Preventing Childhood Obesity - Evidence Policy and Practice.pdf

Evaluation of community-based obesity interventions
tations in terms of research rigor, produce very little
useful evidence to inform policy and practice change.
They should either be more limited in scope, focusing
on specific research questions, or there needs to be a
mechanism to bring in other research funding. 34 A
final option may be to redistribute these agencies ’
funding so that a proportion of funded projects are
comprehensively evaluated, with the remainder freed
from the distractions of a superficial evaluation exercise.
This means that such research requires strong
col laboration between academics and research funders
on the one hand, and government agencies on the
other.
Wales has experienced success in working with government
to identify innovative policies, which have
been initially implemented in an experimental fashion,
allowing randomized trials to be conducted, nested
within the national roll - out of both the free school
breakfast initiative, 26 and the national exercise referral
scheme. However, these examples remain rare, with
governments generally remaining unwilling to expose
novel policies to the glare of a rigorous independent
controlled evaluation, 39 despite the need to take
advantage of these opportunities to generate evidence
of effectiveness. 40 Alternatively, policy decisions are
made in parallel with the conduct of evaluations
rather than being informed by the outcome of the
evaluations. 39
Conclusion
Community-based obesity prevention interventions
will typically include some variability in application to
accommodate different settings and populations. This
presents challenges for evaluators. However, rigorous
evaluation can be achieved through staged development
and evaluation of the intervention program.
This may progressively involve theoretical development,
qualitative testing, modeling, feasibility testing
and an exploratory trial. It will then be possible to
conduct a large - scale intervention and summative
evaluation. At this point, a randomized or cluster randomized
trial is both possible and desirable to achieve
an unbiased estimate of the average effect of the intervention.
It is also critical to include comprehensive
qualitative investigations to identify and understand
the factors that influence the effectiveness of the
intervention. A well developed and comprehensive
approach such as this requires substantial funding
as well as collaboration and commitment between
researchers, funding bodies and government
agencies.
Acknowledgements
Lisa Gibbs acknowledges the NHMRC Capacity
Building Grant for Child and Adolescent Obesity
Prevention and the Jack Brockhoff Child Health and
Wellbeing Program for salary and operational funding
support. The authors also acknowledge the helpful
feedback provided by Andrea Sanigorski following a
review of a draft of the chapter.
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