To battle the obesity epidemic in America, health care professionals and policymakers need relevant, useful data on the effectiveness of obesity prevention policies and programs. Bridging the Evidence Gap in Obesity Prevention identifies a new approach to decision making and research on obesity prevention to use a systems perspective to gain a broader understanding of the context of obesity and the many factors that influence it.

Contents

• THE NATIONAL ACADEMIES
• COMMITTEE ON AN EVIDENCE FRAMEWORK FOR OBESITY PREVENTION DECISION MAKING
• Reviewers
• Preface
• Summary
• 1. Introduction
  • STUDY CHARGE, APPROACH, AND SCOPE
  • OBESITY AS A SOCIETYWIDE PROBLEM
  • DECISION MAKING, OBESITY PREVENTION, AND EVIDENCE NEEDS
  • ORGANIZATION OF THE REPORT
  • REFERENCES
• 2. Obesity Prevention Strategies in Concept and Practice
  • DEFINITIONS AND TYPES OF PREVENTION
  • THE LOGIC OF OBESITY PREVENTION
  • THE SPECTRUM OF OBESITY PREVENTION APPROACHES
  • OBESITY PREVENTION STRATEGIES IN THE BROADER CONTEXT OF OTHER PUBLIC HEALTH INITIATIVES
  • REFERENCES
• 3. Rationale for and Overview of the L.E.A.D. Framework
  • STATUS OF THE EVIDENCE BASE
  • FUNDAMENTAL EVIDENCE CONCEPTS
  • APPLICATION OF AN EXPANDED EVIDENCE FRAMEWORK
  • THE L.E.A.D. FRAMEWORK
  • REFERENCES
• 4. Defining the Problem: The Importance of Taking a Systems Perspective
  • UNDERSTANDING A SYSTEMS APPROACH
  • USES OF SYSTEMS THINKING, APPROACHES, MAPPING, AND MODELING
  • RELATION TO THE L.E.A.D. FRAMEWORK
  • APPLICATION AND FUTURE DIRECTIONS
  • REFERENCES
• 5. Specifying Questions and Locating Evidence: An Expanded View
  • SPECIFYING QUESTIONS: AN EVIDENCE TYPOLOGY FOR THE L.E.A.D. FRAMEWORK
  • POTENTIALLY USEFUL SOURCES OF EVIDENCE
  • GATHERING THE EVIDENCE
  • REFERENCES
• 6. Evaluating Evidence
  • A USER’S PERSPECTIVE
  • IDENTIFICATION OF APPROPRIATE OUTCOMES
  • GENERALIZABILITY AND CONTEXTUAL CONSIDERATIONS
  • EXISTING APPROACHES TO EVALUATING EVIDENCE
  • A PROPOSED APPROACH TO EVALUATING THE QUALITY OF SCIENTIFIC EVIDENCE
  • WHEN SCIENTIFIC EVIDENCE IS NOT A PERFECT FIT: TRADE-OFFS TO CONSIDER
  • REFERENCES
• 7. Assembling Evidence and Informing Decisions
  • GUIDANCE FOR ASSEMBLING THE EVIDENCE
  • A TEMPLATE FOR SUMMARIZING THE EVIDENCE
  • KNOWLEDGE INTEGRATION
  • REFERENCES
• 8. Opportunities to Generate Evidence
  • EXISTING EVIDENCE NEEDS
  • THE NEED FOR NEW DIRECTIONS AND TRANSDISCIPLINARY EXCHANGE
  • LIMITATIONS IN THE WAY EVIDENCE IS REPORTED IN SCIENTIFIC JOURNALS
  • WAYS TO FILL THE GAPS IN THE BEST AVAILABLE EVIDENCE
  • ALTERNATIVES TO RANDOMIZED EXPERIMENTS
  • REFERENCES
• 9. Next Steps
  • COMMUNICATING AND DISSEMINATING THE FRAMEWORK
  • EVALUATING AND REFINING THE FRAMEWORK
  • REFERENCES
• 10. Conclusions and Recommendations
  • CONCLUSIONS
  • RECOMMENDATIONS
• A Acronyms and Glossary
• B Other Evidence Projects
• C Review of Existing Reviews on Obesity Prevention
• D Information Sources for Locating Evidence
• E An In-Depth Look at Study Designs and Methodologies
• F Agendas from Two Workshops
• G Committee Member Biographical Sketches

This study was supported by Tracking No. 20604633 between the National Academy of Sciences and Kaiser Permanente; by Grant No. 61747 with the Robert Wood Johnson Foundation; and by Contract No. 200-2005-13434, Task Order 13 with the Centers for Disease Control and Prevention. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

Suggested citation:

IOM (Institute of Medicine). 2010. Bridging the Evidence Gap in Obesity Prevention: A Framework to Inform Decision Making. Washington, DC: The National Academies Press.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.