SPECIAL TOPIC
A Framework for Addressing the Global Obesity Epidemic at a Local Level: The Child Health Ecological Surveillance System (CHESS)
Figure. Framework for Action on Healthy Body Weight in Children
The diagram overall is a circle. The upper left side of the circle has the caption “Leadership and Will to Act.� To the right of this caption is a small cog labeled “Policy Practice and Scientific Leadership.� This cog is linked to a large cog inside the overall circle. The small cog is also inside an arrow labeled “Mobilize and sustain action on: Modification of components, Factor in knowledge derived, Identification of knowledge gaps, Refinement of metrics, theory, and interventions.� This arrow narrows in toward the center of the overall circle and the large cog inside the overall circle.
The interior of this large cog has four segments: the top segment is labeled “Child Health.� The segment on the left has a small cog labeled “Genetics and Biology.� Inside this cog, in a circle around the edge, are these terms: “Cell,� “Organ,� “System,� and “Whole Body.� Between each term are two arrows, one each pointing toward and away from each term. This small cog is connected to another small cog in the segment at the bottom; the small cog is labeled “Individual Lives.� Inside the cog, in a circle around the edge, are these terms: “Attitudes and Beliefs,� “Physical Activity,� and “Eating Behavior.� Between each term are two arrows, one each pointing toward and away from each term. Inside the circle around the edge is another circle, with these terms: “Family,� “Friends,� “Peers,� and “Networks.� Between each term are two arrows, one each pointing toward and away from each term. This small cog is connected to a third small cog in the segment above and to the right of the cog on the bottom; the small cog is labeled “Environments.� Inside this cog, in a circle around the edge, are these terms: “Social,� “Physical,� “Community,� “Economic,� “Policy,� and “Organizational.� Between each term are two arrows, one each pointing toward and away from each term. Above the segment labeled “Child Health,� outside the large cog, are four segments, labeled “Biomedical,� “Clinical,� “Health Services,� and “Population Health.�
To the right of these segments, on the upper right side of the overall circle, is the caption “Outcomes.� Between this caption and the inner large cog are three cogs, each separately connected to the inner large cog. From top to bottom, the first cog is labeled “Service/System Outcomes,� the second is “Research and Knowledge Outcomes,� and the third is “Health Outcomes.� These three cogs are in an arrow that is labeled “Self-Calibrating Surveillance System� that points back around toward the “Leadership and Will to Act� caption, and is captioned “Infrastructure.�
Volume 5: No. 3, July 2008
