Convergence Partnership 2007 Robert Wood Johnson Foundation W.K. Kellogg Foundation Kaiser Permanente The California Endowment Nemours Health and Prevention Services Centers for Disease Control and Prevention PolicyLink: Program Director

2 Vision Safe neighborhoods, communities and buildings support physical activity as part of everyday life. Fresh, local, and healthy food is available and affordable in all communities and neighborhoods. Healthy foods and beverages are promoted in grocery and other food stores, restaurants, and entertainment venues. Schools offer and promote only healthy food and beverages to students. Schools promote healthy physical activities and incorporate them throughout the day, including before and after school.

3 Vision (cont’) Workplaces and employers offer and promote access to healthy foods and beverages and opportunities for physical activity. Health care organizations and providers promote healthy eating and active living in their own institutional policies and in their clinical practices. Organizations, institutions, and individuals that influence the information and entertainment environments share responsibility for and act responsibly to promote healthy eating and active living. Childcare organizations, including preschool, after-school and early childhood settings, offer and promote only healthy foods and beverages to children and provide sufficient opportunities for, and promote, physical activity.

4 Values Promote equity and social justice Respect, recognize, and build upon the assets and capacity of communities Value learning from new evidence Have the wisdom to change course as dictated by experience

5 Four core strategies that leverage environmental change 1. Build support for environmental and policy changes that promote healthy eating and active living. 2. Promote and support coordination and connections within the healthy eating and active living field 3. Optimize and increase investments in order to enhance the intensity, reach, and the number of community-based initiatives focused on environmental and policy change to enhance healthy eating and active living. 4. Foster market-based change so that healthy food and opportunities for daily activity are available to all, affordable, safe, convenient and attractively presented and marketed.

6 Within and Across Strategies Advance equity Promote cross sector policy, advocacy, networking, and mobilization Foster leadership Move the evidence base forward Employ the best in strategic communication Leverage resources– within, across, and beyond

7 Infrastructure MOUs between partners Program Director Search Prevention Institute and Civic Results Research PolicyLink as Program Director Tides as Financial Manager Committees and Working Groups

Next Steps for Partnership - 8 Advancing the Overall Vision: Put the vision on the public, policy, and media agendas and support the infrastructure to carry the work forward.

9 Next Steps for Partnership: Examples of how to advance the vision: Work with leaders and coalitions in the field Build grassroots capacity and support additional leadership Outreach to broader audience to introduce convergence vision and strategies

10 Convergence Partnership The Sum is Greater than the Parts

Common Community Measures for Obesity Prevention K. Sobush 1, D. Dunet 1, E. Fulmer 2, J. Renaud 2, L. Kettel Khan 1 1 Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity, and Obesity 2 RTI International

Background and Purpose Communities have responded to the US obesity epidemic with a variety of initiatives, including strategies that address the food and physical activity environment. Currently, there are no agreed-upon measures to assess environmental and policy changes. The result is a variety of designs and measures used by communities, evaluators and researchers. The lack of a core set of measures makes it particularly challenging to synthesize results from different studies to expand the base of evidence. The Common Community Measures for Obesity Prevention project will identify a set of core data elements that can be used by communities for self-evaluation as well as by program evaluators and researchers who study the physical activity and food environments at the community level. For each measure, a data collection protocol and potential data sources will be identified.

Methods Potential environmental and policy strategies for obesity prevention were identified through a systematic scan of the literature and key documents. A Select Panel of nationally recognized experts and CDC experts rated the strategies using defined criteria. Strategies were prioritized based on rating results and discussion. Measures for the priority strategies will be identified through a literature scan and expert opinion and then rated using defined criteria. The systematic process is guided by principles of transparency, stakeholder involvement, and documentation.

Results A literature scan identified 270 meta-analysis or review articles published between 2005 and articles were eliminated based on exclusion criteria. Additionally, 31 articles were not obtained by the cut off date for the review. In total, 94 articles and 7 key documents were scanned to identify strategies for obesity prevention. The scan resulted in the identification of 179 strategies. Select panelists rated those strategies and identified 47 promising environmental and policy strategies for obesity prevention. Additional input from experts on the Select Panel and from CDC prioritized approximately 25 strategies.

47 Promising Environmental and Policy Strategies

26 Promising Environmental and Policy Nutrition Related Strategies

17 Promising Environmental and Policy Physical Activity Related Strategies

Conclusions Common measures provide communities with tools to focus their obesity prevention efforts. Additionally, they allow projects from different funding streams to collect common measures. For evaluators and researchers, the core set of measures will be useful as baseline variables for more elaborate studies and as part of a foundation for evaluation. The use of common community measures will provide one method to build the evidence base about policy and environmental strategies for obesity prevention.

Evaluability Assessments of Programs and Policies to Prevent Childhood Obesity L. Kettel Khan 1, H. Wethington 1, S. Pitt Barnes 2, D. Dunet 1, L. Robin 2, N. Dawkins 3, D. Cotton 3, J. Grunbaum 4 L. Leviton 5 1 Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity, and Obesity. Atlanta, GA 2 Centers for Disease Control and Prevention, Division of Adolescent and School Health. Atlanta, GA 3 Macro International, Inc. Atlanta, GA 4 Centers for Disease Control and Prevention, Prevention Research Centers. Atlanta, GA 5 Robert Wood Johnson Foundation, Princeton, NJ

Background and Purpose Identification of effective strategies is critical to build the evidence base for community level obesity prevention. However, rigorous evaluation and empirical research studies are costly and time-consuming Well-designed studies may be unable to reach a definitive conclusion because of unanticipated barriers, e.g., lack of full implementation, inadequacy of data systems, or significant shifts in staff understanding of goals for a program or policy Evaluability assessments provide a systematic way to determine if the program or policy is ready for rigorous evaluation and identifies what refinements may be needed prior to a formal evaluation study Evaluability assessments will be conducted on groups of programs/policies in themed areas in two waves

Methods Identifying Programs and Policies A systematic search process identified nominee programs and policies based on: potential impact innovativeness reach to target population acceptability to stakeholders feasibility of implementation feasibility of adoption transportability sustainability organizational capacity Priority was given to programs and policies that addressed low income populations and ethnic groups with disproportionate childhood obesity.

Methods Evaluability Assessments A two-person team conducts each site visit to assess: implementation data collection staff capacity intended outcomes Interviews with administrators, supervisors, staff, and evaluators: Is it plausible that the intervention will produce the desired outcomes to prevent childhood obesity in the target population? Is it feasible that the program/policy will be fully implemented as intended? What are options for further evaluation? Review program/policy documents Provide feedback on readiness for full evaluation

WAVE 1(Fall ’07) School District Local Wellness Policies (LWP) Afterschool/Daycare Programs Access to healthier foods in inner city, low income communities

WAVE 2 (Spring ’08) Comprehensive School Physical Activity Programs Afterschool/Daycare Programs Access to healthier foods in inner city, low income communities

Results 26 programs and policies were selected in three themes to receive evaluability assessments 6 school district local wellness policies 10 afterschool/daycare programs 10 access to fresh foods programs 21 assessments have been completed as of November programs and policies following under Wave 2 areas will be identified by the expert panel in Spring 2008 Synthesis reports for each theme will identify programs/policies ready for full evaluation Identify one program/policy for comprehensive evaluation in Spring 2008

Conclusions This project demonstrates the feasibility of using a systematic process to conduct evaluability assessments on multiple programs/policies in themed areas ready for comprehensive evaluation. Procedures such as on-line ratings by expert panel members provided a systematic method to effectively leverage subject matter expertise. Structured protocols allowed effective deployment of site visit teams and rapid turn- around of summary reports on readiness for rigorous evaluation.