1 Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention , Atlanta, GA.
2 Division of Violence Prevention, Centers for Disease Control and Prevention , Atlanta, GA.
Child Obes. 2018 Mar;14(S1):S5-S11. doi: 10.1089/chi.2018.0019.
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.
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.
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.
支持健康饮食和积极生活的社区层面策略，如政策、系统和环境变化，其证据和我们的理解正在不断增加。然而，研究人员和评估科学家仍然对预防或维持肥胖患病率下降的建议缺乏信心。
系统筛选和评估（SSA）方法被改编为回顾性过程，以确认肥胖率下降，并更好地了解政策、计划或干预措施如何作为驱动因素发挥作用。儿童肥胖率下降（COBD）项目对 SSA 方法的改编包括以下几个组成部分：（1）建立和召集外部专家咨询小组；（2）确定和选择报告肥胖率下降的地点；（3）确认和审查在肥胖率下降期间发生的策略和存在的背景因素；（4）向地点和领域报告调查结果。
结果/讨论：COBD 项目的主要结果是深入探讨了“在肥胖率下降的社区中，发生了什么以及是如何发生的？”这一问题。本文的主要目的是描述该项目的方法，并提出其局限性和优势。
对安克雷奇、格兰维尔县、纽约市和费城等地自然实验的探索，是我们了解可能影响儿童肥胖的驱动因素和背景因素的开始。这种回顾性检查使我们能够：（1）描述针对性干预措施；（2）检查时间线并总结干预实施情况；（3）记录国家、州、地方和机构政策；（4）研究干预措施的覆盖范围和潜在的多部门分层的影响。
