Towards evidence-based practice in early childhood obesity prevention

Introduction: The rising incidence of obesity, especially among young children, presents a major challenge to public health. Increasing literature points to the importance of focusing on intrauterine life, infancy and the preschool years to establish long-term regulation of energy balance. Several lifestyle behaviors are associated with preventing childhood overweight and obesity. However, little guidance exists on the best mix of interventions to address this growing problem.

Purpose: Programs at the Colorado Department of Public Health and Environment were interested in developing a collaborative state plan to prevent obesity by focusing on early childhood.

Methods: A matrix was created which compared obesity prevention guidelines in Colorado with other recommendations and best practices utilized by other states. A literature review was performed to identify the underlying evidence-base for each recommendation and targeted risk factor and behavior. The articles reviewed were collected using the PubMed database and article bibliographies. To determine the grade of evidence base and prioritize interventions, the American Dietetic Association's Evidence Analysis Library Guidelines were used to create worksheets and an evidence overview template. Key informant interviews were conducted with experts and funders interested in obesity prevention to identify gaps.

Results: As a foundation for plan development and to identify best practice guidelines, the matrix was developed from a number of authoritative organizations. Key decision makers used the Socio-Ecological Model, matrix and evidence overview template to discuss identified gaps and prioritize strategies within Colorado's strategic and state plan processes.