The L.E.A.D. Framework: Using Tools From Evidence-Based Public Health to Address Evidence Needs for Obesity Prevention

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This page was updated on July 16, 2012, to incorporate the corrections in Vol. 9

Shiriki Kumanyika, PhD, MPH; Ross C. Brownson, PhD; Allen Cheadle, PhD

Suggested citation for this article: Kumanyika S, Brownson RC, Cheadle A. The L.E.A.D. Framework: Using Tools From Evidence-Based Public Health to Address Evidence Needs for Obesity Prevention. [Erratum appears in Prev Chronic Dis 2012;9. http://www.cdc.gov/pcd/issues/2012/12_0157e.htm.] Prev Chronic Dis 2012;9:120157. DOI: http://dx.doi.org/10.5888/pcd9:120157

Introduction

The much-discussed urgency of addressing the obesity epidemic does not obviate the need for well-reasoned actions based on the best available evidence. To the contrary, as underscored by the Institute of Medicine (IOM) report on Accelerating Progress in Obesity Prevention — Solving the Weight of the Nation (1), the urgency of addressing the epidemic compels actions, often policy-related and for both the short- and long-term, that are feasible, work well, and work together, and that do not waste scarce resources or have unintended adverse consequences. This essay highlights findings and implications of a prior IOM report, Bridging the Evidence Gap in Obesity Prevention — A Framework to Inform Decision Making (2), in the view of 2 of the IOM study committee members (Appendix) and a colleague who is involved in evaluation of Kaiser Permanente’s Community Health Initiatives.
Decisions about obesity prevention are being made daily in communities, states, and countries worldwide. The Bridging the Evidence Gap report explains that timely and credible evidence is needed to help decision makers decide what to do and understand how to do it, distinguish actions that are likely to be effective from those that are not, justify particular actions in high-risk populations, quantify likely effects, estimate costs and cost-effectiveness, set priorities regarding specific outcomes, determine who benefits, and anticipate potential problems. The report sponsors — Kaiser Permanente, The Robert Wood Johnson Foundation, and the Centers for Disease Control and Prevention — were motivated by their perception that effective approaches to obesity prevention were proving difficult to identify, creating a risk that ongoing efforts to address the problem would be ill-conceived or haphazard.
Below we describe the evidence framework that resulted from the study committee’s consensus process and provide some examples of how it can be applied to evaluate existing evidence and inform the generation of new evidence. The full Bridging the Evidence Gap report and related summaries, as well as the presentations from 2 workshops convened by the committee, are available from IOM at www.iom.edu/Reports/2010/Bridging-the-Evidence-Gap-in-Obesity-Prevention-A-Framework-to-Inform-Decision-Making.aspx.