The steering committee met three times to prioritize obesity prevention strategies for Colorado: 1. At the first meeting, they agreed on the prioritization process and criteria. Between meetings, committee members provided input online. 2. At the second meeting, the committee finalized the criteria and clarified the strategies and potential state roles. Another online survey then rated the strategies. 3. The third meeting shared the prioritization results and gathered additional input for the executive committee. Eight strategies lacked agreement on state roles and some members desired more information on others. The committee voted to include all strategies in the final prioritization.

1. Prioritizing Obesity Strategies
Obesity Integration Steering Committee Meetings
2.29.12, 3.19.12, 4.2.12

2. Prioritization Process
When Purpose/Actions
Meeting 1 (2/29) • Getting Started
• Agreements For Moving Forward
Between Meetings Survey Coming Tomorrow (due 3/9)
(e-input) • Review/Provide Input on Proposed Criteria
• Identify State Roles for Strategies
Meeting 2 (3/19) • Review/Finalize Criteria
9:30am -12:30pm • Clarify Strategies
• Clarify State Roles
Between Meetings Prioritization Survey (sent 3/21, due 3/26)
(e-input) • Rate Strategies Using Final Criteria
• Refine Concise Statement
Meeting 3 (4/2) • Share Results of Prioritization
9:30am – 12:30pm • Gather Additional Input for Ex Committee

3. Agenda Review
 Welcome and Overview
 Review/Finalize Criteria
 Break
 Clarify Strategies and State Roles
 Next Steps and Closure

4. Discussions and Decisions
Discussion: All encouraged to participate
Decisions: For Today & Prioritization Survey (btwn
Meetings 2 & 3)
 60% super majority vote, motioned by a steering
committee member
 One vote per Steering Committee Member
 Executive Committee Members, and other observers,
do not vote

5. Steering Committee Voting
Members
 Sector Team Leads or Designee (8 reps from PSD)
 Healthy Eating (2 reps from PSD)
 LHAs (5 total: 1 rep each from El Paso, Weld, Boulder,
Pueblo, West-Central Partnership)
 External Organizations (3 total: 1 rep each from Live
Well, Kaiser, Health Foundation)

6. Review/Finalize Criteria

7. The “Ask” Regarding Criteria
 11 prioritization criteria proposed
 Asked to make 2 judgments:
 RATE each criteria
 RANK top five criteria
 Opportunity to suggest other criteria
 19 people responded

8. Criteria Ratings - Results
Not at all Well Somewhat Well Fairly Well Well Very Well

9. Rating Takeaways
 All criteria would do fairly well or
better at helping during the
prioritization process.
 Could potentially combine some
criteria:
 Population Impact AND Expected
Reach?
 Community Support, Capacity to
Implement, AND Opportunity for
Leverage?
 Could consider the following
additional criteria:
 Alignment with National Priorities
 Evidence Level

10. Criteria Rankings - Results

11. Ranking Takeaways
 Ranking a more effective way to
distinguish preferences among
criteria that are all helpful.
 “Least Helpful” ranking could be
misleading – only least helpful
among 5 favorites.
 At least 60% of responding
members chose the following as
one of their top 5 criteria:
 Likelihood of population impact
 Capacity to Implement

12. Considerations
 Evidence is being published every day.
 Executive committee will get:
 the full list of strategies with their ranks from the
prioritization survey.
 Future implementation teams will consider:
 Applicability to Colorado
 Resources needed
 PSD will keep you informed.

13. Demonstration of Prioritization
Scoring
 No right way ~ rather match how you want to make the decision
 Rate each strategy against the criteria
 Criteria scale: 1 = “Little” to 5 = “Great”
 Create a prioritization score from your ratings
= add the ratings on each criteria,
divide by the number of criteria,
divide by the number of respondents (raters)
 Expect ties

14. Demonstration of Prioritization
Scoring
Rank
Criteria Criteria B: Rank Rank w/
Paint your A: True Easy to Priority using 2 Rank with multipl
house Blue clean Sum Score criteria using 3 weighting ier
Strategy A 1 3 4 2.0 6 6 6 2
Strategy B 2 3 5 2.5 4 2 2 3
Strategy C 3 2 5 2.5 4 5 5 3
Strategy D 4 5 9 4.5 1 1 1 1
Strategy E 5 3 8 4.0 2 2 3 6
Strategy F 3 3 6 3.0 3 4 3 5

15. Demonstration of Prioritization
Scoring
With 3 criteria
Rank
Criteria A: Criteria B: Criteria C: Priority using 3
True Blue Easy to clean Longlasting Sum Score criteria
Equal Weight 1 1 1
Strategy A 1 3 1 5 1.7 6
Strategy B 2 3 5 10 3.3 2
Strategy C 3 2 3 8 2.7 5
Strategy D 4 5 5 14 4.7 1
Strategy E 5 3 2 10 3.3 2
Strategy F 3 3 3 9 3.0 4

16. Demonstration of Prioritization
Scoring
With 3 criteria and weighting
Criteria A: Criteria B: Criteria C: Criteria C: Priority
True Blue Easy to clean Longlasting Longlasting Score Rank
Weight 1 1 1 1
Strategy A 1 3 1 1 1.5 6
Strategy B 2 3 5 5 3.8 2
Strategy C 3 2 3 3 2.8 5
Strategy D 4 5 5 5 4.8 1
Strategy E 5 3 2 2 3.0 3
Strategy F 3 3 3 3 3.0 3

17. Demonstration of Prioritization
Scoring
With multiplier
Paint your Criteria A: Criteria B: Priority Evidence Final
house True Blue Easy to clean Score (multiplier) Score Rank
Strategy A 1 3 2.0 proven (4) 8.0 2
Strategy B 2 3 2.5 Likely effective 7.5 3
(3)likely effective
Strategy C 3 2 2.5 (3) 7.5 3
Strategy D 4 5 4.5 promising (2) 9.0 1
Strategy E 5 3 4.0 emerging (1) 4.0 6
Strategy F 3 3 3.0 promising (2) 6.0 5

18. Discussion & Decision
 Discussion: Can some of the potential prioritization
criteria be combined based on similarity?
Could potentially combine some criteria:
 Population Impact AND Expected Reach
 Community Support, Capacity to Implement, AND
Opportunity for Leverage
 Decision: Vote on combination(s) suggested.

19. Discussion of Additional
Criteria
 Could consider the following additional criteria:
 Alignment with National Priorities
 Evidence Level

20. In a nutshell…Levels of
Evidence in PSD
 Proven: systematic or narrative reviews; considers study design
and execution, external validity, body of evidence, and results
 Likely Effective: peer review articles in scientific literature;
considers study design and execution, external validity, body of
evidence, and results
 Promising: written program evaluation without formal peer
reviews; considers summative evidence of effectiveness, theory,
and formative evaluation data
 Emerging: ongoing work with little evidence so far, but sound
theory and evaluation in place
 Not Recommended: evidence of effectiveness is
conflicting and/or of poor quality and/or suggestive of harm

21. Discussion & Decision
 Discussion: How many criteria should be included in
the prioritization rubric?
 Top 3
 Top 5
 All
 Decision: Vote on number of criteria to be included
in final prioritization rubric.

22. Discussion & Decision
 Discussion: Should any of the prioritization criteria be
more heavily weighted than others?
 Decision: Vote on weighting.

23. Clarify Strategies and State Roles

24. The “Ask” Regarding
Strategies and CDPHE Roles
 58 strategies presented (only included those Notes:
with some level of evidence) 1. Evidence level noted
inaccurately on
 Asked to select appropriate CDPHE roles and survey for 2 Built
Environment
identify information gaps for each strategy: Strategies:
• Transportation
 Three purposes: policy/access to
transit
 Info about CDPHE role may provide information
that will be helpful at a later stage in the EBPH • Open space
preservation
process.
 Can we eliminate any strategies based on no 2. Diabetes Prevention
Program has now
CDPHE role? been designated as
“Proven”
 What information is needed before we can move
forward?
 Pages 4-13

25. Takeaways
 Four roles were most commonly noted for CDPHE:
 Influence state-level policy with regard to this strategy
 Provide funding to local or state partners to implement this
strategy
 Provide guidance and/or technical assistance to local or state
implementation partners
 Coordinate activities with other state agencies
 No strategies met elimination criteria, but the specific
CDPHE role was unclear for 8 strategies (see page 5).
 Members desire more information about 8 strategies (see
pages 6-13)

26. Literature Review Results
SECTOR EVIDENCE RATINGS
Schools 7 Likely Effective; 2 Promising; 5 Emerging
Child Care 4 Likely Effective; 3 Emerging; 2 Not
Recommended
Food Systems 2 Likely Effective; 3 Promising
Health Systems 2 Proven; 3 Likely Effective; 1 Promising; 1
Emerging
Worksites 5 Proven; 1 Likely Effective
Media 1 Likely Effective; 2 Promising; 2 Emerging; 1
Not Recommended
Community 1 Proven; 5 Likely Effective; 1 Emerging
Built Environment 5 Likely Effective; 2 Emerging

27. Discussion & Decision
 Discussion: Should strategies where no clear
agreement was reached about a CDPHE role be
included or excluded from the prioritization process?
 Decision: Vote on whether to eliminate 8 strategies in
final prioritization rubric.

28. Discussion & Decision
 Discussion: Should any strategies not previously identified by the
sector teams be included in the prioritization process?
 For each new strategy discussed, need:
 Description
 Evidence: Individual Study? Narrative Review? Systematic Review?
 Potential State Role
 Decision: Vote on whether or not there is a state role for each
new strategy proposed. If so, the strategy moves to the list to be
prioritized.

29. Final Tally of # of Strategies
Moving Forward for Prioritization

30. Next Steps:
Prioritization Process
When Purpose/Actions
Meeting 1 (2/29) • Getting Started
• Agreements For Moving Forward
Between Meetings Survey Coming Tomorrow (due 3/9)
(e-input) • Review/Provide Input on Proposed Criteria
• Identify State Roles for Strategies
Meeting 2 (3/19) • Review/Finalize Criteria
9:30am -12:30pm • Clarify Strategies
• Clarify State Roles
Between Meetings Prioritization Survey (sent 3/21, due 3/26)
(e-input) • Rate Strategies Using Final Criteria
• Refine Concise Statement
Meeting 3 (4/2) • Share Results of Prioritization
9:30am – 12:30pm • Gather Additional Input for Ex Committee

31. Thank You and Closure
 On the index card provided let us know
What is still on your mind?
 Leave note sheets on table before you leave
 For those on the phone: email your responses to:
Laurie.schneider@ucdenver.edu