Last data update: Jan 27, 2025. (Total: 48650 publications since 2009)
Records 1-11 (of 11 Records) |
Query Trace: Dawkins N[original query] |
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Childhood Obesity Declines Project: A different methodology
Kettel Khan L , Ottley P , Harris C , Dawkins-Lyn N , Dooyema C , Jernigan J , Kauh T , Young-Hyman D . Child Obes 2018 14 S5-s11 BACKGROUND: The evidence for and our understanding of community-level strategies such as policies, system, and environmental changes that support healthy eating and active living is growing. However, researchers and evaluation scientists alike are still not confident in what to recommend for preventing or sustaining declines in the prevalence of obesity. METHODS: The Systematic Screening and Assessment (SSA) methodology was adapted as a retrospective process to confirm obesity declines and to better understand what and how policies and programs or interventions may contribute as drivers. The Childhood Obesity Declines (COBD) project's adaptation of the SSA methodology consisted of the following components: (1) establishing and convening an external expert advisory panel; (2) identification and selection of sites reporting obesity declines; (3) confirmation and review of what strategies occurred and contextual factors were present during the period of the obesity decline; and (4) reporting the findings to sites and the field. RESULTS/DISCUSSION: The primary result of the COBD project is an in-depth examination of the question, "What happened and how did it happen in communities where the prevalence of obesity declined?" The primary aim of this article is to describe the project's methodology and present its limitations and strengths. CONCLUSIONS: Exploration of the natural experiments such that occurred in Anchorage, Granville County, New York City, and Philadelphia is the beginning of our understanding of the drivers and contextual factors that may affect childhood obesity. This retrospective examination allows us to: (1) describe targeted interventions; (2) examine the timeline and summarize intervention implementation; (3) document national, state, local, and institutional policies; and (4) examine the influence of the reach and potential multisector layering of interventions. |
The Childhood Obesity Declines Project: A review of enacted policies
Dooyema C , Jernigan J , Warnock AL , Dawkins-Lyn N , Harris C , Kauh T , Kettel Khan L , Ottley P , Young-Hyman D . Child Obes 2018 14 S22-s31 BACKGROUND: State- and local-level policies can influence children's diet quality and physical activity (PA) behaviors. The goal of this article is to understand the enacted state and local policy landscape in four communities reporting declines in childhood obesity. METHODS AND RESULTS: State-level policies were searched within the CDC's online Chronic Disease State Policy Tracking System. Local level policies were captured during key informant interviews in each of the sites. Policies were coded by setting [i.e., early care and education (ECE) also known as child care, school, community], jurisdictional level (i.e., state or local) and policy type (i.e., legislation or regulation). The time period for each site was unique, capturing enacted policies 5 years before the reported declines in childhood obesity in each of the communities. A total of 39 policies were captured across the 4 sites. The majority originated at the state level. Two policies pertaining to ECE, documented during key informant interviews, were found to be adopted at the local level. CONCLUSION: Similarities were noted between the four communities in the types of polices enacted. All four communities had state- and/or local-level policies that aimed to improve the nutrition environment and increase opportunities for PA in both the ECE and K-12 school settings. This article is a step in the process of determining what may have contributed to obesity declines in the selected communities. |
Childhood Obesity Declines Project: An effort of the National Collaborative on Childhood Obesity Research to explore progress in four communities
Kauh TJ , Dawkins-Lyn N , Dooyema C , Harris C , Jernigan J , Kettel Khan L , Ottley P , Young-Hyman D . Child Obes 2018 14 S1-s4 BACKGROUND: Recent findings show that national childhood obesity prevalence overall is improving among some age groups, but that disparities continue to persist, particularly among populations that have historically been at higher risk of obesity and overweight. Over the past several years, many jurisdictions at the city or county level across the nation have also reported declines. Little evaluation has focused on understanding the factors that influence the implementation of efforts to reduce childhood obesity rates. This article summarizes the rationale, aims, and overall design of the Childhood Obesity Declines Project (COBD), which was the first of its kind to systematically study and document the what, how, when, and where of community-based obesity strategies in four distinct communities across the nation. METHODS: COBD was initiated by the National Collaborative on Childhood Obesity Research (NCCOR), was led by a subset of NCCOR advisors and a research team at ICF, and was guided by external advisors made up of researchers, decision makers, and other key stakeholders. The research team used an adapted version of the Systematic Screening and Assessment method to review and collect retrospective implementation data in four communities. RESULTS: COBD found that sites implemented strategies across the many levels and environments that impact children's well being (akin to the social-ecological framework), building a Culture of Health in their communities. CONCLUSIONS: COBD demonstrates how collaboratives of major funders with the support of other experts and key stakeholders, can help to accelerate progress in identifying and disseminating strategies that promote healthy eating and physical activity. |
Childhood Obesity Declines Project: An exploratory study of strategies identified in communities reporting declines
Ottley PG , Dawkins-Lyn N , Harris C , Dooyema C , Jernigan J , Kauh T , Kettel Khan L , Young-Hyman D . Child Obes 2018 14 S12-s21 BACKGROUND: Although childhood obesity rates have been high in the last few decades, recent national reports indicate a stabilization of rates among some subpopulations of children. This study examines the implementation of initiatives, policies, and programs (referred to as strategies) in four communities that experienced declines in childhood obesity between 2003 and 2012. METHODS AND RESULTS: The Childhood Obesity Decline project verified obesity declines and identified strategies that may have influenced and supported the decline in obesity. The project used an adaptation of the Systematic Screening and Assessment method to identify key informants in each site. Four settings were highlighted related to childhood: (1) communities, (2) schools, (3) early care and education, and (4) healthcare. The findings indicate that programs and policies were implemented across local settings (primarily in schools and early childhood settings) and at the state level, during a timeframe of supportive federal policies and initiatives. CONCLUSIONS: Multilevel approaches were aimed to improve the nutrition and physical activity environments where children spend most of their time. We hypothesized that other, more distal strategies amplified and reinforced the impact of the efforts that more directly targeted children. The simultaneous public health messaging and multilayered initiatives, supported by cross-sector partnerships and active, high-level champions, were identified as likely important contributors to success in attaining declines in rates of childhood obesity. |
Childhood Obesity Declines Project: Highlights of community strategies and policies
Jernigan J , Kettel Khan L , Dooyema C , Ottley P , Harris C , Dawkins-Lyn N , Kauh T , Young-Hyman D . Child Obes 2018 14 S32-s39 BACKGROUND: The social ecological model (SEM) is a framework for understanding the interactive effects of personal and environmental factors that determine behavior. The SEM has been used to examine childhood obesity interventions and identify factors at each level that impact behaviors. However, little is known about how those factors interact both within and across levels of the SEM. METHODS: The Childhood Obesity Declines (COBD) project was exploratory, attempting to capture retrospectively policies and programs that occurred in four communities that reported small declines in childhood obesity. It also examined contextual factors that may have influenced initiatives, programs, or policies. Data collection included policy and program assessments, key informant interviews, and document reviews. These data were aggregated by the COBD project team to form a site report for each community (available at www.nccor.org/projects/obesity-declines ). These reports were used to develop site summaries that illustrate how policies, programs, and activities worked to address childhood obesity in each study site. RESULTS/CONCLUSIONS: Site summaries for Anchorage, AK; Granville County, NC; Philadelphia, PA; and New York City, NY, describe those policies and programs implemented across the levels of the SEM to address childhood obesity and examine interactions both across and within levels of the model to better understand what factors appear important for implementation success. |
The Childhood Obesity Declines Project: Implications for research and evaluation approaches
Young-Hyman D , Morris K , Kettel Khan L , Dawkins-Lyn N , Dooyema C , Harris C , Jernigan J , Ottley P , Kauh T . Child Obes 2018 14 S40-s44 BACKGROUND: Childhood obesity remains prevalent and is increasing in some disadvantaged populations. Numerous research, policy and community initiatives are undertaken to impact this pandemic. Understudied are natural experiments. The need to learn from these efforts is paramount. Resulting evidence may not be readily available to inform future research, community initiatives, and policy development/implementation. METHODS: We discuss the implications of using an adaptation of the Systematic Screening and Assessment (SSA) method to evaluate the Childhood Obesity Declines (COBD) project. The project examined successful initiatives, programs and policies in four diverse communities which were concurrent with significant declines in child obesity. In the context of other research designs and evaluation schemas, rationale for use of SSA is presented. Evidence generated by this method is highlighted and guidance suggested for evaluation of future studies of community-based childhood obesity prevention initiatives. Support for the role of stakeholder collaboratives, in particular the National Collaborative on Childhood Obesity Research, as a synergistic vehicle to accelerate research on childhood obesity is discussed. RESULTS/DISCUSSION: SSA mapped active processes and provided contextual understanding of multi-level/component simultaneous efforts to reduce rates of childhood obesity in community settings. Initiatives, programs and policies were not necessarily coordinated. And although direct attribution of intervention/initiative/policy components could not be made, the what, by who, how, to whom was temporally associated with statistically significant reductions in childhood obesity. CONCLUSIONS: SSA provides evidence for context and processes which are not often evaluated in other data analytic methods. SSA provides an additional tool to layer with other evaluation approaches. |
Identifying promising practices for evaluation: the National Breast and Cervical Cancer Early Detection Program
DeGroff A , Cheung K , Dawkins-Lyn N , Hall MA , Melillo S , Glover-Kudon R . Cancer Causes Control 2015 26 (5) 767-74 PURPOSE: The Centers for Disease Control and Prevention conducted a systematic screening and assessment process to identify promising practices implemented by grantees of the National Breast and Cervical Cancer Early Detection Program and its partners that were appropriate for rigorous evaluation. METHODS: The systematic screening and assessment (SSA) process was conducted from September 2010 through March 2012 and included five steps: (1) nominations of promising practices; (2) a first rating by subject matter experts; (3) field-based evaluability assessments; (4) a second rating by experts; and (5) use of results. Nominations were sought in three program areas including health education and promotion, quality assurance and quality improvement, and case management/patient navigation. RESULTS: A total of 98 practices were nominated of which 54 % were eligible for the first review by the experts. Fifteen practices were selected for evaluability assessment with ten forwarded for the second review by the experts. Three practices were ultimately recommended for rigorous evaluation, and one evaluation was conducted. Most nominated practices were based on evidence-based strategies rather than representing new, innovative activities. Issues were identified through the process including inconsistent implementation and lack of implementation fidelity. CONCLUSION: While the SSA was successful in identifying several programs for evaluation, the process also revealed important shortcomings in program implementation. Training and technical assistance could help address these issues and support improved programming. |
Evaluation design of New York City's regulations on nutrition, physical activity, and screen time in early child care centers
Breck A , Goodman K , Dunn L , Stephens RL , Dawkins N , Dixon B , Jernigan J , Kakietek J , Lesesne C , Lessard L , Nonas C , O'Dell SA , Osuji TA , Bronson B , Xu Y , Kettel Khan L . Prev Chronic Dis 2014 11 E184 This article describes the multi-method cross-sectional design used to evaluate New York City Department of Health and Mental Hygiene's regulations of nutrition, physical activity, and screen time for children aged 3 years or older in licensed group child care centers. The Center Evaluation Component collected data from a stratified random sample of 176 licensed group child care centers in New York City. Compliance with the regulations was measured through a review of center records, a facility inventory, and interviews of center directors, lead teachers, and food service staff. The Classroom Evaluation Component included an observational and biometric study of a sample of approximately 1,400 children aged 3 or 4 years attending 110 child care centers and was designed to complement the center component at the classroom and child level. The study methodology detailed in this paper may aid researchers in designing policy evaluation studies that can inform other jurisdictions considering similar policies. |
Results of evaluability assessments of local wellness policies in 6 US school districts
Pitt Barnes S , Robin L , O'Toole TP , Dawkins N , Kettel Khan L , Leviton LC . J Sch Health 2011 81 (8) 502-511 BACKGROUND: A US federal mandate that school districts devise and implement local wellness policies (LWPs) has potential widespread impact on the nutritional content of foods and beverages available in schools and on the amount of physical activity that students engage in; however, evidence concerning the mandate's effectiveness is limited. This study describes the content of LWPs of 6 US school districts and steps taken toward their implementation and evaluation. METHODS: During visits to 6 school districts, we interviewed 88 school and community representatives about the content of their district's LWPs and how the LWPs were being implemented and evaluated. RESULTS: The 6 LWPs were consistent with the federal mandate, although they varied in content and degree of specificity, and none had been fully implemented. All 6 districts were pursuing strategies to ensure that foods and beverages available at school met nutrition standards but did not offer nutrition education to all K-12 students. All 6 districts offered students only limited opportunities for physical activity, and all 6 collected data to monitor process and outcomes of their LWPs. CONCLUSIONS: Partial implementation of LWPs in the districts we visited resulted in significant improvement in the nutritional quality of foods available at district schools, but only slight improvement in students' opportunities for school-based physical activity. We provide recommendations for school districts on implementation and evaluation. Future research is needed to determine the impact of these LWPs on students' health. |
Training and technical assistance to enhance capacity building between prevention research centers and their partners
Spadaro AJ , Grunbaum JA , Dawkins NU , Wright DS , Rubel SK , Green DC , Simoes EJ . Prev Chronic Dis 2011 8 (3) A65 INTRODUCTION: The Centers for Disease Control and Prevention has administered the Prevention Research Centers Program since 1986. We quantified the number and reach of training programs across all centers, determined whether the centers' outcomes varied by characteristics of the academic institution, and explored potential benefits of training and technical assistance for academic researchers and community partners. We characterized how these activities enhanced capacity building within Prevention Research Centers and the community. METHODS: The program office collected quantitative information on training across all 33 centers via its Internet-based system from April through December 2007. Qualitative data were collected from April through May 2007. We selected 9 centers each for 2 separate, semistructured, telephone interviews, 1 on training and 1 on technical assistance. RESULTS: Across 24 centers, 4,777 people were trained in 99 training programs in fiscal year 2007 (October 1, 2006-September 30, 2007). Nearly 30% of people trained were community members or agency representatives. Training and technical assistance activities provided opportunities to enhance community partners' capacity in areas such as conducting needs assessments and writing grants and to improve the centers' capacity for cultural competency. CONCLUSION: Both qualitative and quantitative data demonstrated that training and technical assistance activities can foster capacity building and provide a reciprocal venue to support researchers' and the community's research interests. Future evaluation could assess community and public health partners' perception of centers' training programs and technical assistance. |
Ensuring accountability in public health prevention research: evaluating the Prevention Research Centers Program at the Centers for Disease Control and Prevention
Wright DS , Grunbaum JA , Dawkins N , Dino G , Chervin D , Barnes K , Olarita-Dhungana J , Simoes E . J Public Health Manag Pract 2011 17 (2) E1-E9 This article discusses the contributions of Prevention Research Centers program at the Centers for Disease Control and Prevention to public health policies, programs, and practices aimed at improving health and eliminating health disparities.The Prevention Research Centers (PRC) Program at the Centers for Disease Control and Prevention funds centers in schools of public health and medicine to conduct health-promotion and disease-prevention research and other activities, using a community-based participatory research approach. A national program evaluation assessed PRC Program contributions to public health practices and policies, community-based participatory research implementation, and PRCs’ infrastructures and organizational factors. An overview of the evaluation development and implementation activities is provided, along with highlighted results from program indicators, contextual studies, and other complementary activities. Evaluation design used both quantitative and qualitative methods. Lessons learned from the evaluation process include having a clear purpose to provide clarity to the evaluation and ensuring that the study design and data collection methods capture important outcomes. The PRC evaluation demonstrated PRC Program accomplishments and provided insight to the process of participatory research at the PRCs. Challenges with data collection instigated changes to how evaluation data will be collected in the future. The evaluation strategies and lessons learned can guide other national public health research programs in conducting their own evaluations and navigating challenges inherent when assessing such complex programs. |
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