Background and Purpose
Over the past thirty years, the prevalence of obesity in the United States has more than doubled among adults and more than tripled among children and adolescents. To address this growing epidemic, obesity prevention interventions are extending beyond individual behavior change strategies and applying policy and environmental approaches that support healthy eating and active living. Despite this increased focus on policies and environments, the field of obesity prevention lacks abundant evidence about effective policies, programs, and practices. While it well-established that the strongest evidence comes from rigorous research or evaluation studies, these types of studies are costly in terms of time and resources. As a result of the increased demand to identify and promote evidence-based policies and practices in obesity prevention, the Division of Nutrition, Physical Activity, and Obesity (DNPAO) at the CDC conducted Evaluability Assessments (EAs) to assess the evaluation readiness of active living initiatives related to active transportation and joint use agreements. The EA process, which can be replicated by public health researchers and practitioners, can result in the identification of practice-based interventions that may be worthy of additional evaluation. for the purposes of this project, active transportation initiatives can be further defined as transportation and travel initiatives that encourage active transport by enhancing and promoting a supportive infrastructure for walking and bicycling and joint use agreements (JUAs) are state-, district-, or school-level policies that allow for shared use of space or facilities among partners to improve access to recreational sites and opportunities for physical activity.
Description
The EA is an innovative and cost-effective method to systematically assess promising initiatives. The primary objectives of EAs are to conserve limited resources by recommending evaluation only when initiatives are adequately implemented and to increase the potential of future evaluation investments to fill important research gaps. During an EA, evaluators work with an initiative’s administrators and key stakeholders to prepare them for evaluation. This consists of document reviews, site visits, and interviews to examine additional criteria, such as an initiative’s feasibility of implementation, reach to target population, and options for further evaluation.
Lessons Learned
From 2011-2012, DNPAO conducted 5 EAs related to active transportation and 5 EAs examining joint use agreements. The five active transportation initiatives assessed included: (1) Boston Bike to Farmers’ Market Program; (2) Missouri Livable Streets Project; (3) Nashville Area Regional Transportation Plan; (4) San Francisco Sunday Streets; and (5) Washtenaw County, Michigan Building Healthy Communities Initiative. The five JUAs engaged in an Evaluability Assessment included: (1) Fairfax County, Virginia JUA; (2) Earlimart, California JUA; (3) Hudson Falls, New York Schools JUA; (4) State of Arkansas JUA; and (5) Los Angeles, California Joint Use Moving People to Play Initiative. The outcomes from the 10 EAs conducted will be described. This includes a synthesis of the potential impact, stakeholder involvement, feasibility of implementation and adoption, transportability, sustainability, and organizational capacity of the active living initiatives. Overall, our findings demonstrated that the active living initiatives most ready for rigorous evaluation demonstrated significant reach to their target population, sustainable funding sources, strong political support, and progress made in collecting preliminary data. The process of conducting an EA and the application of the criteria depicted in Table 1 will also be described.
Conclusions and Implications
The EA method can be an effective process for determining the evaluation readiness of policies, programs, and practices related to active living. Results from the EAs conducted by CDC, as well as EAs implemented by other organizations, can help to guide evaluation and research investments and to identify promising policy and environmental initiatives for the purposes of dissemination and adoption in other states and communities. Further evaluation studies of the active transportation initiatives and joint use agreements identified as promising through this project can also build the evidence base in policies and environments that support active living and obesity prevention.
Next Steps
The information garnered from this project has already been used to provide feedback and technical assistance to the developers and program managers of each active living initiative, and will be used to position the most promising interventions for formal evaluation when funding becomes available. The findings collected from the EAs will also be synthesized and disseminated to other states and communities conducting similar efforts.
Support / Funding Source
This study was conducted by ICF International and funded by the Centers for Disease Control and Prevention.
