Good Intentions or Good Outcomes?

Good intentions for obesity prevention don’t always translate into good outcomes. It’s hard and uncertain work to dig out of the mess of excess obesity we have. That’s why it’s critically important to distinguish between a good idea and a proven intervention for obesity prevention.

A new study in Preventive Medicine illustrates this issue quite well. The authors claim to have proven that simply putting up a sign in a park is a “relatively inexpensive, simple, sustainable, and scalable strategy for evoking behavior change.” What a great way to get people to take a walk in the park and improve their health!

But that’s not quite what they proved. What they actually showed is that if they showed women pictures of a park — one with a sign to encourage walking and one without — the picture with the sign made them more likely to say they they intend to get moving. These were people sitting in front of a computer. Oh, and men were unmoved by this intervention.

There’s nothing terribly wrong with this research, except for the overreaching conclusions. The research provides nothing more than a suggestion that a real experiment is worth conducting. It’s not proof of the strategy’s efficacy. Intentions are not the same as outcomes.

In a recent review of the impact of built environments on physical activity, obesity, and cardiovascular disease, the authors noted that “there is limited research on the link between access to recreation environments and weight-related outcomes.”

Settling for inconclusive research on obesity prevention does great harm. It dooms us to diverting money from effective interventions to useless ones. We don’t really know which is which. It reminds us of John Wanamaker’s famous quip about advertising:

“Half the money I spend on advertising is wasted; the trouble is I don’t know which half.”

Advertisers now have validated methods to solve that riddle. Public health researchers should adhere to a similar standard.

Click here to read the study in Preventive Medicine and here to read the review of built environments, physical activity, obesity, and cardiovascular disease.

Parked, photograph © Ed Yourdon / flickr

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