An Evaluation Framework for Obesity Prevention Policy Interventions

Leeman, Jennifer; Sommers, Janice; Vu, Maihan B.; Jernigan, Jan; Payne, Gayle Holmes; Thompson, Donovan J.; Heiser, Claire; Farris, Rosanne P.; Ammerman, Alice S.

doi:10.5888/pcd9.110322

Cited by 33 publications

(33 citation statements)

References 21 publications

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“…In the US, the Centers for Disease Control and Prevention have developed clear policies promoting weight loss and prevention of weight-related illness (e.g. Leeman et al, 2012). Similarly, UK public health policy advocates weight loss through individual lifestyle change (Department of Health [DoH], 2013; National Institute of Health and Care Excellence [NICE], 2014).…”

Section: Introductionmentioning

confidence: 99%

Self-directed interventions to promote weight loss: a systematic review and meta-analysis

Tang

Abraham

Greaves

et al. 2016

Health Psychology Review

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Downloaded by [2.124.227.49] at 11:47 19 April 2016 2 Many self-directed weight-loss interventions have been developed using a variety of delivery formats (e.g. internet, smartphone) and change techniques. Yet, little research has examined whether self-directed interventions can exclusively promote weight loss. MEDLINE, Embase, PsycINFO, CINAHL, and the Cochrane Library were systematically reviewed for randomised controlled trials evaluating self-directed interventions in relation to weight loss outcomes in adults. Standard mean differences (SMD) and 95% confidence intervals (CI) were calculated using a random effects model. Twenty-seven trials incorporating 36 comparisons met our inclusion criteria. Participants using self-directed interventions lost significantly more weight (MD = -1.56 kg, CI -2.25, -0.86 ranging from 0.6 to 5.3 kg) compared to those in the minimal-intervention or no-treatment groups (3.1-month follow-up median). The majority of interventions were internet-based (18 evaluations) and these were effective at 3 months (MD = -1.74 kg, CI -2.65, -0.82 ranging from 0.6 to 4.8 kg) (SMD = -0.48, 95% CI -0.72, -0.24, I² = 82%; p < .0001; 16 evaluations) and 6 months follow-up (MD = -2.71 kg, CI -4.03, -1.39 ranging from 2.2 to 5.3 kg) (SMD = -0.59, 95% CI -0.99, -0.19, I² = 76%; p = .004; 4 evaluations). Self-directed weight-loss interventions can generate modest weight loss for up to 6 months but may need to be supplemented by other interventions to achieve sustained and clinically meaningful weight loss.

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Section: Introductionmentioning

confidence: 99%

Self-directed interventions to promote weight loss: a systematic review and meta-analysis

Tang

Abraham

Greaves

et al. 2016

Health Psychology Review

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“…Fruit and vegetable consumption is influenced by individual characteristics and social, cultural and physical environments [18]. Dietary interventions addressing the individual level through nutrition education have shown some success [19][20][21] yet, a recent review indicates that individual education alone is costly and unlikely to have the desired effects in the absence of policies and environments that enable individuals to make healthy choices [22]. At the environmental level, local access and availability of fruits and vegetables is associated with fruit and vegetable consumption.…”

Section: Introductionmentioning

confidence: 99%

The effect of education plus access on perceived fruit and vegetable consumption in a rural African American community intervention

Barnidge¹,

Baker²,

Schootman³

et al. 2015

Health Educ. Res.

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African Americans have an increased risk of cardiovascular disease partly due to low fruit and vegetable consumption. This article reports the results of an intervention to provide nutrition education and access to fruits and vegetables through community gardens to change dietary behaviors among African Americans in rural Missouri. Cross-sectional surveys evaluated the intervention effect on blood pressure, body mass index (BMI), and perceived fruit and vegetable consumption in this quasi-experimental study with a comparison group. Hypertension (OR = 0.52, 95% CI: 0.38-0.71) and BMI (OR = 0.73, 95% CI: 0.52-1.02) were lower in the intervention county at mid-intervention. Participation in nutrition education (OR = 2.67, 95% CI: 1.63-4.40) and access to fruits and vegetables from a community garden (OR = 1.95, 95% CI: 1.20-3.15) were independently associated with perceived fruit and vegetable consumption. The strongest effect on perceived fruit and vegetable consumption occurred with high participation in nutrition education and access to community gardens (OR = 2.18, 95% CI: 1.24-3.81). Those with access but without education had a reduced likelihood of consuming recommended servings of fruits and vegetables (OR = 0.57, 95% CI: 0.34-0.95). Education plus access interventions may be best at increasing consumption of fruits and vegetables in a rural African American population.

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“…Many authors have noted that complex systems solutions are needed to address problems like obesity and related chronic disease 105-107 . Complexity extends to the policy process, which is rarely linear, operates under limited information, and presents temporal challenges including simultaneity of events and heterogeneity of lag times; all of this makes policy evaluation particularly difficult 108 .…”

Section: Introductionmentioning

confidence: 99%

Modeling Social Norms and Social Influence in Obesity

et al. 2015

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The worldwide increase in obesity has led to changes in what is considered “normal” or desirable weight, especially among populations at higher risk. We show that social norms are key to understanding the obesity epidemic, and that social influence mechanisms provide a necessary linkage between individual obesity-related behaviors and population-level characteristics. Because influence mechanisms cannot be directly observed, we show how three complex systems tools may be used to gain insights into observed epidemiologic patterns: social network analysis, agent-based modeling, and systems dynamics modeling. However, simulation and mathematical modeling approaches raise questions regarding acceptance of findings, especially among policy makers. Nevertheless, we point to modeling successes in obesity and other fields, including the NIH-funded National Collaborative on Childhood Obesity Research (NCCOR) Envison project.

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An Evaluation Framework for Obesity Prevention Policy Interventions

Cited by 33 publications

References 21 publications

Self-directed interventions to promote weight loss: a systematic review and meta-analysis

Self-directed interventions to promote weight loss: a systematic review and meta-analysis

The effect of education plus access on perceived fruit and vegetable consumption in a rural African American community intervention

Modeling Social Norms and Social Influence in Obesity

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