Preventing Childhood Obesity - Evidence Policy and Practice.pdf

Evidence framework for childhood obesity prevention
• There is a need for more interventions looking into
the needs of specific sub - populations, including
immigrant groups, low - income groups, and specific
ethnic and cultural groups.
• There is a shortage of long - term programs evaluating
and monitoring interventions. Long - term outcomes
could include changes in knowledge and
attitudes, behaviors (diet and physical activity) and
adiposity outcomes.
• New approaches to interventions, including prospective
meta - analyses, should be considered.
• Community - based demonstration programs can be
used to generate evidence, gain experience,
develop capacity and maintain momentum.
• There is a need for an international agency to encourage
networking of community - based interventions,
support methods of evaluation and assist in the
analysis of the cost – effectiveness of initiatives.
• There is insufficient evidence on the impacts of cultural
values, beliefs, expectations and attitudes
around food, physical activity and body size perception
to inform interventions in the high - risk
ethnic groups.
• Better evidence is needed about the most effective
ways of feeding BMI information back to parents
and for health professionals to raise the issue of
their children ’ s weight with parent.
• Evidence on the most effective and cost - effective
monitoring systems and their impacts on national
and community actions.
Conclusions
The traditional approaches borrowed from evidence -
based medicine need to be adapted to suit obesity
prevention — trying to retain the rigour of evidence
assessments and uses but trying to incorporate the
flexibility and complexity needed for public health
intervention research. The IOTF framework attempts
to achieve this by articulating the various questions
that the evidence needs to address, by expanding the
definitions of evidence, by highlighting the need for
modeling where there are gaps in the empirical data,
by lifting the value of informed stakeholder input for
those research questions where contextual factors are
important, by taking a “solution-oriented ” approach
to determining interventions, and by defining how a
“ policy/practice - based evidence ” paradigm can better
align evidence with the realities of decision making.
Acknowledgements
Tim Gill, Shiriki Kumanyika, Tim Lobstein, Colin
Bell, Andrea Sanigorski, Elizabeth Waters, Rob Carter,
Marj Moodie.
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