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, 172181, 277296.

See also Research designs

how well do alternative designs work?, 180181

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, 89, 133157

guidance for assembling the evidence, 135144

knowledge integration, 154155

the L.E.A.D. framework for obesity prevention decision making, 134

a template for summarizing the evidence, 144, 146154

tools for assembling evidence, 145146

Assessing Cost-Effectiveness in Obesity Study, 98

Assessment, 9394, 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, 3940

screening in schools, 75

Building a resource base

recommendations concerning, 1213, 203204

C

Caloric balance. See Energy-balance equation

Campbell Collaboration, 123

Campbell perspective, 174177, 279, 281282, 284, 288

design elements used in constructing quasi-experiments, 178179

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, 100102

Case study research

as sources of evidence, 103104, 109

Causal pathways, 63, 93

Causality, 27, 174180.

See also Average causal effect;

Mapping

perspectives on, 174180

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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Index A B ACE-Obesity. See Assessing Cost-Effectiveness in Obesity Body mass index (BMI), 23 Study changes in the distribution of, 24 Adaptability, 122, 168, 295 lowering, 36, 39–40 defined, 209 screening in schools, 75 Adoption, 141, 145 Building a resource base Advocacy groups, 201 recommendations concerning, 12–13, 203–204 African Americans. See Ethnicity Alternative study designs to randomized experiments, C 172–181, 277–296. See also Research designs how well do alternative designs work?, 180–181 Caloric balance. See Energy-balance equation American Indians. See Ethnicity Campbell Collaboration, 123 Applicability. See Generalizability Campbell perspective, 174–177, 279, 281–282, 284, 288 Appraisals design elements used in constructing quasi-experiments, defining, 57, 227 178–179 Archival studies Canadian Task Force on the Periodic Health Examination, as sources of evidence, 101 121 Arkansas framework for combating childhood and Cancer. See Diseases related to obesity adolescent obesity, with national recommendations Cardiovascular disease. See Diseases related to obesity for action, 97 Case-comparison studies. See Case-control studies Assembling evidence and informing decisions, 8–9, Case-control studies 133–157 as sources of evidence, 100–102 guidance for assembling the evidence, 135–144 Case study research knowledge integration, 154–155 as sources of evidence, 103–104, 109 the L.E.A.D. framework for obesity prevention decision Causal pathways, 63, 93 making, 134 Causality, 27, 174–180. See also Average causal effect; a template for summarizing the evidence, 144, 146–154 Mapping tools for assembling evidence, 145–146 perspectives on, 174–180 Assessing Cost-Effectiveness in Obesity Study, 98 CBO. See Congressional Budget Office Assessment, 93–94, 97, 144. See also Evaluating CBPR. See Community-based participatory research evidence CDC. See U.S. Centers for Disease Control and Prevention Audiences. See Target audiences Certainty. See also Internal validity; Level of certainty Average causal effect, 177 Clarity, 8, 144. See also Assembling evidence and informing decisions 

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Cluster randomization design, 172–173 Cost-minimization analysis Cochrane Collaboration of Systematic Reviews, 59, 121, as areas of evidence needed, 95 138, 225 Cost-utility analysis COCOMO. See Common Community Measures for as areas of evidence needed, 95 Obesity Prevention Cross-cutting factors, 39–40 Cohort studies, 215 Cross-sectional studies as sources of evidence, 100–101 as sources of evidence, 100–102 Committee on an Evidence Framework for Obesity Prevention Decision Making, 2, 17, 19–22, 197 D Common Community Measures for Obesity Prevention, 110, 224 Decision makers, 3, 27, 201. See also Target audiences Communicating and disseminating the framework, defined, 211 188–193 and intermediaries, 22, 188–189 channels, 190–191 Decision making implementation and monitoring, 192–193 comprehensive approach for preventing and addressing messages and materials, 192 childhood obesity, 29 objectives, 188 context of, 138 partnerships, 191–192 evidence-informed, 2 recommendations concerning, 14–15, 205–206 obesity prevention, and evidence needs, 26–30 target audiences, 188–190 physical, social, and emotional health consequences of Communities and neighborhoods obesity in adults, children, and youth, 27 approaches designed to foster changes in, 27, 43–44 relative risk of health problems associated with obesity Community assessment (needs assessment), 91–93, 135 in adults, 27 Community-based participatory research, 295 Defining the problem, 71–87. See also Systems perspective Community Preventive Services Task Force, 123 application and future directions, 83–84 Comorbidities. See Diseases related to obesity relation to the L.E.A.D. framework, 83 Comparative effectiveness research, 118–120 understanding a systems approach, 72–74 as areas of evidence needed, 93–94 uses of systems thinking, approaches, mapping, and Comparative experiments modeling, 75–83 as areas of evidence needed, 93–94 Delphi Method, 126–127 Comprehensive approach for preventing and addressing Design elements childhood obesity, 29 that strengthen causal inferences in observational Conceptual frameworks for evidence selection studies, 285 lack of, 57–58 used in constructing quasi-experiments in Campbell’s Conclusions, of the L.E.A.D. framework for obesity perspective, 178–179 prevention decision making, 198–201 Desired outcomes, 194. See also Evaluating and refining Congressional Budget Office, 162 the L.E.A.D. framework Consensus views. See Expert knowledge Diabetes. See Diseases related to obesity Consolidated Standards of Reporting Trials, 121 Dietary Guidelines for Americans, 40, 46 Content analysis, 61 Diseases related to obesity, 21, 26–27, 36–37 as sources of evidence, 104–108 Disparities, 38–39 Context, 5, 138 Dissemination evaluating, 7–8, 115–123 of the L.E.A.D. framework, 10, 188–193 influencing interventions, 63–64 “Downstream” approaches, 39 from a systems perspective/rationale, 71–87, 151–152 Continuous quality assessment, of ongoing programs, 171 E Coordinated Approach to Child Health program, 49 Cost/benefit analysis EBM. See Evidence-based medicine as areas of evidence needed, 95–96 EBPH. See Evidence-based public health Cost-effectiveness analysis EBPP. See Evidence-based public policy as areas of evidence needed, 95–96 Ecological models, 28–29, 41–42, 72 Cost-feasibility analysis Economic cost analysis, 288–290 as areas of evidence needed, 95 Index 

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as sources of evidence, 101 Evidence-based decision making, 2, 28 Editors. See Journals and journal editors in public health, 1, 60–61 Effectiveness research, 98, 123, 133–142, 149. See also Evidence-based medicine, 2, 59–60, 171 Generalizability; Impact Evidence-based public health, 60–61 as areas of evidence needed, 93–94 Evidence-based public policy, 61 as sources of evidence, 106, 108–109 Evidence-related projects, 223–226 Effects, evaluation, 224 size of, 106, guidelines, 223 Efficacy. See Level of certainty measures, 224 Energy-balance equation, 6, 18, 22–23, 37–38 systematic reviews, 224–225 Ethnicity, 24–25, 96, 173 uses of, 226 Ethnographic studies, 103 Evidence synthesis, 105–108, 125, 136, 139, 213 Evaluability assessment meta-analyses, 106–107 of emerging innovations, 170–171, 200 mixed-method evidence synthesis, 107–108 Evaluating and refining the L.E.A.D. framework, 193–195 as sources of evidence, 105–108 adoption and utilization of, 193 syntheses of qualitative research, 107 data collection methods and opportunities, 194–195 systematic reviews, 105–106 desired outcomes, 194 types of evidence synthesis methods and examples of integration of evaluation findings into the L.E.A.D. their uses, 106 framework, 195 Evidence tables, 149–151. See also Assembling evidence objectives, 193–194 and informing decisions recommendations concerning, 14–15, 205–206 template for, 150 Evaluating evidence, 7–8, 115–131, 224 Existing evidence needs, 161–163 approaches to, 62 considerations for increasing evaluation of obesity criteria for assessing quality of evidence, 125–126 prevention initiatives, 162 existing approaches to evaluating evidence, 121, selected recommendations for research in childhood 123–124 obesity prevention, 163 generalizability and contextual considerations, 120–122 Existing tools for assembling evidence, 144–146. identification of appropriate outcomes, 118–120 See also Assembling evidence and informing the L.E.A.D. framework for obesity prevention decision decisions making, 116 Experimental and quasi-experimental studies, 101, 103, a proposed approach to evaluating the quality of 125 scientific evidence, 124–128 types of experimental and quasi-experimental evidence a user’s perspective, 117–118 and examples of their uses, 103 when scientific evidence is not a perfect fit—trade-offs Experimental designs, 60, 175 to consider, 128 Expert knowledge, 123, 126 Evaluating interventions. See also Assembling evidence and as sources of evidence, 109–110 informing decisions types of expert knowledge and examples of their uses, effectiveness, 137–139 110 impact, 141–142 External validity. See Generalizability Evaluation framework for childhood obesity prevention policies and F interventions, 39 for government efforts to support capacity development FCC. See Federal Communications Commission for preventing childhood obesity, 119 Federal Communications Commission, 281, 283 for industry efforts to develop low-calorie and nutrient- Fidelity, 142–143 dense beverages and promote their consumption by Focus groups, 65, 103 children and youth, 120 Foresight Tackling Obesities: Future Choices Project, Evidence. See Assembling evidence and informing 80–83 decisions; Evaluating evidence; Gaps in evidence; Form components, 143. See also Generalizability Locating evidence; Opportunities to generate Foundations, 12–13, 190, 203–204. See also Target evidence; Sources of evidence; Status of the current audiences evidence base  Index

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Framework. See also L.E.A.D. framework Health Canada, 145 conclusions regarding, 198–201 Health communication and social marketing approaches, defining, 21–22 to obesity prevention, 44–45 need for, 3 Health consequences of obesity, physical, social objectives regarding, 193–194 and emotional, 27 Frequency, 92 Health disparities, 92. See also Disparities Functional components, 143. See also Generalizability Health Forecasting, 127 Funders. See Research funders; Resources needed Health impact assessment, 94, 127 Healthy Eating Active Living Convergence Partnership, 189, 191–192 G HEALTHY study, 96 HHS. See U.S. Department of Health and Human Gaps in evidence, 26–30, 56–59 Services ways to fill, 169–171 High-risk populations, 163 Gathering evidence, 110–111. See also Information evidence to identify, 91–93 sources for locating evidence HIV. See Human immunodeficiency virus Generalizability, 7–9, 58, 62, 95–96, 116–118, 143, 166, “How” questions, 6–7, 95–96, 98–99 200 how do we implement this information for our and contextual considerations, 120–123 situation?, 142–144, 149–150, 153–154 defined, 213 areas of concerns and examples of evidence needed, 95 evaluating, 13 posing “Why,” “What,” and “How” questions after a limitations in the way evidence is reported in scientific policy or program is in place, 96–98 journals, 166–169 Human immunodeficiency virus quality rating criteria for external validity, 122 programs to prevent, 293 recommendations concerning, 13–14, 204–205 Hypertension. See Diseases related to obesity Generating evidence. See Opportunities to generate evidence recommendations concerning, 13–14, 204–205 I Geographic mapping, 102 Government, as an evidence source, 272 Identification of appropriate outcomes, 118–120 Grading of Recommendations Assessment, Development, evaluation framework for government efforts to and Evaluation, 144–145 support capacity development for preventing Graph theoretic approach, 180 childhood obesity, 119 Grey and unpublished literature evaluation framework for industry efforts to develop as evidence sources, 271 low-calorie and nutrient-dense beverages and Guidance for assembling the evidence, 135–144. See also promote their consumption by children and youth, Assembling evidence and informing decisions 120 existing tools for assembling evidence, 144–146 Identifying and locating evidence how do we implement this information for our evidence synthesis methods, 105–108 situation?, 142–144 an expanded view, 89–114 what specifically should we do about this problem?, experimental and quasi-experimental studies, 101, 136–142 103 why should we do something about this problem in our expert knowledge, 109–110 situation?, 135–136 gathering the evidence, 110–111 Guidelines the L.E.A.D. framework for obesity prevention decision other evidence projects, 223 making, 90 mixed-method studies, 104–105 nonexperimental or observational studies, 100–102 H parallel evidence, 108–109 potentially useful, 100–110 Harm, 7, 28, 83 qualitative research, 103–104 Head Start program, 279 specifying questions—an evidence typology for the HEALCP. See Healthy Eating Active Living Convergence L.E.A.D. framework, 91–100 Partnership Index 

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K Impact of interventions, 93–94, 136–142, 149, 151–153 Kaiser Permanente, 20, 197 of the L.E.A.D. framework, 193–194 Knowledge integration, 134, 154, 200 Impact evaluation (or assessment), 127 defined, 215 as areas of evidence needed, 93–94 Implementation, 141, 168, 192–193 of interventions, 95–96, 122, 142–144 L of the L.E.A.D. framework, 192–193 L.E.A.D. framework, 5, 66–68 Incorporating systems thinking communication and dissemination of, 187–193 recommendations concerning, 12, 203 conclusions regarding, 199, 201 Indicated interventions, 37–38, 141, 153 evaluation and refinement of, 187, 193–195 Information sources for locating evidence, 269–275 fundamental evidence concepts in, 59–65 government, 272 implementing fully, 111 Grey and unpublished literature, 271 key assumptions guiding use of, 11, 202 policies and programs, 273–275 and new opportunities for research, 3 scientific literature databases, 269–270 for obesity prevention decision making, 67, 73 surveys, polls, and rankings, 272 and population health problems, 55 Initiative on the Study and Implementation of Systems, 78 rationale for and overview of, 55–70, 149 Institute of Medicine, 18–19, 124, 135, 161, 197 recommendations concerning, 14–15, 205–206 Institutionalization, of an intervention or program, 122, using the L.E.A.D. framework, 4–10 168. See also Quality rating criteria for external Level of certainty, 7, 8, 11, 59, 62, 64, 115, 118, 121, validity 123, 124, 127, 138, 149, 152, 161, 172, 174–176, Integration 200, 202, 283–284, 287–288, 294. See also Internal of evaluation findings into the L.E.A.D. framework, validity 187, 195 key assumptions/threats to internal validity and of the L.E.A.D. framework into public health decision example remedies for randomized controlled trials making and related research, 188, 194, 195 and alternatives, 176 of relevant evidence and knowledge into systems, 154 Locate Evidence, Evaluate Evidence, Assemble Evidence, Interdisciplinary integration, 84 Inform Decisions. See L.E.A.D. framework Internal validity. See also Level of certainty Locating evidence, 7 key assumptions/threats to, and example remedies for information sources for, 269–275 randomized controlled trials and alternatives, 176 strategies for, 89–114, 148–149 International Obesity Task Force, 65, 91 Logic models/modeling, 28, 65, 135–136, 151, 294 Interrupted time series analysis, 174, 176, 180, 277–278, for obesity prevention, 39–41, 119 281–283 as sources of evidence, 103–104 as sources of evidence, 101, 103–105 Longitudinal studies, 100, 102, 118, 282, 289 Interventions as sources of evidence, 100, 102 defined, 215 Low-income IOM. See Institute of Medicine as a risk factor for obesity, 24, 26, 163 IOTF. See International Obesity Task Force ISIS. See Initiative on the Study and Implementation of Systems M Iterative steps, in system dynamics modeling, 79 ITS. See Interrupted time series analysis Maintenance, 141, 168, 187, 201, 224 assessing the extent of for an intervention, 118 as a dimension of generalizability, 52, 122 J as part of RE-AIM, 144–145 Managed care programs, 45 Journals and journal editors, 11–12, 14, 15, 20, 57, 65, Mapping, 84, 104, 139, 141, 146, 293–294, See also 110, 111, 160, 166, 190–191, 193, 200–201, 203, Matching, mapping, pooling, and patching 205, 206, 293. See also Target audiences defined, 215  Index

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of obesity causality in the United States, 79–81 Natural experiments, 9, 159, 163, 169, 200 systems, 12, 74, 203 defined, 216 the obesity “system”—a broad causal map, 81 NCCOR. See National Collaborative on Childhood MATCH. See Multilevel Approach to Community Health Obesity Research Matched cohort studies Needs assessment, 150, 216 as sources of evidence, 101, 103 as areas of evidence needed, 96 Matching, 139, 146, 177, 290–292, 294. See also New York City Department of Health, 43–44, 137 Matching, mapping, pooling, and patching Next steps, in communicating, disseminating, evaluating the Multilevel Approach to Community Health model and refining the L.E.A.D. framework, 10, 187–195. used to align the source of evidence with the targets See also L.E.A.D. framework of an intervention, plan and evaluate programs, and communicating and disseminating the framework, integrate knowledge for community partnering, 292 188–193 Matching, mapping, pooling, and patching, 139, 160, communication and dissemination plan, 187 290–296 conclusions regarding, 201 as tools for assembling evidence, 146 evaluating and refining the framework, 193–195 Measurement evaluation and refinement plan, 187 approaches to, 64–65 NHANES. See National Health and Nutrition of BMI in schools, 75 Examination Surveys Menu-labeling case study, 99 NIH. See National Institutes of Health Meta-analyses, 57, 105–107, 138–139, 145, 167, 171, Nonequivalent control group design. See Observational 180, 227 studies Mexican Americans. See Ethnicity Nonexperimental studies, 216. See also Observational Military readiness, effect of obesity on, 26 studies Mixed-method evidence synthesis as sources of evidence, 107–108 O Mixed-method studies, 104–105, 125, as sources of evidence, 104–105 Obesity, 1, 23, 200, 216 types of mixed-method evidence and examples of their diseases related to, 21, 26 uses, 104–105 and health consequences in adults, children, and youth, Monitoring, the L.E.A.D. framework, 192–193 27 Multilevel, multisector obesity prevention approaches, and overweight as a societywide problem, 1, 17, 22–26 46–49 prevalence of, 18, 23–25, 44 example of a multilevel approach—childhood obesity Obesity prevention approaches, 35–54 prevention in Texas, 47–49 approaches designed to foster changes in communities multilevel, multisector approach to childhood obesity and neighborhoods, 43–44 prevention in Texas, 48 approaches involving changes in organizational policies, need for, 46–47 environments, and practices, 42–43 Multilevel Approach to Community Health, 291–292 in the broader context of other public health initiatives, Multisite designs, 172–173. See also Randomized 49–51 controlled trials considerations for increasing evaluation of, 162 current evidence base, 9–10, 55–59, 201–202, 227–267 definitions and types of prevention, 36–39 N differences from obesity treatment, 21 National Chronic Disease Directors, 190 health communication and social marketing National Collaborative on Childhood Obesity Research, approaches, 44–45 191–192 interventions in health care settings, 45 National Health and Nutrition Examination Surveys, 1, lessons for obesity prevention from other public 22–24, 45, 272 health problems, 50 National Health Examination Survey, 22 logic models for obesity prevention, 39–40 National Health Interview Survey, 105 multilevel, multisector obesity prevention approaches, National Institutes of Health, 45, 127, 154, 162, 165 46–49 Native Hawaiians. See Ethnicity policy and legislative approaches, 42 Index 

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population-based, 22 types of parallel evidence and examples of their uses, the spectrum of obesity prevention approaches, 41–49 109 target behaviors for, 41 PATCH. See Planned Approach to Community Health types of, 37–39 Patching, 139, 141, 146, 290, 295–296. See also in the United Kingdom, 80, 82–83 Matching, mapping, pooling, and patching Obesity “system” Planned Approach to Community Health, 295 a broad causal map, 81 Peer-reviewed journals. See Journals and journal editors simplified version of the United Kingdom Foresight Physical activity. See Energy-balance equation Group’s causal loop obesity system map, 82 Planned Approach to Community Health, 295 Objectives, of communicating, disseminating, evaluating, Policies and programs as evidence sources, 273–275 and refining the L.E.A.D. framework, 188, 193–194 Policy analysis Observational studies, 65, 100–102, 125, 139, 176, as sources of evidence, 101 283–287 Policy makers. See Target audiences comparison of their results with results of randomized Policy scanning/tracking studies, 180–181 locating, 274 design elements that strengthen causal inferences in as sources of evidence, 127 observational studies, 285 Pooling, 139, 140, 145, 146, 290, 293–294. See also as evidence sources, 100–102 Matching, mapping, pooling, and patching types of observational evidence and examples of their Population-based interventions for obesity, 35, 37, 42 uses, 102 challenges of applying the traditional evidence base to, within the evidence hierarchy, 60 57–59 Opportunities to generate evidence, 5, 9–10, 117, 159–186 Population health problems alternatives to randomized experiments, 172–181 addressing with transdisciplinary exchange, 164–165 existing evidence needs, 161–183 and the L.E.A.D. framework, 55 the L.E.A.D. framework for obesity prevention decision and a systems approach, 74 making, 161 Practice-based interventions (or evidence), 14, 169, 200, limitations in the way evidence is reported in scientific 205, 294–296 journals, 166–169 Pre-/posttest designs, 175–177, 287–288 the need for new directions and transdisciplinary Predictive studies exchange, 164–166 as sources of evidence, 101–102 perspectives on causal inference, 174–180 Prevalence, 77, 107, 211 recommendations concerning, 13–14, 204–205 and economic-cost analysis study designs, 288–290 ways to fill the gaps in the best available evidence, as a measure of the scope of a problem, 99, 107, 169–171 118 Organizational policies, environments, and practices. See of obesity compared to the paucity of the knowledge also Obesity prevention approaches base with which to inform prevention efforts, 56 approaches involving changes in, 42–43 of obesity in diverse populations, 18 Osteoarthritis. See Diseases related to obesity Prevention, of obesity in adults and children, 36 Outcomes definitions and types of, 36–39 for decision making, as a dimension of external validity, Professional organizations, 190, 204. See also Target 122 audiences for evaluating obesity prevention interventions, 58–59 Program planners, 201. See also Target audiences Overweight Program theory analysis prevalence in the United States, 1 as sources of evidence, 103–104 Propensity scoring, 286–287 Prospective studies, 215 P Public health organizations, 12. See also Target audiences Public health problems—lessons for obesity prevention, Pacific Islanders. See Ethnicity strategies to address, 50 Paradigm shift in thinking about obesity prevention, 17, Publishers of research findings, 4, 11, 13, 14, 22, 117, 35 190. See also Journals and journal editors; Target Parallel evidence, 100, 108–109, 126 audiences as sources of evidence, 108–109  Index

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Q Regression discontinuity design, 101, 176, 180, 277–281 illustration using the example of an evaluation of the Qualitative research, 60, 65, 84, 103–104, 125, 137–139, effect of school lunch programs on children’s health, 153 280 assessing quality of, 125–127 Replicability, 167 for evaluating evidence, 62 Reporting likely effectiveness, 152–153 as sources of evidence, 100, 103–105, 107–108 Reporting likely reach and impact, 153 synthesis of, 105, 107–108 Reporting template, for summarizing evidence, 146–154 types of qualitative evidence and examples of their uses, evidence table, 149–151 104 example L.E.A.D. framework evidence report, 148–149 Quality rating criteria for external validity, 122 questions asked by the decision maker, 147 maintenance and institutionalization, 122 strategies for locating evidence, 148–149 outcomes for decision making, 122 summary of evidence, 151–154 program or policy implementation and adaptation, 122 Representativeness, 122, 166–168. See also reach and representativeness, 122 Generalizability; Reach Quantitative data (or research), 65, 84, 125, 127, 138– Research designs, experimental and quasi-experimental 139, 145, 153, 277, 279, 280–281, 295–296 common, 277–290 Quasi-experimental studies, 60, 64, 84, 125, 138, 145, economic cost analysis, 288–290 164, 174, 178, 277, 278, 283, 287 interrupted time series analysis, 281–283 as sources of evidence, 100–101, 103, 105–106 observational studies, 283–287 Questions pre-/posttest designs, 287–288 asked by the decision maker, 99, 147–148 regression discontinuity design, 279–281 that guide the gathering of evidence, 6–7, 91 a typology of research designs, 277 that need to be answered, types of, 61–62 Research funders, 4, 22, 189. See also Target audiences recommendations for, 11, 13–15, 202–206 Research needed. See Needs assessments; Next steps R Researchers, 3, 14, 189. See also Target audiences Randomized controlled trials, 57, 62, 116, 138–139, 176, recommendations for, 11–15, 202–205 277, 280 Resources needed, to utilize the L.E.A.D. framework, alternatives to, 172–181 11–12 multisite designs, 172 Review of existing reviews on obesity prevention, prevailing preference for, 164 227–267 as sources of evidence, 101, 103, 105 critical reviews, 260–261 Randomized encouragement design, 174, 176, 218 integrative reviews, 230–231, 242–243, 250–251, RCTs. See Randomized controlled trials 262–263 RD. See Regression discontinuity design narrative reviews, 236–237, 248–249, 254–255 Reach, 122, 141, 149, 168 review of reviews, 250–251 defined, 218 reviews, 232–233, 258–259 Realist reviews, 63, 106, 138, 145, 153, 219 synthesis research studies, 238–239 Recommendations, of the committee, 10–15, 201–206 systematic reviews, 220, 228–235, 238–261 building a resource base, 12–13, 203–204 Risk factors. See Ethnicity; High-risk populations; communicating, disseminating, evaluating, and refining Low-income the L.E.A.D. framework, 14–15, 205–206 Risk reduction approach, 37 establishing standards for evidence quality, 13, 204 Robert Wood Johnson Foundation, 20, 170, 197 incorporating systems thinking, 12, 203 Rubin’s perspective, 177–178, 279, 286 supporting the generation of evidence, 13–14, 204–205 potential outcomes model, 177 utilizing the L.E.A.D. framework, 11–12, 202–203 RWJF. See Robert Wood Johnson Foundation Reductionist research, 62, 84 Refining the L.E.A.D. framework. See Evaluating and S refining the L.E.A.D. framework Registry of reports SAMHSA. See Substance Abuse and Mental Health establishing, 203–204 Services Administration Index 0

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Scientific literature mapping, 293 databases as evidence sources, 269–270 matching, 290–292 Secondary analysis observational studies, 283–286 as sources of evidence, 100–102 patching, 295–296 Selective interventions, 37–38, 141, 153 pooling, 293–294 Sensitivity analysis, 176 pre-/posttest, 287–288 Sesame Street program, 278 regression discontinuity, 279–281 Shape Up Somerville, 95, 289 typology of research designs, 277–279 Simplified version of the causal loop obesity system map, Subpopulations affected, 24–26, 38 82 Substance Abuse and Mental Health Services Simulation modeling, 79 Administration, 295 Social determinants Summary of evidence, 151–154. See also Template for as areas of evidence needed, 91–93 summarizing the evidence defined, 220 Surveys, 60 Social marketing strategies, 38, 44–45 polls, and rankings as evidence sources, 272 Society for Prevention Research, 123 as sources of evidence, 100–102 Sources of evidence, 100–110, 140, 169–171. See also Sustainability Gathering evidence; Identifying and locating as areas of evidence needed, 95–96 evidence; Information sources for locating evidence defined, 220 Special Supplemental Nutrition Program for Women, in evaluating impact of interventions, 144 Infants, and Children, 119 SUTVA. See Stable unit treatment value assumption Specifying questions, 6–7 Syntheses applying the evidence typology—an illustrative existing tools, 144–146 example, 98–100 of information from disparate sources, 139–141 an evidence typology for the L.E.A.D. framework, methods, of evidence, 105–108, 126 91–100 of qualitative research, 107 “How” questions, 95–96 research studies, 238–239 posing “Why,” “What,” and “How” questions after a System dynamics, 74 policy or program is in place, 96–98 Systematic reviews, 60, 105–106, 224–225 questions that guide the gathering of evidence, 91 Systems approach, 71–74 “What” questions, 93–94 Systems investigation, 74 “Why” questions, 91–93 Systems perspective, 5–6, 36, 64, 71–87, 221 Spectrum of Prevention, 41, 46 importance of, 30 Stable unit treatment value assumption, 177 logic models and the complexity of interventions, Stakeholders, 15, 201, 206, 220. See also individual 136–137 Systems science, 74 stakeholders Standards for evidence quality Systems theory, 74 recommendations concerning, 13, 204 Systems thinking, 74 Statistical regression, 288 concepts and variables in, 76–77 Status of the current evidence base, 56–59 encouraging the use of, 12 choice of outcomes, 58–59 increasing understanding of, 11 lack of conceptual frameworks, 57–58 uses of, examples, 75–83 quantity of available evidence, 57 review of existing reviews on obesity prevention, T 227–267 Stocks and flows, 77. See also Systems thinking Target audiences, of the L.E.A.D. framework, 3–4, 22, Strategic planning 188–190, 201 as areas of evidence needed, 95 decision makers and intermediaries, 188–189 Study approach, 3–4 other important audiences, 189–190 Study designs and methodologies, an in-depth look, publishers of research results, 190 277–300 research funders, 189 economic cost analysis, 288–290 researchers, 189 interrupted time series analysis, 281–283  Index

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Target populations, 38. See also Subpopulations affected obesity prevention in the United Kingdom, 80, 82–83 Template for summarizing the evidence, 144, 146–154. See primer on concepts and variables in systems thinking, also Assembling evidence and informing decisions 76–77 elements of the reporting template, 146–148 the tobacco control movement, 75, 78–79 evidence table, 149–151 Using the L.E.A.D. framework, 4–10 question asked by the decision maker, 147–148 assembling evidence and informing decisions, 8–9 strategy for locating evidence, 148–149 evaluating evidence, 7–8 summary of evidence, 151–154 to inform decisions, 147 Texas, multi-level approach to childhood obesity locating evidence, 7 prevention, 47–49 opportunities to generate evidence, 9–10 Tobacco control movement, 50–51, 75, 78–79, 140, 169 recommendations concerning, 11–12, 202–203 lessons for obesity prevention, 43, 46 specifying questions, 6–7 sources of evidence, as natural experiments, 169 systems perspective, 5–6 systems thinking, 75–79 USPSTF. See U.S. Preventive Services Task Force Transdisciplinary research, 164–166 Transdisciplinary team science V factors facilitating and constraining, 165 Transferability. See Generalizability Validity, 221. See also Generalizability; Level of certainty Translation, 10, 32, 154, 201, 215, 221 external, 7, 62, 64, 121–123, 168, 175 of evidence, 96 internal, 7, 62, 64, 175–176, 282, 284 of an intervention, 95–96 VERBTM campaign, 45 knowledge translation, 154 Transparency in decision making, 64 W Transparent Reporting of Evaluations with Nonrandomized Designs, 121 Washington State Department of Health, 152–153 Trends, in obesity rates, 23–26, 92 “What if” scenarios, 83. See also Systems thinking Typology of research designs, experimental and quasi- “What” questions, 6–7, 93–94, 98–99 experimental, 277. See also Research designs 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 U what specifically should we do about this problem?, Universal interventions, 37–38, 40, 141, 153 136–142, 149–153 “Upstream” approaches, 39 WHO. See World Health Organization U.S. Centers for Disease Control and Prevention, 12, 20, “Why” questions, 6–7, 91–93, 96, 99 45, 49, 127, 169–170, 190, 197, 203, 291 areas of concerns and examples of evidence needed, 92 U.S. Department of Agriculture, 192 posing “Why,” “What,” and “How” questions after a U.S. Department of Health and Human Services, 192 policy or program is in place, 96–98 Secretary of, 12–13, 203–204 why should we do something about this problem in our U.S. Preventive Services Task Force, 121, 123, 127 situation?, 135–136, 148, 150–151 U.S. Surgeon General, 50 WIC. See Special Supplemental Nutrition Program for USDA. See U.S. Department of Agriculture Women, Infants, and Children Uses of systems thinking, approaches, mapping, and Within-subjects design, 177. See also Rubin’s perspective modeling, 75–83 Women’s Health Initiative Dietary Modification Trial, 173 BMI screening in schools, 75 World Cancer Research Fund, 40 mapping of obesity causality in the United States, World Health Organization, 37 79–81 Index