Surveillance, Program Evaluation and Research

State and local-level surveillance is an essential function of public health to monitor prevalence and trends in behaviors, risk factors, health outcomes, and populations at risk for unhealthy lifestyles, obesity, and related diseases. Decision-makers and stakeholders use surveillance information for a variety of purposes including program planning, policy development and evaluation. Effective surveillance is ongoing, population-based, and dynamic in order to provide information targeting populations at-risk, in defined geographic areas, and to fill information gaps. As a component of program evaluation, surveillance provides information to assess intermediate and long-term program outcomes such as changes in diet, physical activity, obesity, and disease outcomes. Comprehensive program evaluation further involves the data collection and reporting process and short-term outcome measures to assess the impact of interventions to prevent and control obesity and improve health behaviors in the community and across the state. Evaluation studies involving the use of controls, comparison populations, and longitudinal follow-up may be employed to provide definitive information regarding the cause-and-effect associations between interventions treatments and outcomes. Research can provide new knowledge and evidence of the most effective approaches to decrease risk, prevent obesity, and improve health outcomes in the population.

Assessment of information on the health of the community is one of the three core functions of public health community assessment as a function of public health is further elaborated among elements of the Essential Public Health Services including: (1) monitoring health status to identify community health problems; (2) inform, educate, and empower people about health issues; (3) evaluate effectiveness, accessibility, and quality of personal and population-based health services; and (4) research for new insights and innovative solutions to health problems.

Center for Obesity Research and Education C.O.R.E

An initiative of SUNY Cortland whose purpose is to serve as a research and educational resource for endeavors on obesity and physical activity to reduce the burden of obesity in children and adults through research, education, and service. The centerpiece of CORE is the creation and maintenance of a statewide database regarding current and on-going physical demographics of children in grades K-6 within each of the 62 New York State Counties. The immediate outcome of this data collection will be an account of overweight status of our children in NYS.

Spearheaded by Philip J. Buckenmeyer, and Jeff Bauer, Ph.D. the CORE initiative became operational as of May 2004. The strength of CORE is its multidisciplinary composition that includes 14 faculty from various departments across campus. These departments support up to 1,400 student teachers across the state, which provide an immediate contact to several NYS regions.

A Healthy People 2010 goal is to ensure that states and local health departments have the infrastructure to effectively provide essential public health services, including the health data and surveillance systems necessary to provide information on risk, illness, disability, and death from acute and chronic conditions. To help ensure that data and information systems are accessible, accurate, timely, and complete, several Healthy People 2010 objectives have been developed and incorporated into this plan (see Goal 10).

The active use of reliable and valid information from a variety of sources to guide program planning, decision-making, and evaluation is the hallmark of the New York State Strategic Plan for Overweight and Obesity Prevention. This is built upon the foundation of established, ongoing statewide surveillance systems including the Behavioral Risk Factor Surveillance System (BRFSS) of adults, the Youth Risk Behavior Surveillance System (YRBSS) of high school students, the Pediatric Nutrition Surveillance System (PedNSS) of low-income preschoolers, and the Pregnancy Risk Assessment Monitoring System (PRAMS) of child-bearing women. These provide important risk factor and outcome measures of relevance to overweight and obesity prevention for monitoring and assessing trends in their respective population groups. Complementary information from other ongoing statewide data systems are also used to measure obesity-related morbidity and mortality outcomes, economic burden, and other population characteristics. These include hospital discharge information from the Statewide Planning and Research Cooperative System (SPARCS), Vital Records, population statistics provided through the U.S. Bureau of the Census and the New York State Data Center, and Medicaid.

While New York State is rich in available data resources, there are population groups who are not assessed and areas where surveillance could be either expanded or enhanced to better monitor overweight/obesity prevention efforts. There is, for example, no established surveillance system for elementary school children in New York State or in the nation. The YRBSS surveys primarily high school students, but could be modified to include middle school students. It relies on self-reported anthropometric and behavioral data. Other surveillance systems could also be modified to report measures of interest to overweight/obesity prevention and risk factor control.

The success of overweight and obesity prevention in New York State depends upon sound research and thorough program evaluation to guide the development and implementation of targeted, effective, and culturally sensitive interventions. Research focuses risk-factor-management efforts to reduce the prevalence of overweight, the morbidity of obesity and obesity-related diseases, the mortality rates from obesity-related diseases and the overall economic burden of overweight and obesity on New York State. Evaluation facilitates efficient utilization of overweight/obesity program resources.