About Building the Evidence on Best Practices to Engage Private Industry in Childhood Obesity Prevention
In 2014, about one-third of children and adolescents in the United States were overweight or obese. Except for young children ages 2–5 years, these rates have increased since the 1980s. Experts such as the National Academy of Medicine have recommended that governments engage with private sector actors and stakeholders to address child and adolescent obesity.
Designed to build the evidence base on the impact of and best practices for engaging private industry in preventing childhood obesity, this Robert Wood Johnson Foundation (RWJF) assessment employed a mixed-methods approach to examine a sample of private sector commitments and a range of business practices in place to address the U.S. childhood overweight and obesity epidemic, including but not limited to anything funded by the Robert Wood Johnson Foundation (RWJF).
Family Health International (FHI) 360 was commissioned by RWJF, under the oversight of Laura C. Leviton, senior evaluation adviser to the Foundation. The FHI team was overseen by co-principal investigators Jennifer Kreslake, PhD, MPH and Richard Sawyer, PhD, and included Ramya Krishna, MPH; Lisa Toledo, BA; Namita Vaidya, MPH; and Andre Weldy, MPH.
This assessment examined the contribution of 46 companies to changing the food and beverage environments to reduce the risk of unhealthy weight gain among young people between January 2005 and December 2015. High-profile agreements included the new Coca-Cola Company® arrangement for physical activity, as well as agreements by the Children's Food and Beverage Advertising Initiative; the Alliance for a Healthier Generation; the Healthy Weight Commitment Foundation; ChildObesity180; and the Partnership for a Healthier America.
Study methods comprised a mixed-methods approach and multiple data sources, and are described in detail in Appendix 2 of the report. Initially, an in-depth literature search was conducted to provide background information about the study topic. It also served as a preliminary source for the environmental scan of business practices, and evaluation of commitments and practice changes. The environmental scan research was conducted to access data sources identified through the literature search, company websites, nongovernmental organization (NGO) websites, and other internet sites.
The most common efforts to evaluate commitments were based on third-party verifications of industry efforts. Verification represents a type of process evaluation that encompasses assessment, monitoring, and measurement of the implementation of commitments and practice changes over a specified time frame. More infrequent were evaluations of proximal or intermediate outcomes such as advertising exposure among target audiences or increased purchases of healthy products. Distal health-related outcomes such as the impact on reducing body mass index (BMI) or achieving weight reduction targets were not investigated among the evaluations reviewed for this study.
Third-party evaluations produced some of the highest-quality data assessed in this report, particularly among evaluators that provided detailed methods and measures in reporting of results. Public-private partnerships are encouraged to make use of independent evaluators and make the detailed methodology publicly available. Evaluations should follow best practices for evaluation (detailed in pages 32–37 of this report), including:
- Use methods and measures that can be incorporated into a repeated-measures design (i.e., collecting baseline data with routine follow-ups);
- Assume participation in (or provision of data to) third-party evaluation efforts as part of commitment to an initiative;
- Use consistent methods and standardized measures to improve comparability of evaluation results across companies or over time;
- Avoid measures identified as having limited reliability and/or validity;
- Apply consistent evaluation methods across multiple partnerships or initiatives.
For more in-depth findings and discussion, please refer to the final report.