Obesity

Logic of appropriateness and logic of consequences of obesity – Obesity prevention and the role of hospital and community-based health services: a scoping review

Figure 1.

Although it may be unrealistic to expect local-level program personnel to have the capacity to conduct full-scale comprehensive evaluations, it is not at all unreasonable for local-level programs to have in place practical mechanisms that conwequences enable them to detect, record, og report on reasonable indicators of the progress and the impact of a program. Relevant programs or policies could include regulatory changes that affect an organization or voluntary changes that could be implemented by an organization itself e. Institutional outcomes are changes in organizational cultures, norms, policies, and procedures related to dietary patterns and physical activity behaviors. The funding body was not involved directly in the design or completion of the study or in the writing of the manuscript. Archer, S. From the outset, efforts are made to ensure that systems are in place to evaluate the process and generate the information used to inform midcourse corrections in the intervention and ascertain the extent to which important outcomes are achieved.

  • Cushing, and R.

  • This feature raises the significance of the logic of appropriateness.

  • System dynamics modeling for public health: Background and opportunities.

  • The logics become prominent depending on preferences and consequences or identities and rules.

References

Fam Community Health. The evaluation framework also illustrates the range of important inputs and outcomes while giving careful consideration to the following factors: The interconnections comsequences quality of interactions within and among the multiple sectors involved in childhood obesity prevention initiatives; The adequacy of support and resources for policies and programs; The contextual appropriateness, relevance, and potential power of the planned policy, intervention, or action; The relevance of multiple levels and types of outcomes e. Pomeranz, J. Opinion pieces and editorials were not included. Page 33 Share Cite.

This approach is difficult to apply to policy interventions because they involve a continual and often cyclical interplay among inputs, activities, and outputs and because the path to successful outcomes is neither linear nor constant 11,13, Granted that the logics have one purpose to reach, nevertheless one of them is conformed to current conditions. For farm-to-school policy, people reached may include children, family, community members, school employees, and farmers. Available online pdf icon [PDF According to me, this was an example of the logic of appropriateness. Genetics of obesity: what have we learned? This was a consequentialist action.

Outcome Examples Improve the self-efficacy of adolescents in using the Nutrition Facts label to select healthier options at the grocery store and in quick serve restaurants. Preventing Childhood Obesity: Health in the Balance. This chapter discusses the challenges and opportunities for evaluating childhood obesity prevention efforts. The scope and scale of evaluation efforts should be appropriately matched to the obesity prevention action. This could include looking at moving beyond traditional structural boundaries to look at alternative models of care to the medical model including the use of support roles outside of those typically considered to be health professionals, particularly in the role of ongoing support [ 5658 ].

  • For eating behaviors, the focus is on overall dietary quality approprlateness well as appropriate caloric consumption, achieved by increasing plant-based dietary components; reducing the consumption of sugar-sweetened beverages and of high-calorie, energy-dense foods; increasing breastfeeding and responsive child feeding; and ensuring the intake of nutrients needed to promote optimal linear growth. Existing public sector surveillance systems and special surveys serve as critical components for the ongoing monitoring and tracking of a wide range of childhood obesity-related indicators.

  • Implementing the policy may include activity at multiple levels of the executive branch of government or wnd involved settings and sectors. Evaluation may also assess the extent to which policies followed model policy guidance from organizations with expertise in obesity prevention policy eg, National Policy and Legal Analysis Network to Prevent Childhood Obesity.

  • Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health. Register for a free account to start saving and receiving special member only perks.

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  • What I mean is that this logic determines how actors act in appropriate ways, as expressed through their identities.

  • Obesity is serious because it is associated with poorer mental health outcomes and reduced quality of life.

In addition, adults need wppropriateness do activities that strengthen muscles at least 2 days a week. Indirect costs of obesity: a review of the current literature. To enact a policy, activities focus on looking for windows of opportunity, identifying the policy makers who will sponsor or promote the policy, and formally enacting the drafted policy in the form of a law, regulation, or budget. People and families may make decisions based on their environment or community. On the contrary, the EU could not do anything against Russia excluding some sanctions imposed.

Abd was summarised using a standardised extraction form developed for the review see Tables 12345 to identify the clinical areas where prevention is effective and the fundamental elements of implementation. Obesity ;17 5 — Where training and resources have focussed on prevention, there is an increase in the rate of screening provided but only a limited change in the rates of brief advice or referral to an intervention service [ 12151617 ]. Nutr Rev 59 3 :S40—S Page, and B.

Consequences of Obesity

The final step of the 5As framework recommends providing support to help people achieve and maintain their weight goals. How similar is big food? Ethical principles, as well as numerous precedents, can be cited to support the concept that government has a responsibility to protect the health of the public and therefore the authority to intervene in relevant societal sectors and processes Economos et al. Suggested Citation: "2 Framework for Evaluating Progress. Control of obesity is an important priority to reduce the burden of chronic disease.

Consequencee suggests that the current range of choices related to physical activity and food intake is limited and biased toward the unhealthy end of the continuum such that policies are needed to improve the environment for free choice. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website. Industry progress to market a healthful diet to American children and adolescents. Miller, M. Rahman, T. J Gen Intern Med.

While anc logic of expected consequences is considering what is loss, what is income, the logic of appropriateness is based on normative beliefs that make actions appropriate under certain conditions and inappropriate under others. Families cannot change their genes, but they can encourage healthy eating habits and obrsity activity. CDC is not responsible for Section compliance accessibility on other federal or private website. Policies also should be cost-effective; in other words, they should use resources in ways that contribute to improvements that are equal to or greater than alternative policies or programs. The involvement of multiple sectors requires that practitioners work with nontraditional partners; the influence of contextual factors confounds efforts to define the boundaries of a policy intervention. The framework is organized according to the 4 standard sections of a logic model: inputs, activities, outputs, and outcomes For example, does the farm-to-school policy include language that is strong enough to ensure the resources necessary to support implementation 5?

Midgley G. Therefore, the school food environment is a logical focus for efforts to encourage healthy dietary behaviors. Lifestyle strategies for weight control: experience from the Finnish Diabetes Prevention Study.

  • Griffiths, L. Each of the factors dynamically influence the others so need should not be considered in isolation [ 53 ].

  • Further development is needed to assess how well the framework accommodates these types of real-world complexity. Granted that the logics have one purpose to reach, nevertheless one of them is conformed to current conditions.

  • As reviewed ina number of countries and regions have been developing and implementing strategic plans to promote physical activity and healthful eating and to prevent obesity IOM,

  • At the final stage in the process, activities are directed toward maintaining policy implementation and ensuring sustained effect through monitoring, enforcement, and further policy modification. What's this?

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What does loic logic of appropriateness mean? This is because it includes common security, global security, cooperative security and comprehensive security. Do what is most appropriate. Its focus point is anarchy, that is anarchic balance of power and military that is considered as it will make people safe. What I mean is that it seems as if their focus point is identity, 1 Goldmann, p. Current estimates of the economic cost of obesity in the United States.

  • The other three focus on primary healthcare, but also consider other health services. Fortmann, B.

  • Because profit has to be kept in the background. They must act in the direction of some norms the EU has.

  • The program provides funding to states to administer a variety of initiatives.

  • J Am Med Assoc 16 — Evaluations inform decision.

  • No doubt, it will maintain its importance in international relations.

Section Navigation. Either a blockade or an air strake… The decision was not obesitt favor of air strake because of his loss could be higher than his gain. This situation compels policymakers and scholars to think about the concept. And second, it means protection from sudden and hurtful disruptions in the patterns of daily life. On This Page. Telephone:

Watch The Obesity Epidemic external icon to learn about factors that contribute to the obesity epidemic, as well as several community initiatives to prevent and reduce obesity. Figure 1. Additional outputs include acceptability and affordability. It will be about members of the EU. It is a turning point for actors driven by the logics. Outputs are the direct, tangible results of activities. This feature raises the significance of the logic of appropriateness.

According to the logic of consequences: 1. Related Topics. To receive email updates about this topic, enter your email address. Click here to sign up. Research continues on the role of other factors in energy balance and weight gain such as chemical exposures and the role of the microbiome.

They must act in the direction of some norms the Appropriateness and has. It should be noted that there is a significant correlation obeeity the logic of expected consequences and structural theory of interests. Individual-level interventions are resource-intensive and have limited potential for lasting success as long as environments promote unhealthy behaviors and limit access to healthy foods and safe opportunities for physical activity 3,4. Findings can, for example, help to distinguish whether disappointing outcomes are due to problems with the policy or with its implementation. For example, implementing farm-to-school policy can occur at the state, school district, and local school levels. By trying to respond to these questions, I hope to come up with a more complete understanding of my subject.

What kind of situation is this? Indirect costs of obesity: a review of the current literature. The major discussion in the White House was what to respond to this threat. It is possible to connect it with traditional security in this respect. Remember me on this computer. Because profit has to be kept in the background.

Even if the subject appears difficult, it reflects reality. What aprpopriateness the logic of appropriateness mean? Nationwide, communities and states are responding to the challenge by implementing a range of innovative policy approaches. Once a logic model has been created, practitioners can use it as a guide to developing evaluation questions and an evaluation plan.

  • In contexts such as these, in which local programs are implemented while a larger-scale nationwide intervention is occurring, there may be parallel and reinforcing activities that present challenges in assessing the relative contribution of each intervention.

  • Annual medical spending attributable to obesity: payer-and service-specific estimates. Interventions at the policy level require a different approach to evaluation than that used for interventions at the individual and group levels.

  • Several national and state cross-sectional and longitudinal surveys provide indicators and outcomes related to childhood obesity prevention surveillance and monitoring Appendixes C and D.

  • You will be subject to the destination website's privacy policy when you follow the link. The central outputs of the first 2 steps of policy making formulation and enactment are the actual policies proposed and enacted.

  • This feature raises the significance of the logic of appropriateness.

Evaluation is the critical step in the identification of both successful and ineffective policies and interventions, thus allowing appropriatenees to be invested in the most effective manner. Get This Book. The healthy start partnership: an approach to obesity prevention in young families. Policy makers, funders, and other elected and appointed decision makers. From the outset, efforts are made to ensure that systems are in place to evaluate the process and generate the information used to inform midcourse corrections in the intervention and ascertain the extent to which important outcomes are achieved. Nutrition and chronic disease prevention: Priorities for US minority groups. BOX Examples of Population-Based Obesity Prevention Approaches Policy and Legislative Approaches Relevant approaches could include limiting the availability of sugar-sweetened beverages and high-calorie, energy-dense foods in certain settings e.

He estimated that the US would make profit in nad long run thanks to oil in Iraq. Search The CDC. For more, see Healthy Weight — Finding a Balance. The central outputs of the first 2 steps of policy making formulation and enactment are the actual policies proposed and enacted. At the final stage in the process, activities are directed toward maintaining policy implementation and ensuring sustained effect through monitoring, enforcement, and further policy modification. What kind of situation is this? Who am I?

T he nation is in the midst of initiating changes in policies and actions that are intended to combat the childhood obesity epidemic across many sectors, including government, relevant private-sector industries, communities, schools, work appropriateness and, families, and the health care sector. Cawley, J. Krukowski, R. The social and cultural diversity within the United States precludes assumptions about the transferability of interventions from one subsector of the population to another. In taking a scoping approach to the role of health services, this review was able to draw out that a significant barrier to the implementation of prevention guidelines are the perceptions of health professionals. This weight gain shifted many people from the healthy weight range into the overweight range, from the overweight range into the obese range, or from a moderate to an extreme level of obesity. Health care is predominantly delivered within a reactive model of care which is at odds with the concept of prevention [ 55 ].

Therefore, it is important to create environments that make it easier to engage in physical activity and eat healthy foods. On This Page. Skip directly to search Skip directly to A to Z list Skip directly to site content. We added the factors of human security and traditional security to our subject.

  • Archer, S.

  • Another point that is worth mentioning is an assumption of March and Olsen.

  • The papers which focussed on maternity based services highlight the immediate consequences of maternal obesity including higher rates of gestational diabetes, high blood pressure and pre-eclampsia and higher risk births. Stroup, and W.

  • This approach is difficult to apply to policy interventions because they involve a continual and often cyclical interplay among inputs, activities, and outputs and because the path to successful outcomes is neither linear nor constant 11,13, And second, it means protection from sudden and hurtful disruptions in the patterns of daily life.

Environmental justice: Obesity, physical activity, and healthy eating. Brownson, J. Psychiatr Serv. Raising awareness of obesity, drawing attention to the associated economic and logic of appropriateness and logic of consequences of obesity care costs, passing new laws or regulations, and implementing community action strategies abd mobilize change all require resources, political will, and public support from those whose lives or livelihoods could be affected. Due to the range of methods and small numbers of many of the studies the results are not necessarily generalisable but a recurrence of themes indicates that perceptions and beliefs should be considered when incorporating obesity prevention into health care services. They base this conclusion on comparisons of what has been accomplished through voluntary measures and what is perceived as being needed, as. The delivery of preventive care to clients of community health services.

It is a turning point for actors driven by the logics. We can add Turkey to that group of countries inside the union. By reviewing interventions, Center TRT staff have identified challenges in policy evaluation, such as identifying the start and end points of policy interventions, documenting processes and successes, and fully measuring success following policy enactment. To enact a policy, activities focus on looking for windows of opportunity, identifying the policy makers who will sponsor or promote the policy, and formally enacting the drafted policy in the form of a law, regulation, or budget. Obesity is a complex health issue resulting from a combination of causes and individual factors such as behavior and genetics. Obesity and its associated health problems have a significant economic impact on the US health care system, 11 including direct and indirect costs.

Background

Patient provider communication about the health effects of obesity. Sociocultural influences are part of the environment affecting physical activity and appropfiateness habits, and interact with other aspects of the environment Swinburn et al. Policy options for prevention: The case of alcohol. However, there is great variability within and across these legislative databases. Identification of the behavioral and environmental variables that contribute to the populationwide obesity epidemic and how they influence and interact with each other is needed to determine which prevention efforts are the most promising.

Google Scholar 4. Thus, best. Fifth, useful evaluations are contextually relevant, are culturally responsive, and make use of the full repertoire of methodologies and methods Chapter 3. What is the present character and extent of the childhood obesity epidemic at this time in the contexts being served? Obesity prevention: A proposed framework for translating evidence into action.

These explanations complement each other and help to clarify the meaning of the logic of consequences. Indirect costs relate to sickness and death and include lost productivity. This is an important example on this point. Figure 1. For example, does the farm-to-school policy include language that is strong enough to ensure the resources necessary to support implementation 5? For example, a person may not walk or bike to the store or to work because of a lack of sidewalks or safe bike trails.

Page 95 Share Cite. Davis TC, et al. Moodie, and S. McElwaine KM, et al.

Cosequences Quarterly 87 1 Identification of the behavioral and environmental variables that contribute to the populationwide obesity epidemic and how they influence and interact with each other is needed to determine which prevention efforts are the most promising. Implement a policy that mandates daily physical education in a public school district. As indicated above, evaluation is often viewed as primarily being within the purview of foundations, government, and academic institutions.

The outputs of the implementation and maintenance steps logic of appropriateness and logic of consequences of obesity the framework address 4 of the 5 RE-AIM criteria: reach, adoption, implementation, and maintenance. In this consequencew I shall evaluate them. Moreover, human security can be fallen apart to seven specific elements like economic, food, health, environmental, personal, community, political. For example, farm-to-school policies require that local farmers, food distribution systems, and schools agree to participate ie, adopt. Practitioners can draw on the Center TRT framework to identify and adapt components to include in their progressive logic models. While the logic of expected consequences is considering what is loss, what is income, the logic of appropriateness is based on normative beliefs that make actions appropriate under certain conditions and inappropriate under others. Obesity and its associated health problems have a significant economic impact on the US health care system, 11 including direct and indirect costs.

In addition, obesity has implications for armed forces recruitment. People and families may make decisions based on their environment or community. There is an undeniable fact that both the logic of consequences and the logic of appropriateness wish to get beyond the limits of interpretations of historical observations and descriptions of behavior events. Obesity is a complex health issue resulting from a combination of causes and individual factors such as behavior and genetics. According to the logic of appropriateness: 1.

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In the section below we apply the 5A framework to consider different elements of obesity prevention and how these have been reported in the literature. The evaluation framework presented in this report is offered in direct support of the U. Additionally, stakeholders may vary in their judgments about how much improvement is sufficient for a program to be viewed as high quality and effective Shadish, The purpose of this scoping review is to examine what the published literature indicates about the role of hospital and community based health services in adult obesity prevention in order to map the evidence and identify gaps in existing research.

At the same time, vigilant and credible monitoring of these population-level indicators and indices is critical to the overall national plan to prevent childhood obesity, and is a responsibility that should be assumed by the health agencies of the government Chapter 4. Evaluations inform decision- And logic Purposes of Evaluation for Different Audiences Purpose Audience Inform decision-making and provide accountability Policy makers, funders, and other elected and appointed decision makers Understand how a program or policy worked as implemented in particular contexts and the relative contribution of each component to improve the intervention for replication, expansion, or dissemination or to advance scientific knowledge Program developers, researchers, and administrators Improve the program, enhance the daily program operations, or contribute to the development of the organization Program managers and staff Promote social justice and equity in the program Program participants, their families, and communities SOURCE: Greene Pearce, C. This review highlights that whilst a population health approach is important to address the complexity of obesity, it is important that the remit of health services is extended beyond medical treatment to incorporate obesity prevention through screening and referral.

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Either a or or an air strake… The decision was not in favor of air strake because of his loss could be higher than his gain. Center TRT has created and logic list of evaluation questions and potential data sources that are mapped to components of the framework available by request to corresponding author. Granted that the logics have one purpose to reach, nevertheless one of them is conformed to current conditions. See strategies to prevent obesity and school health guidelines. Figure 2 provides an illustration of a logic model for a farm-to-school policy that is in the formulating stage of policy making. We describe these 4 sections in more detail and provide an illustration of how practitioners might apply them to evaluate a state-level farm-to-school policy to create infrastructure and allocate funding to coordinate the purchase and distribution of locally grown foods to schools. To browse Academia.

Although it begins to capture the complex and emergent nature of policy making, the framework may yield logic models that oversimplify. This is because it includes common security, global security, cooperative security and comprehensive security. Obesity is a threat to the health of the US population. What is the economic case for treating obesity? For farm-to-school policies, outputs include whether schools continue to order and serve the same or greater amounts of locally grown foods as when the program started.

Prev Chronic Dis ; Learn about community strategies to make it easier to be physically active. Even if the subject appears difficult, it reflects reality. What does the logic of appropriateness mean? Practitioners cannot anticipate all possible consequences and, therefore, should assess both positive and negative unintended outcomes

Engaging stakeholders, raising awareness, and advocating for change are essential activities throughout the policy-making process 9. Democratic political life is ordered by institutions. The list includes sections related to formative, process, and outcomes evaluation. Family health history reflects the effects of shared genetics and environment among close relatives. Evaluation may also assess the extent to which policies followed model policy guidance from organizations with expertise in obesity prevention policy eg, National Policy and Legal Analysis Network to Prevent Childhood Obesity.

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Table 4 Scope of literature by category. A qualitative inquiry about weight counseling lgoic in community health centers. Resources and Inputs. By clinicians not discussing weight and lifestyle with people before it becomes a significant problem there is a missed opportunity to prevent illness development based on known risk factors. Login or Register to save! Oken E, et al. An exception is Chapter 3which only includes recommendations 2 and 3 because they explicitly identify the need to account for diverse perspectives when designing culturally relevant interventions that address the special needs of diverse populations and high-risk groups.

Health Education Research 21 6 Bauer UE, et al. Limiting the review to English language references may have excluded some evidence. The linkage of interventions that aim to produce structural, environmental, and behavioral changes in individuals and populations relevant to childhood obesity prevention. A large-scale and more complex or sophisticated evaluation may conduct all types of these evaluations and assess a variety of multiple outcomes, as well as explain how they were achieved.

To ,ogic a policy, activities focus on looking for windows of opportunity, identifying the policy makers who will sponsor or promote the policy, and formally enacting the drafted policy in the form of a law, regulation, or budget. The logics become prominent depending on preferences and consequences or identities and rules. Facebook Twitter LinkedIn Syndicate.

However, as everybody knows, Russia did it. Consequenced Esen. Steps in an evaluation: Engage stakeholders Describe the policy initiative Focus the evaluation Gather credible evidence Justify conclusions Disseminate and use findings Phases of evaluation: Formative Process Outcome. On This Page. Among the most challenging aspects of the policy-making process are the influence of multiple sectors eg, transportation industry, food industry and contextual factors such as special interest groups, policy makers, and the broader sociopolitical environment 9, The long-term goal of obesity prevention policy is to be effective, equitable, and cost-effective at the population level

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Approprkateness Oliver Stuenkel. Outputs are the direct, tangible results of activities. This situation compels policymakers and scholars to think about the concept. Practitioners can draw on the Center TRT framework to identify and adapt components to include in their progressive logic models. On This Page. Its focus point is anarchy, that is anarchic balance of power and military that is considered as it will make people safe.

They must act in the direction of some norms the EU has. Appropristeness strategies to prevent obesity and school health guidelines. The involvement of multiple sectors requires that practitioners work with nontraditional partners; the influence of contextual factors confounds efforts to define the boundaries of a policy intervention. Am J Clin Nutr ; Practitioners cannot anticipate all possible consequences and, therefore, should assess both positive and negative unintended outcomes Enter the email address you signed up with and we'll email you a reset link.

The best example which will be given regarding inadequacy of traditional security was experienced at the end of the Cold War. Balancing the number of calories consumed from foods and beverages with the number of calories the body uses for activity plays a role in preventing excess weight gain. By and large, rules, norms, institutions and identities have importance for this way of thinking. On the other hand, it does not exclude interests.

  • The relevance of multiple levels and types of outcomes e. Interventions could include annual screening for obesity, counseling about physical activity and diet, and expanded insurance coverage for behavioral and nutritional counseling.

  • The framework is organized according to the appropriaateness standard sections of a logic model: inputs, activities, outputs, and outcomes By reviewing interventions, Center TRT staff have identified challenges in policy evaluation, such as identifying the start and end points of policy interventions, documenting processes and successes, and fully measuring success following policy enactment.

  • Gordon-Larsen, P. Similarly, emphasizing effects of having a heavier population on infrastructure and other aspects of the economy may increase negative attitudes about obese people.

  • Some illnesses may lead to obesity or weight gain. Activities are the actions or events that engage and transform inputs to produce outputs and outcomes.

  • Such concerns often relate to public policy i. Making paradigmatic sense of mixed methods practice.

Because it is based on institutions, norms, rules. Policies interact with other existing and emerging policies to affect outcomes; activities and outputs also may be designed to address the requirements of multiple policies. Outputs include media coverage and other communication eg, logic of appropriateness and logic of consequences of obesity briefs. After a cknsequences is enacted, additional inputs include the administrative structures, staffing, and material resources necessary to implement the policy and the systems that will be employed for policy monitoring and enforcement. Components of process: Problem Solutions to problems Politics. Although the framework outlines short-term, intermediate, and long-term outcomes, many initiatives will capture change only in short-term outcomes ie, changes to the environment. The notion, levels, categories, and types of in appropriateness are set by actors themselves either alone or together, under institutional settings that would set norms and standards for all their members.

They must resist strong counterpressures from those who see themselves as socially obbesity economically disadvantaged by the changes that are contemplated. A summary of the papers in each category, and the extracted data can be found in Tables 12345. Constitution, which guarantees the right to free speech and extends this protection to commercial entities. International Journal of Pediatric Obesity 5 4

  • Relevant approaches could include limiting the availability of sugar-sweetened beverages and high-calorie, energy-dense foods in certain settings e.

  • Some illnesses may lead to obesity or weight gain.

  • In particular, evaluation can contribute to an improved understanding of the effects of different types of strategies and actions—leadership actions, augmented economic and human resources, partnerships, and coalitions—on the short-term, intermediate-term, and long-term outcomes.

  • Scoping review flow chart. The ability to document these events, the methods of which are accessible online Fawcett et al.

Limiting the review to English language references may have excluded some evidence. Green suggests that clinical interventions are typically implemented in settings with a great deal of control over the dose, context, and circumstances. The following are different types of evaluations that are conducted. This would not mean communication of health promoting messages to the people living in a community as part of a specific intervention.

Fourth, evaluation is valuable at all phases of childhood obesity prevention actions, including program development, program implementation, and assessment of a wide range of outcomes. Toward Reform of Program Evaluation. Page 79 Share Cite. Schreiner, D. Each of these recommendations is further expanded upon in Chapters 4 through 8in which the committee recommends specific implementation actions that should be taken to ensure the availability of adequate resources and a focus on strengthening childhood obesity prevention efforts and their evaluation. USDA U. Whilst it is acknowledged that the health care system alone is not the answer to reducing the population impact of obesity [ 53 ], there is evidence that health services can significantly contribute to obesity prevention commencing with screening all patients for risk factors and providing brief advice.

It means, first, safety from such threats as hunger, disease and repression. Obesity and its associated health problems have a significant economic impact on the US health care system, 11 including direct and indirect costs. This was a consequentialist action. Solid lines depict components that apply to the current state of policy. What I mean is that this logic determines how actors act in appropriate ways, as expressed through their identities.

They will then identify activities and outputs that are relevant to formulating policy such as engaging stakeholders, andd awareness, and drafting policy solutions process evaluation. Russia can be a good example on this point. Who am I? Practitioners cannot anticipate all possible consequences and, therefore, should assess both positive and negative unintended outcomes For example, practitioners who are evaluating the formulation of a policy will identify inputs such as data needed to assess political will, develop the policy, and identify stakeholders formative evaluation. Skip directly to site content Skip directly to page options Skip directly to A-Z link.

The two-way arrows highlighted in Figure symbolize the dual benefit that is likely to result when the academic and governmental sectors partner with local programs to enhance evaluation capacity at the local level. On the evaluation of systemic science education reform: Searching for instructional sensitivity. Health consequences obesity taking action to improve safety and quality. Children and adolescents spend up to half their waking hours in school, where they may consume as much as one-third to one-half of their daily calories. Complex realities associated with the obesity epidemic include practical and policy considerations, some of which may impede progress or lead to unintended adverse consequences that must be addressed during the design, implementation, and evaluation of measures to accelerate obesity prevention. When specifically looking at factors influencing health professionals decision to provide counselling regarding physical activity, the health professionals own levels of physical activity, whether or not they have specific training, knowing the patient well and the patient having risk factors for chronic disease were all influencing factors [ 22 ].

Some people argue that the term denotes all the measures that threaten human survival, daily life and dignity. Funding from the Centers for Disease Control and Logic of appropriateness and logic of consequences of obesity CDC and others is spurring the emergence of promising obesity prevention initiatives, presenting a distinct opportunity to build the body of practice-based evidence. Download Free PDF. Stakeholders are defined broadly to include special interest groups, the general public, policy makers, representatives from the sectors or settings that will implement the policy, and others with an investment in the policy and its outcomes. While the logic of expected consequences is considering what is loss, what is income, the logic of appropriateness is based on normative beliefs that make actions appropriate under certain conditions and inappropriate under others. Obesity is also associated with the leading causes of death in the United States and worldwide, including diabetes, heart disease, stroke, and some types of cancer.

March, James G. The best example which will be given regarding inadequacy of traditional security was experienced at the end of the Cold War. Behaviors can include physical activity, inactivity, dietary patterns, medication use, and other exposures.

  • Cognitive and social outcomes c. This book will be of interest to federal, state, and local government agencies; educators and schools; public health and health care professionals; private-sector companies and industry trade groups; media; parents; and those involved in implementing community-based programs and consumer advocacy.

  • The fifth criterion, effectiveness, is addressed in outcomes. Protecting People.

  • Assessment and lifestyle management of patients with obesity: clinical recommendations from systematic reviews.

  • Being overweight can impede the management of chronic conditions and is the second highest contributor to burden of disease.

  • Defining the genetic architecture of the predisposition to obesity: a challenging but not insurmountable task external icon.

Acceptability and receipt of preventive care for chronic-disease health obesity behaviours reported by clients of community mental health services. Recommendation 3: Government, industry, communities, and schools should expand or develop relevant surveillance and monitoring systems and, as applicable, should engage in research to examine the impact of childhood obesity prevention policies, interventions, and actions on relevant outcomes, paying particular attention to the unique needs of diverse groups and high-risk populations. Large-scale interventions often build on multiple evaluations from the outset of the project so that at each step along the development and implementation of the project, data are collected and analyzed to assess the best use of resources and to make refinements as needed. Heslehurst N, et al.

Training opportunities to enhance the ability of stakeholders to conduct evaluations are needed. As discussed further below and in Chapter 3it is important to be particularly attentive to existing health and economic disparities in conducting evaluations of childhood obesity prevention actions and programs as reflected in the type of evaluation questions asked and the criteria used to make judgments about program quality and effectiveness. Parsons, and A. This type of modeling can be used to understand a variety of factors—obesity trends in the United States, the types of interventions needed to alter obesity trends, the subpopulations that should be targeted by specific interventions, and the length of time needed for actions to generate effects Laura Kettel-Khan, CDC, personal communication, May 27, Evaluating the extent to which strategies are being developed e.

Search all BMC articles Search. The California Department of Health Services has replicated the SRTS program in other cities, which has led to outcomes such as community audits of street, sidewalk, and bikeway conditions; the improved mobility of pedestrians and bicyclists; reduced speed and volume of motor vehicles; and improved motor vehicle compliance with traffic laws Parisi Associates, Page 85 Share Cite. Evaluation should also be conducted with appropriate respect for diverse cultural practices, traditions, values, and beliefs Pyramid Communications, ; Thompson-Robinson et al.

In addition, adults need to do activities that strengthen muscles at ap;ropriateness 2 days a week. Further development is needed to assess how well the framework accommodates these types of real-world complexity. Those people who concentrate on consequence think that human actor choose among alternatives by analyzing their possible consequences for personal or collective objectives.

Reach is the absolute number, proportion, and representativeness of people exposed to the policy. Actors are presumed to appropriatteness rules that particular identities to particular situations. By trying to respond to these questions, I hope to come up with a more complete understanding of my subject. We describe these 4 sections in more detail and provide an illustration of how practitioners might apply them to evaluate a state-level farm-to-school policy to create infrastructure and allocate funding to coordinate the purchase and distribution of locally grown foods to schools. Another example spring to my mind is the invasion of Iraq.

Milbank Quarterly 87 1 Analyses of the contribution of community change to population health outcomes that have been conducted in other areas of public health, such as automobile and highway safety, may offer insight into methods that can be used to assess the contribution of environmental changes e. Focus on the robustness and sustainability of the system to tackle obesity. Download references.

Systematic prevention of overweight and logic of appropriateness and logic of consequences of obesity in adults: a qualitative and quantitative literature analysis. In the absence aand generalizable solutions, effective planned childhood obesity prevention efforts will consist of a variety of potential strategies and actions based on an assessment of local needs, assets, conditions, and available resources. Strategies and actions to prevent obesity can be enhanced through communication, marketing, and promotion and new technologies. PubMed Google Scholar. The evaluation framework also illustrates the range of important inputs and outcomes while giving careful consideration to the following factors:. Efforts to evaluate obesity prevention programs should take into account the interconnected factors that shape the fabric of the daily lives of children and youth.

The framework is intended to provide a comprehensive overview of the entire process with the expectation that practitioners will select and adapt those components that are relevant to the stage of their initiatives and use them to develop their own progressive logic models Obesity is a threat to the health of the US population. March, James and Heber, Simon, Organizations,p.

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  • For example, incorporating local foods into unhealthy recipes is a potential unintended consequence of farm-to-school policies. According to the logic of consequences: 1.

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  • As noted above, every program deserves an evaluation appropriatendss not every intervention program needs to or has the capacity to undertake a full-scale and comprehensive evaluation. Similarly, reducing calorie intake with a more nutritious lunch purchased in the school cafeteria may be offset by the increased consumption of high-calorie snacks after school.

Protecting People. The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U. What kind of situation is this? Practitioners can respond to this challenge by iteratively revising their logic model to fit progressive stages in the policy-making process to identify the emergence of new inputs, activities, and outputs over time We tried to combine them. The framework is organized according to the 4 standard sections of a logic model: inputs, activities, outputs, and outcomes Epub Aug

The next step of the 5As framework is providing appropdiateness aimed at assisting people to set goals to self-manage lifestyle changes. By clinicians not discussing weight and lifestyle with people before it becomes a significant problem there is a missed opportunity to prevent illness development based on known risk factors. The ability to document these events, the methods of which are accessible online Fawcett et al. They must then identify and support strategies and actions that will be acceptable with respect to gains and losses.

The committee noted that a central database or information repository that tracks obesity-related legislation and that can be periodically updated is needed. A comprehensive inventory of the available databases and measurement tools is beyond the scope of this study. In the section below we apply the 5A framework to consider different elements of obesity prevention and how these have been reported in the literature.

Nooyens, and T. Obesity: why be concerned? Resources and Inputs, Strategies, and Actions What are the quality and reach or power of the action as designed? Page 48 Share Cite. References 1. Facilitative leadership. Child labor and protecting young workers around the world.

The prevalence of obesity in the United States has led to increased investment in obesity prevention and a growing focus on interventions that extend beyond individual behaviors to also address changes in environments and policies 1,2. Identifying processes and outputs during policy formulation may be important to retaining stakeholder engagement before policy enactment. Engaging stakeholders, raising awareness, and advocating for change are essential activities throughout the policy-making process 9. He estimated that the US would make profit in the long run thanks to oil in Iraq. What are my alternatives?

The final step of the 5As framework recommends providing support to help people achieve and maintain their weight goals. DeAngelis, P. Certain programs, policies, strategies, or actions may be effective for some groups but not others. Page 72 Share Cite.

Informed by previous social change models, this initiative was one of the first community-based. Existing conseequences sector surveillance systems and special surveys obesity prevention programs in india as critical components for the ongoing monitoring and tracking of a wide range of childhood obesity-related indicators. Physical Activity Evaluation Handbook. The 13 studies which specifically looked at this issue are summarised in Category 5 of Tables 12345. Furthermore, obesity prevention activities are often consistent with the goals of a wide range of other health initiatives, including those concerned with supporting chronic disease prevention, school health, work site health promotion, and urban planning strategies such as Smart Growth. Edgar, and L.

A fifth consequencss was identified in the process of undertaking the review: 5 Health staff or health service consumer perceptions of and beliefs about obesity and obesity prevention. The program includes several components that have proven to be effective, including classroom education, special events, obesity incentives that encourage children and adolescents to choose alternative forms of transportation to schools, as well as technical assistance to identify and remove the barriers to walking, bicycling, carpooling, or taking transit to school. Set of recommendations on the marketing of foods and non-alcoholic beverages to children. Page 47 Share Cite. Other large-scale, multilevel, community-based childhood obesity prevention initiatives in the United States, including Healthy Eating Active Communities 1 and Healthy Eating Active Living, 2 offer additional lessons for conducting this type of initiative through their resources and publications.

The evaluation framework that oc committee developed offers a depiction of the resources, strategies and actions, and outcomes that are important to childhood obesity prevention. Kumanyika, S. Reprints and Permissions. The quality of the theory or logic and rationale for the proposed intervention, program, or action can then be assessed by turning to relevant literature and to experts, as well as practitioners in the contexts being served. This factor was missing all together from the systematic review summarising best practice in applying the framework [ 23 ].

What's this? Nevertheless, how people respond to an environment that promotes physical inactivity and intake of high-calorie foods suggests that genes do play a role in developing obesity. Annual medical spending attributable to obesity: payer-and service-specific estimates. Figure 2.

Nutrition, physical activity and the prevention of obesity: Policy developments in the WHO European region. It is helpful to think about the components of the evaluation framework—sectors, resources and inputs, strategies and actions, and outcomes—in light of the four evaluation questions Box Foreman, J. Other studies have shown that patients may not be told they are overweight or have the health consequences of being overweight discussed [ 2132 ]. Parisi Associates. Television food marketing to children revisited: The Federal Trade Commission has the constitutional and statutory authority to regulate. Reprints and Permissions.

West Virginia school officials use the results of this obesity prevention programs in india to identify knowledge gaps and make curriculum recommendations. Not a MyNAP member yet? Gillman, C. Since the need for effective evaluation is ongoing, both the capacity and oobesity of evaluation will be positively influenced by the presence of a national commitment to support obesity prevention research and the rapid dissemination of research findings—across the geographical landscape—to stakeholders involved in prevention efforts in states and communities. These may include effective ways of engaging communities; assessing the needs and circumstances of communities and populations; assessing resources and planning programs; or connecting needs, resources, and circumstances with appropriate interventions Green, The consequences of obesity and excess weight gain in pregnancy.

Moreover, they do not ignore the reality of calculations and anticipations of consequences. When we take consequencea relationship between traditional and human security and the logic of appropriateness and the logic of consequences into account, we can show some bonds between them. Policies interact with other existing and emerging policies to affect outcomes; activities and outputs also may be designed to address the requirements of multiple policies. For example, incorporating local foods into unhealthy recipes is a potential unintended consequence of farm-to-school policies.

Once a logic model has been created, practitioners can use it as a guide to developing evaluation questions and an evaluation plan. Section Navigation. Changing behaviors and health outcomes at the population level will require multiple initiatives and an extended period and will, therefore, often exceed the scope of any single initiative 2. Productivity measures include employees being absent from work for obesity-related health reasons, decreased productivity while at work, and premature death and disability. Remember me on this computer.

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Human security can be said to have two main aspects. People who have obesity, compared to those with a healthy weight, are at increased risk for many serious diseases and health conditions, including the following: llogic. Activities are the actions or events that engage and transform inputs to produce outputs and outcomes. Obesity is a complex health issue resulting from a combination of causes and individual factors such as behavior and genetics. Metin Esen. Balancing the number of calories consumed from foods and beverages with the number of calories the body uses for activity plays a role in preventing excess weight gain. The process tends to be incremental and cyclical, involving the continual modification of existing policies and development of new policies.

Obesity and its associated health problems have andd significant economic impact on the US health care system, 11 including direct and indirect costs. Drugs such as steroids and some antidepressants may also cause weight gain. The list includes sections related to formative, process, and outcomes evaluation. Russia can be a good example on this point. Facebook Twitter LinkedIn Syndicate. Obesity is a threat to the health of the US population.

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