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FrontMatter -- Reviewers -- Preface -- Contents -- Summary -- 1 Introduction -- 2 Obesity Prevention Strategies in Concept and Practice -- 3 Rationale for and Overview of the L.E.A.D. Framework -- 4 Defining the Problem: The Importance of Taking a Systems Perspective -- 5 Specifying Questions and Locating Evidence: An Expanded View -- 6 Evaluating Evidence -- 7 Assembling Evidence and Informing Decisions -- 8 Opportunities to Generate Evidence -- 9 Next Steps -- 10 Conclusions and Recommendations -- Appendix A: Acronyms and Glossary -- Appendix B: Other Evidence Projects -- Appendix C: Review of Existing Reviews on Obesity Prevention -- Appendix D: Information Sources for Locating Evidence -- Appendix E: An In-Depth Look at Study Designs and Methodologies -- Appendix F: Agendas from Two Workshops -- Appendix G: Committee Member Biographical Sketches -- Index.

The health status of people of color in the United States remains unconscionably low when contrasted with that of the U.S. majority population, largely due to factors that are modifiable. This paper addresses the issue of using social marketing to reduce health disparities, with a focus on improving dietary and physical activity behaviors and the environments that influence these behaviors. We emphasize the need for the social marketer to adopt a mindset that focuses on and values the perceptions and priorities of the target population and to view dietary and physical activity behaviors through a cultural lens. We highlight the importance of using frameworks such as the theory of reasoned action and the socio-ecological model to enhance the focus on salient personal and environmental variables for a given target population, and we discuss implications for social marketers, for example, in implementing segmentation and promotion strategies. Social marketers who attempt to facilitate changes in dietary and physical activity practices in minority communities face a daunting task. However, we are confident that such efforts are more likely to be successful if they build upon the culturally relevant concepts and key features of social marketing planning and implementation outlined in this paper. This article reflects issues that were raised during a presentation at the Charting the Course for Social Marketing to Promote Diet and Physical Activity Conference. As a result, we have confined this discussion to addressing those issues related to our presentation, namely assessing the effectiveness and appropriateness of social marketing as a tool to reduce health disparities. In addition, we have attempted to adhere to the objectives of the overall conference theme. Therefore, while we address some broader issues concerning the need to develop culturally appropriate social marketing programs, much of the discussion is directed toward and focuses on specific points raised at the conference.

Objective.To identify characteristics of effective interventions designed to increase physical activity (PA) or fitness among African-Americans.Data Sources.Articles published between 1985 and 2006.Study Inclusion Criteria.Studies reporting PA or fitness change data in African-American participants were included.Data Extraction.Information on study design, intervention, data collection methods, and outcomes was extracted using a standardized form.Data Synthesis.Studies were ranked on quality and were summarized separately for adults and children.Results.We identified 29 studies in adults and 14 studies in children. Most were randomized controlled trials. All but six specifically targeted African-Americans; comparisons of effectiveness in African-Americans vs. others were not possible. Methodological heterogeneity limited comparisons of findings across studies. In adults, most studies showed significant within-group pre-post improvements in PA, but only 10 studies found differences between intervention and comparison groups. Most studies in children were null.Conclusions.Effective programs in adults were from randomized controlled trials and involved structured exercise programs. Studies with explicit cultural adaptations did not necessarily result in better PA outcomes. Additional studies are needed with larger sample sizes, longer follow-up, attention controls, strategies informed by proven behavior change theories, and objective PA assessment.

Each decade, the American Heart Association (AHA) develops an Impact Goal to guide its overall strategic direction and investments in its research, quality improvement, advocacy, and public health programs. Guided by the AHA's new Mission Statement, to be a relentless force for a world of longer, healthier lives, the 2030 Impact Goal is anchored in an understanding that to achieve cardiovascular health for all, the AHA must include a broader vision of health and well-being and emphasize health equity. In the next decade, by 2030, the AHA will strive to equitably increase healthy life expectancy beyond current projections, with global and local collaborators, from 66 years of age to at least 68 years of age across the United States and from 64 years of age to at least 67 years of age worldwide. The AHA commits to developing additional targets for equity and well-being to accompany this overarching Impact Goal. To attain the 2030 Impact Goal, we recommend a thoughtful evaluation of interventions available to the public, patients, providers, healthcare delivery systems, communities, policy makers, and legislators. This presidential advisory summarizes the task force's main considerations in determining the 2030 Impact Goal and the metrics to monitor progress. It describes the aspiration that these goals will be achieved by working with a diverse community of volunteers, patients, scientists, healthcare professionals, and partner organizations needed to ensure success.