Preventing Childhood Obesity - Evidence Policy and Practice.pdf

CHAPTER 21
Monitoring of c hildhood o besity
Jacob C. Seidell
EMGO Institute for Health and Care Research, Institute of Health Sciences, VU University
and VU University Medical Centre, Amsterdam, The Netherlands
Summary and recommendations
for research and practice
• D efi nitions distinguish between monitoring and
screening. Monitoring is purposive, systematic
measuring to determine trends over time, variation
between populations or places, and so on. Screening
is purposive, systematic measurement as well but its
purpose is case finding, not the determination of
population trends.
• The purpose (trends, differences in populations)
and value (measuring leads to action, especially if it
is local data fed back to local agencies) need to be
considered.
• Childhood obesity does not meet the criteria for
screening (mainly because of lack of evidence of
effectiveness of interventions).
• There is debate about the obligations and value
of feeding (interpreted) anthropometry information
back to parents (and for adolescents to them
individually).
• The methodology used for monitoring is poor in
most cases and, therefore, should be a priority for
establishing monitoring systems.
Definitions
In this chapter I define monitoring as purposive, systematic
measuring to determine trends over time,
variation between populations or places, and so on.
I define screening as purposive, systematic meas-
Preventing Childhood Obesity. Edited by
E. Waters, B.A. Swinburn, J.C. Seidell and R. Uauy.
© 2010 Blackwell Publishing.
urement as well, but its purpose is case finding, not
the determination of population trends.
In many cases also the term surveillance is used
interchangeably with monitoring. According to the
Webster ’ s dictionary, clinical surveillance refers to
the monitoring of diseases or public health - related
indicators by epidemiologists and public health
professionals. The differences between monitoring
and surveillance are often obscure, although in
many instances monitoring pertains to observations
and surveillance comprises observations
and actions. Surveillance, for instance, includes
systems to detect “ events ” such as infectious
disease out breaks. Frequently, however, a monitoring
system is thought to be much more than just collecting
and interpreting series of routinely collected
data.
For instance, according to the United Nations
Populations Fund a monitoring system consists of five
critical elements 1
1 . defi nition of essential data to collect, including case
definitions;
2. systematic collection of data;
3. organization and analysis of data;
4. implementation of health interventions based on
the data; and
5. Re-evaluation of interventions.
According to the World Health Organization
Framework Convention on Tobacco Control ( WHO
FCTC ) surveillance is systematic ongoing collection,
collation and analysis of data and the timely dissemination
of information to those who need to know,
so that action can be taken. 2 Tobacco control surveillance
includes prevalence of tobacco use, its
health and economic consequences, its socio - cultural
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