CDC’s Health Equity Resource Toolkit: Disseminating Guidance for State Practitioners to Address Obesity Disparities

Payne GH, James SD, Hawley L, Corrigan B, Kramer RE, Overton SN, Farris RP, Wasilewski Y
Source: Health Promot Pract
Publication Year: 2015
Patient Need Addressed: Chronic Conditions, Food insecurity
Population Focus: Vulnerable/disadvantaged
Intervention Type: Partnership
Type of Literature: White
link: https://www.ncbi.nlm.nih.gov/pubmed/24962967
Abstract

Obesity has been on the rise in the United States over the past three decades, and is high. In addition to population-wide trends, it is clear that obesity affects some groups more than others and can be associated with age, income, education, gender, race and ethnicity, and geographic region. To reverse the obesity epidemic, the Centers for Disease Control and Prevention) promotes evidence-based and practice-informed strategies to address nutrition and physical activity environments and behaviors. These public health strategies require translation into actionable approaches that can be implemented by state and local entities to address disparities. The Centers for Disease Control and Prevention used findings from an expert panel meeting to guide the development and dissemination of the Health Equity Resource Toolkit for State Practitioners Addressing Obesity Disparities (available at http://www.cdc.gov/obesity/health_equity/toolkit.html). The Toolkit helps public health practitioners take a systematic approach to program planning using a health equity lens. The Toolkit provides a six-step process for planning, implementing, and evaluating strategies to address obesity disparities. Each section contains (a) a basic description of the steps of the process and suggested evidence-informed actions to help address obesity disparities, (b) practical tools for carrying out activities to help reduce obesity disparities, and (c) a “real-world” case study of a successful state-level effort to address obesity with a focus on health equity that is particularly relevant to the content in that section. Hyperlinks to additional resources are included throughout.

Insights Results

Overview of article

  • This article discusses the process used to develop the Toolkit, the content and structure of the Toolkit and a web-based resource recently developed to help practitioners use the Toolkit

Methods of article

  • The toolkit was developed to provide healthcare providers with a systematic approach to program planning using a health equity lens. 3 sources guided the toolkit’s development: 1) Expert panel; 2) Review of existing planning and change models; and 3) States and communities who provided information used in case studies
  • Expert panel discussions focused on increasing access to fruits and vegetables via healthy food retail with a focus on underserved communities, engaging in physical activity by increasing opportunities for walking with a focus on the disabled community and on other subpopulations that face disparities, and promoting healthy beverage choices with an emphasis on fresh, clean water with a particular focus on adolescents and how those 3 strategies can be applied to reduce obesity-related health disparities
  • The goal of the toolkit is to enhance the capacity of state and federal departments to address health inequity for obese populations

Results

  • This toolkit provides a 6-step process for planning, implementing and evaluating strategies to address obesity disparities: 1) Program assessment and capacity building; 2) Gathering and using data to identify and monitor obesity disparities through a health equity lens; 3) Developing multisector and nontraditional partnerships; 4) Applying a health equity lens to the design and selection of strategies; 5) Monitoring and evaluating progress; and 6) Ensuring sustainability. Continuous communication and adaptation for cultural competency are included in the center of the figure to highlight the importance of communication and cultural competency
  • The content and structure of the Toolkit includes providing information on the framework used, the goal of the Toolkit, the planning process and case studies used, and resources provided
  • The Toolkit addresses obesity using the social ecological model, where interventions to prevent obesity can effectively take place at multiple levels of the model with a particular emphasis on systems and environmental-level interventions
  • More specifically, the Toolkit begins with an introduction of the burden of obesity in the United States and some of the disparities in the experience of that burden. The Toolkit then provides a description of a recommended conceptual framework, the social ecological model, and follows with sections that discuss a 6-step planning process. Each planning section contains: 1) A basic description of the steps of the process and suggested evidence-informed actions to help address obesity disparities; 2) Practical tools for carrying out activities to help reduce obesity disparities; and 3) A “real-world” case study of a successful state-level effort to address obesity with a focus on health equity that is particularly relevant to the content in that section

Key takeaways/implications

  • Recently, a web-based resource was developed to supplementary guide practitioners in their application of the Toolkit to new and existing programs for reducing health disparities in obesity
  • Moving forward, people using the Toolkit should document whether the 6-step planning process is effective and helpful, and propose modifications to fit individual program needs. It would also be helpful to document and report measurement approaches and methods that help to bring interventions to practice
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