Tracking Success: Friend or Foe of Progress on Obesity?

If we're going to make progress on obesity, the approach to tracking success must be collaborative, thoughtful, ongoing and included in the planning process.
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Since the United Nation's Millennium Development Goals (MDG) were established nearly 15 years ago, obesity has become one of the most pervasive issues on the global public health agenda. With more than 40 million young children around the world considered overweight or obese, it's clear that the issue has become too large to ignore. As the clock counts down to 2015 when the MDG expire, the public health community is looking for ways to sustain the health gains achieved.

For groups implementing the MDG, the UN provided a framework, resources and measurement milestones to track impact overtime. Although obesity was not included among the MDG, governments, nongovernmental organizations, foundations, academic institutions and corporations have introduced a variety of programs to address the issue. While this surge of healthy lifestyle initiatives around the world should be applauded, there is little known about the architecture of these programs, on-the-ground implementation or even their effectiveness.

Tracking success and understanding what works can help fill this knowledge gap and create the greatest impact possible. However, too often, evaluation is an afterthought. Some groups see evaluation as a costly burden that only nets in punitive actions like reduced or revoked funding. Others view it as a one-time process reluctantly done as a grant requirement. Sustaining the fight against obesity requires funders and program implementers come to consensus on the merits of evaluation and the importance of uniform metrics.

Community health leaders across seven countries came together last year in Granada, Spain at the "Healthy Lifestyles Program Evaluation Workshop" to share best practices for developing effective school-based healthy lifestyle programs focused on nutrition education, physical activity and access to fresh foods. Lessons from the workshop, convened by The Mondelēz International Foundation and published in September's Food and Nutrition Bulletin, provide a great case for how knowledge sharing, ongoing evaluation and finding common ground on success indicators can improve nutrition outcomes.

Workshop participants leveraged the Program Impact Pathways framework to help improve program impact, refine goals and identify success measures consistent with those goals. An important workshop outcome is that leaders were able to hear from others' experiences to help identify and shore up deficiencies in their own programs. For example, leaders from the Mondelēz Hope Kitchen Program in China were not measuring the program's impact on knowledge of nutrition, hygiene and health. As a result of in-depth discussion, Hope Kitchen leaders determined that increasing access to healthy foods is key to tackling childhood obesity. Since then, the program has expanded school gardens as a strategy to diversify school meals, while continuing to change the school food environment. This is just one example of many. Overall, leaders from programs in the United Kingdom, Italy, Brazil, Russia, Spain and Germany were inspired to make adjustments to the way they implemented and evaluated their programs.

Let's learn from the Millennium Development Goals experience and that of this workshop. If we're going to make progress on obesity, the approach to tracking success must be collaborative, thoughtful, ongoing and included in the planning process. Just as poverty, hunger and inequality are widespread, obesity is not the problem of any one country or organization. What works in Brazil can be useful in Russia and China and vice versa. Seeing the merit in evaluation and tracking success often means sharing stories of what works so that others might tweak their strategies to get the greatest impact. It also means believing that, without it, success is unattainable.