The organizing committee () developed the conference goals, format, methods, and participant invitation list. NIH staff served on the organizing committee and played important roles in planning the conference and facilitating the dissemination and use of the recommendations.
Conference organizing committee
The full report of the conference, including slide presentations, is available on websites (www.activelivingresearch.org
), and the highlights are summarized here. The 1-day invitational meeting brought together research staff from multiple funding agencies and senior and junior investigators from diverse fields to make recommendations for improving the methodology of environmental and policy research based on gaps in the literature and public health needs.
Leading scientists made focused presentations with slides and brief written summaries of specific recommendations. Discussants provided an additional perspective on each topic. Initial presentations identified both the need for environmental and policy research and specific gaps in knowledge related to diet and physical activity. Later presentations proposed methodologies that could be used to improve research to fill the gaps. After each presentation, participants formed small groups to discuss targeted questions and generate recommendations. Each small group was facilitated by a presenter and assigned a recorder. The groups were instructed to recommend promising methods to improve the rigor and quality of environmental and policy research related to obesity prevention as well as to specify research priorities, including studies to improve methodology. Most small groups used a voting process to prioritize recommendations.
After the conference, recommendations were compiled across all small groups and edited to combine similar points. Then draft lists of recommendations were sent to presenters for their review. Following this step, all meeting participants were asked to complete an online survey to rank their highest priorities from each of nine lists in five topic areas, as shown in . Surveys were completed by 41 of 53 conference participants, for a 77% response rate.
Top-scoring recommendations for improving the methodology of environment and policy research related to obesity, diet, and physical activitya
Survey Results and Discussion
The top-ranked two to five recommendations for each list are provided in . Recommendations varied by topic area, but several themes repeatedly emerged as priorities.
Several useful research methods were identified that could advance the knowledge of obesity-related environmental and policy factors but were underutilized due to the limitations of funding mechanisms or a lack of familiarity among investigators. More emphasis on rigorous prospective investigations or quasi-experimental evaluations of natural experiments (i.e., environment or policy changes not controlled by the investigator) would advance this field, which has relied mainly on cross-sectional studies. Using existing measures to conduct surveillance of food and built environments and industry practices could advance both research and public health practice. There was strong consensus that additional cross-sectional, multilevel studies would be valuable to improve the understanding of interactions across environmental, social, and individual factors, and to examine how multilevel associations and the outcomes of interventions may vary by age and population subgroup. (A multilevel approach takes into account the individual, social, and environmental factors related to physical activity and eating and considers how each level influences behavior or interacts with the other levels.)
Research priorities were identified that had strong promise for informing approaches to reverse the obesity epidemic. Studies of policymaking and implementation, including methods of engaging communities in advocacy, were identified as high priority. Health impact assessment was ranked as a promising policy-assessment method in need of further development. Incorporating economic methods into diet and physical activity research also was recommended. To facilitate such research, improvements in policy measurement and the engagement of policy research experts were viewed as necessary. Some recommendations for speeding the communication and application of research may be outside the purview of research-funding agencies but could be considered by other scientific organizations and health policy groups. A repeated theme was the urgent need for research that could inform environmental and policy solutions for the low-income populations and communities of color at highest risk of obesity. Tailored measures, interactions between environmental and individual variables, policy-change processes, and community-engagement methods need to be examined for each high-risk subgroup. Mixed methods involving quantitative and qualitative data collection are promising for accelerating the research on high-risk populations.
Conference participants endorsed the need for supporting the development and use of common environmental measures and training in appropriate statistical strategies for environmental and policy research. In particular, training in the methods to analyze multilevel studies, the analysis of studies with small numbers of units, and the utilization of combinations of qualitative and quantitative data were deemed high priorities.
Because of the particular challenges of conducting environmental and policy research as well as the need for collaboration among diverse interdisciplinary groups, dedicated research-funding mechanisms were recommended. Advanced training in methods of environmental and policy research and support for interdisciplinary collaboration were highly ranked.