Preventing Chronic Disease | Developing Stories From the Field to Highlight Policy, Systems, and Environmental Approaches in Obesity Prevention - CDC
TOOLS AND TECHNIQUES
Developing Stories From the Field to Highlight Policy, Systems, and Environmental Approaches in Obesity Prevention
Marissa Zwald, MPH; Jan Jernigan, PhD; Gayle Payne, PhD; Rosanne Farris, PhD
Suggested citation for this article: Zwald M, Jernigan J, Payne G, Farris R. Developing Stories From the Field to Highlight Policy, Systems, and Environmental Approaches in Obesity Prevention. Prev Chronic Dis 2013;10:120141. DOI: http://dx.doi.org/10.5888/pcd10.120141
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Abstract
As obesity prevention initiatives increasingly shift toward approaches focused on policy, systems, and environmental change, opportunities to share experiences from the field and lessons learned are growing. Stories are a tool to illustrate processes and outcomes of initiatives that can complement quantitative results. The use of stories, however, is not widely recognized, and the methods and tools available to develop stories are limited. Therefore, we describe the methods used to collect, develop, and disseminate stories featuring comprehensive obesity prevention efforts that various state health departments are planning and implementing. We also discuss potential challenges and provide recommendations that public health practitioners may consider when developing similar stories.Introduction
Because of an increased emphasis on implementing policy, systems, and environmental (PSE) strategies to support healthful eating and active living, opportunities to share experiences from the field are growing among public health practitioners. Stories, or focused narratives that convey a sequence of events, can serve as a potential vehicle for communicating obesity prevention and control efforts at federal, state, and local levels to a broad audience, including researchers, policy makers, and other practitioners (1–5). Stories have been widely used by nonhealth sectors such as business, education, and social sciences to showcase programs and services, and they have been used increasingly by the public health sector to illustrate processes and outcomes that are not captured by quantitative methods (6).The collection, development, and dissemination of stories from the field can support the advancement, assessment, and translation of public health initiatives. To advance public health efforts, stories can be shared with policy makers, funders, and local news media to bring increased visibility to an initiative, demonstrate the value of funded projects, document a return on investment or cost savings, and mobilize and garner needed resources (3,5–11). When disseminated to priority populations, stories can make people aware of an initiative and motivate and support PSE changes (2).
Stories also represent a tool for assessing and evaluating public health policies and practices. Stories can be developed throughout all stages of an initiative to communicate results and accomplishments to key stakeholders, particularly in the early phases of an initiative when outcomes cannot be fully determined from surveillance data or anticipated outcomes are not yet achieved (3,5,6). Distinct from quantitative epidemiologic studies or evaluation methods, stories rich in detail can capture results of collaboration with individuals and organizations; communicate successes, barriers, and lessons learned; and describe both intended and unintended consequences that span varying stages of the initiative, which are often challenging to convey with numbers only (1,3,6,11).
To bridge the translational gaps between practitioners, researchers, and policy makers, stories developed by practitioners can inform key stakeholders of public health policies and practices being implemented in the field (4,5,11–13). When communicated to other practitioners, stories can also translate critical information and guidance on how similar initiatives should be implemented. This information can include descriptions of where, when, and how an initiative was implemented; why it was successful; and key considerations for practitioners implementing similar efforts (6).
Despite the numerous benefits that stories can provide to individuals and organizations, practitioners do not often use this method of describing the processes or outcomes of a public health policy or practice. Stories may not be developed regularly because of the perceived subjectivity and susceptibility to bias and because of the traditional reliance on quantitative outcomes in public health (1,3,5,6,11,13). In public health organizations, the limited staff capacity, resources, and expertise to construct an effective story may also influence the adoption of stories. Similarly, Lewis et al have suggested that the methods and tools for practitioners or organizations to develop stories are infrequently disseminated (6). More specifically, as the implementation of PSE strategies are increasingly emphasized in chronic disease prevention, the limited methods and tools available for the development of such stories do not address the challenges associated with communicating more comprehensive results. Implementing a PSE change can be a lengthy and complex process, requiring numerous steps and engagement from multiple sectors (14). As a result, documenting the implementation of PSE strategies may not be as straightforward as stories featuring programmatic efforts describing the processes or outcomes related to individual program participants.
We describe the methods and tools used by the Division of Nutrition, Physical Activity, and Obesity (DNPAO) at the Centers for Disease Control and Prevention (CDC), in collaboration with state health departments funded through the State-Based Nutrition, Physical Activity, and Obesity (NPAO) Program, to collect, develop, and disseminate stories from the field as well as recommendations and challenges practitioners may consider when developing similar stories.
HERRAMIENTAS Y TÉCNICAS
Desarrollo de historias desde el campo para destacar las políticas, los sistemas y los enfoques ambientales para la prevención de la obesidad
Marissa Zwald, MPH; Jan Jernigan, PhD; Gayle Payne, PhD; Rosanne Farris, PhD
Suggested citation for this article: Zwald M, Jernigan J, Payne G, Farris R. Developing Stories From the Field to Highlight Policy, Systems, and Environmental Approaches in Obesity Prevention. Prev Chronic Dis 2013;10:120141. DOI: http://dx.doi.org/10.5888/pcd10.120141.
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