187
NHANES. See National Health and Nutrition Examination Surveys
NIH. See National Institutes of Health
Nonequivalent control group design. See Observational studies
Nonexperimental studies, 216.
See also Observational studies
O
Obesity, 1, 23, 200, 216
diseases related to, 21, 26
and health consequences in adults, children, and youth, 27
and overweight as a societywide problem, 1, 17, 22–26
prevalence of, 18, 23–25, 44
Obesity prevention approaches, 35–54
approaches designed to foster changes in communities and neighborhoods, 43–44
approaches involving changes in organizational policies, environments, and practices, 42–43
in the broader context of other public health initiatives, 49–51
considerations for increasing evaluation of, 162
current evidence base, 9–10, 55–59, 201–202, 227–267
definitions and types of prevention, 36–39
differences from obesity treatment, 21
health communication and social marketing approaches, 44–45
interventions in health care settings, 45
lessons for obesity prevention from other public health problems, 50
logic models for obesity prevention, 39–40
multilevel, multisector obesity prevention approaches, 46–49
policy and legislative approaches, 42
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population-based, 22
the spectrum of obesity prevention approaches, 41–49
target behaviors for, 41
types of, 37–39
in the United Kingdom, 80, 82–83
Obesity “system”
a broad causal map, 81
simplified version of the United Kingdom Foresight Group’s causal loop obesity system map, 82
Objectives, of communicating, disseminating, evaluating, and refining the L.E.A.D. framework, 188, 193–194
Observational studies, 65, 100–102, 125, 139, 176, 283–287
comparison of their results with results of randomized studies, 180–181
design elements that strengthen causal inferences in observational studies, 285
as evidence sources, 100–102
types of observational evidence and examples of their uses, 102
within the evidence hierarchy, 60
Opportunities to generate evidence, 5, 9–10, 117, 159–186
alternatives to randomized experiments, 172–181
existing evidence needs, 161–183
the L.E.A.D. framework for obesity prevention decision making, 161
limitations in the way evidence is reported in scientific journals, 166–169
the need for new directions and transdisciplinary exchange, 164–166
perspectives on causal inference, 174–180
recommendations concerning, 13–14, 204–205
ways to fill the gaps in the best available evidence, 169–171
Organizational policies, environments, and practices.
See also Obesity prevention approaches
approaches involving changes in, 42–43
Osteoarthritis. See Diseases related to obesity Outcomes
for decision making, as a dimension of external validity, 122
for evaluating obesity prevention interventions, 58–59
Overweight
prevalence in the United States, 1
P
Pacific Islanders. See Ethnicity
Paradigm shift in thinking about obesity prevention, 17, 35
Parallel evidence, 100, 108–109, 126
as sources of evidence, 108–109
types of parallel evidence and examples of their uses, 109
PATCH. See Planned Approach to Community Health
Patching, 139, 141, 146, 290, 295–296.
See also Matching, mapping, pooling, and patching
Planned Approach to Community Health, 295
Peer-reviewed journals. See Journals and journal editors
Physical activity. See Energy-balance equation
Planned Approach to Community Health, 295
Policies and programs as evidence sources, 273–275
Policy analysis
as sources of evidence, 101
Policy makers. See Target audiences
Policy scanning/tracking
locating, 274
as sources of evidence, 127
Pooling, 139, 140, 145, 146, 290, 293–294.
See also Matching, mapping, pooling, and patching
Population-based interventions for obesity, 35, 37, 42
challenges of applying the traditional evidence base to, 57–59
Population health problems
addressing with transdisciplinary exchange, 164–165
and the L.E.A.D. framework, 55
and a systems approach, 74
Practice-based interventions (or evidence), 14, 169, 200, 205, 294–296
Pre-/posttest designs, 175–177, 287–288
Predictive studies
as sources of evidence, 101–102
Prevalence, 77, 107, 211
and economic-cost analysis study designs, 288–290
as a measure of the scope of a problem, 99, 107, 118
of obesity compared to the paucity of the knowledge base with which to inform prevention efforts, 56
of obesity in diverse populations, 18
Prevention, of obesity in adults and children, 36
definitions and types of, 36–39
Professional organizations, 190, 204.
See also Target audiences
Program planners, 201.
See also Target audiences
Program theory analysis
as sources of evidence, 103–104
Propensity scoring, 286–287
Prospective studies, 215
Public health organizations, 12.
See also Target audiences
Public health problems—lessons for obesity prevention,
strategies to address, 50
Publishers of research findings, 4, 11, 13, 14, 22, 117, 190.
See also Journals and journal editors;
Target audiences
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Q
Qualitative research, 60, 65, 84, 103–104, 125, 137–139, 153
assessing quality of, 125–127
for evaluating evidence, 62
as sources of evidence, 100, 103–105, 107–108
synthesis of, 105, 107–108
types of qualitative evidence and examples of their uses, 104
Quality rating criteria for external validity, 122
maintenance and institutionalization, 122
outcomes for decision making, 122
program or policy implementation and adaptation, 122
reach and representativeness, 122
Quantitative data (or research), 65, 84, 125, 127, 138–139, 145, 153, 277, 279, 280–281, 295–296
Quasi-experimental studies, 60, 64, 84, 125, 138, 145, 164, 174, 178, 277, 278, 283, 287
as sources of evidence, 100–101, 103, 105–106
Questions
asked by the decision maker, 99, 147–148
that guide the gathering of evidence, 6–7, 91
that need to be answered, types of, 61–62
R
Randomized controlled trials, 57, 62, 116, 138–139, 176, 277, 280
alternatives to, 172–181
multisite designs, 172
prevailing preference for, 164
as sources of evidence, 101, 103, 105
Randomized encouragement design, 174, 176, 218
RCTs. See Randomized controlled trials
RD. See Regression discontinuity design
Reach, 122, 141, 149, 168
defined, 218
Realist reviews, 63, 106, 138, 145, 153, 219
Recommendations, of the committee, 10–15, 201–206
building a resource base, 12–13, 203–204
communicating, disseminating, evaluating, and refining the L.E.A.D. framework, 14–15, 205–206
establishing standards for evidence quality, 13, 204
incorporating systems thinking, 12, 203
supporting the generation of evidence, 13–14, 204–205
utilizing the L.E.A.D. framework, 11–12, 202–203
Reductionist research, 62, 84
Refining the L.E.A.D. framework. See Evaluating and refining the L.E.A.D. framework
Registry of reports
establishing, 203–204
Regression discontinuity design, 101, 176, 180, 277–281
illustration using the example of an evaluation of the effect of school lunch programs on children’s health, 280
Replicability, 167
Reporting likely effectiveness, 152–153
Reporting likely reach and impact, 153
Reporting template, for summarizing evidence, 146–154
evidence table, 149–151
example L.E.A.D. framework evidence report, 148–149
questions asked by the decision maker, 147
strategies for locating evidence, 148–149
summary of evidence, 151–154
Representativeness, 122, 166–168.
See also Generalizability;
Reach
Research designs, experimental and quasi-experimental common, 277–290
economic cost analysis, 288–290
interrupted time series analysis, 281–283
observational studies, 283–287
pre-/posttest designs, 287–288
regression discontinuity design, 279–281
a typology of research designs, 277
Research funders, 4, 22, 189.
See also Target audiences
recommendations for, 11, 13–15, 202–206
Research needed. See Needs assessments;
Next steps
Researchers, 3, 14, 189.
See also Target audiences
recommendations for, 11–15, 202–205
Resources needed, to utilize the L.E.A.D. framework, 11–12
Review of existing reviews on obesity prevention, 227–267
critical reviews, 260–261
integrative reviews, 230–231, 242–243, 250–251, 262–263
narrative reviews, 236–237, 248–249, 254–255
review of reviews, 250–251
reviews, 232–233, 258–259
synthesis research studies, 238–239
systematic reviews, 220, 228–235, 238–261
Risk factors. See Ethnicity;
High-risk populations;
Low-income
Risk reduction approach, 37
Robert Wood Johnson Foundation, 20, 170, 197
Rubin’s perspective, 177–178, 279, 286
potential outcomes model, 177
RWJF. See Robert Wood Johnson Foundation
S
SAMHSA. See Substance Abuse and Mental Health Services Administration
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Scientific literature
databases as evidence sources, 269–270
Secondary analysis
as sources of evidence, 100–102
Selective interventions, 37–38, 141, 153
Sensitivity analysis, 176
Sesame Street program, 278
Shape Up Somerville, 95, 289
Simplified version of the causal loop obesity system map, 82
Simulation modeling, 79
Social determinants
as areas of evidence needed, 91–93
defined, 220
Social marketing strategies, 38, 44–45
Society for Prevention Research, 123
Sources of evidence, 100–110, 140, 169–171.
See also Gathering evidence;
Identifying and locating evidence;
Information sources for locating evidence
Special Supplemental Nutrition Program for Women, Infants, and Children, 119
Specifying questions, 6–7
applying the evidence typology—an illustrative example, 98–100
an evidence typology for the L.E.A.D. framework, 91–100
“How” questions, 95–96
posing “Why,” “What,” and “How” questions after a policy or program is in place, 96–98
questions that guide the gathering of evidence, 91
“What” questions, 93–94
“Why” questions, 91–93
Spectrum of Prevention, 41, 46
Stable unit treatment value assumption, 177
Stakeholders, 15, 201, 206, 220.
See also individual stakeholders
Standards for evidence quality
recommendations concerning, 13, 204
Statistical regression, 288
Status of the current evidence base, 56–59
choice of outcomes, 58–59
lack of conceptual frameworks, 57–58
quantity of available evidence, 57
review of existing reviews on obesity prevention, 227–267
Stocks and flows, 77.
See also Systems thinking Strategic planning
as areas of evidence needed, 95
Study approach, 3–4
Study designs and methodologies, an in-depth look, 277–300
economic cost analysis, 288–290
interrupted time series analysis, 281–283
mapping, 293
matching, 290–292
observational studies, 283–286
patching, 295–296
pooling, 293–294
pre-/posttest, 287–288
regression discontinuity, 279–281
typology of research designs, 277–279
Subpopulations affected, 24–26, 38
Substance Abuse and Mental Health Services Administration, 295
Summary of evidence, 151–154.
See also Template for summarizing the evidence
Surveys, 60
polls, and rankings as evidence sources, 272
as sources of evidence, 100–102
Sustainability
as areas of evidence needed, 95–96
defined, 220
in evaluating impact of interventions, 144
SUTVA. See Stable unit treatment value assumption Syntheses
existing tools, 144–146
of information from disparate sources, 139–141
methods, of evidence, 105–108, 126
of qualitative research, 107
research studies, 238–239
System dynamics, 74
Systematic reviews, 60, 105–106, 224–225
Systems approach, 71–74
Systems investigation, 74
Systems perspective, 5–6, 36, 64, 71–87, 221
importance of, 30
logic models and the complexity of interventions, 136–137
Systems science, 74
Systems theory, 74
Systems thinking, 74
concepts and variables in, 76–77
encouraging the use of, 12
increasing understanding of, 11
uses of, examples, 75–83
T
Target audiences, of the L.E.A.D. framework, 3–4, 22, 188–190, 201
decision makers and intermediaries, 188–189
other important audiences, 189–190
publishers of research results, 190
research funders, 189
researchers, 189
OCR for page 322
Bridging the Evidence Gap in Obesity Prevention: A Framework to Inform Decision Making
Target populations, 38.
See also Subpopulations affected
Template for summarizing the evidence, 144, 146–154.
See also Assembling evidence and informing decisions
elements of the reporting template, 146–148
evidence table, 149–151
question asked by the decision maker, 147–148
strategy for locating evidence, 148–149
summary of evidence, 151–154
Texas, multi-level approach to childhood obesity prevention, 47–49
Tobacco control movement, 50–51, 75, 78–79, 140, 169
lessons for obesity prevention, 43, 46
sources of evidence, as natural experiments, 169
systems thinking, 75–79
Transdisciplinary research, 164–166
Transdisciplinary team science
factors facilitating and constraining, 165
Transferability. See Generalizability
Translation, 10, 32, 154, 201, 215, 221
of evidence, 96
of an intervention, 95–96
knowledge translation, 154
Transparency in decision making, 64
Transparent Reporting of Evaluations with Nonrandomized Designs, 121
Trends, in obesity rates, 23–26, 92
Typology of research designs, experimental and quasi-experimental, 277.
See also Research designs
U
Universal interventions, 37–38, 40, 141, 153
“Upstream” approaches, 39
U.S. Centers for Disease Control and Prevention, 12, 20, 45, 49, 127, 169–170, 190, 197, 203, 291
U.S. Department of Agriculture, 192
U.S. Department of Health and Human Services, 192
Secretary of, 12–13, 203–204
U.S. Preventive Services Task Force, 121, 123, 127
U.S. Surgeon General, 50
USDA. See U.S. Department of Agriculture
Uses of systems thinking, approaches, mapping, and modeling, 75–83
BMI screening in schools, 75
mapping of obesity causality in the United States, 79–81
obesity prevention in the United Kingdom, 80, 82–83
primer on concepts and variables in systems thinking, 76–77
the tobacco control movement, 75, 78–79
Using the L.E.A.D. framework, 4–10
assembling evidence and informing decisions, 8–9
evaluating evidence, 7–8
to inform decisions, 147
locating evidence, 7
opportunities to generate evidence, 9–10
recommendations concerning, 11–12, 202–203
specifying questions, 6–7
systems perspective, 5–6
USPSTF. See U.S. Preventive Services Task Force
V
Validity, 221.
See also Generalizability;
Level of certainty
external, 7, 62, 64, 121–123, 168, 175
internal, 7, 62, 64, 175–176, 282, 284
VERBTM campaign, 45
W
Washington State Department of Health, 152–153
“What if” scenarios, 83.
See also Systems thinking
“What” questions, 6–7, 93–94, 98–99
areas of concerns and examples of evidence needed, 93
posing “Why,” “What,” and “How” questions after a policy or program is in place, 96–98
what specifically should we do about this problem?, 136–142, 149–153
WHO. See World Health Organization
“Why” questions, 6–7, 91–93, 96, 99
areas of concerns and examples of evidence needed, 92
posing “Why,” “What,” and “How” questions after a policy or program is in place, 96–98
why should we do something about this problem in our situation?, 135–136, 148, 150–151
WIC. See Special Supplemental Nutrition Program for Women, Infants, and Children
Within-subjects design, 177.
See also Rubin’s perspective
Women’s Health Initiative Dietary Modification Trial, 173
World Cancer Research Fund, 40
World Health Organization, 37
