No abstract

For the USA, the only nationally representative data source capturing trends in obesity in this period was the National Health and Nutrition Examination Survey, which uses repeated cross-sectional data to document national trends in obesity in the USA. For global trends, the only systematic reviews of obesity across the globe were the Global Burden of Disease Obesity study and the Non-communicable Disease Risk Factor Collaboration study. In general, the population distribution of body mass index (BMI) in the USA has shifted towards the upper end of its distribution over the past three decades. The global distribution has similarly increased, albeit with large regional differences. US and global studies suggest an increasing trend in obesity since the 1980s, and there is a dearth of nationally representative longitudinal studies using measured anthropometry to capture trends in adult obesity in the USA for the same individuals over time. Greater efforts are needed to identify factors contributing to the continued increases in obesity.

The general benefits of peer support and findings suggesting that it may be more effective among those at heightened disadvantage indicate that peer support should be considered in programs intended to reach and benefit those too often hardly reached. Because engendering trust and respect was significantly associated with participant retention, programs should emphasize this strategy.

CONTEXT: Screening children for social determinants of health (SDOHs) has gained attention in recent years, but there is a deficit in understanding the present state of the science.OBJECTIVE: To systematically review SDOH screening tools used with children, examine their psychometric properties, and evaluate how they detect early indicators of risk and inform care.

Peer support from community health workers, promotores de salud, and others through community and health care organizations can provide social support and other assistance that enhances health. There is substantial evidence for both the effectiveness and the cost-effectiveness of peer support, as well as for its feasibility, reach, and sustainability. We discuss findings from Peers for Progress, a program of the American Academy of Family Physicians Foundation, to examine when peer support does not work, guide dissemination of peer support programs, and help integrate approaches such as e-health into peer support. Success factors for peer support programs include proactive implementation, attention to participants' emotions, and ongoing supervision. Reaching those whom conventional clinical and preventive services too often fail to reach; reaching whole populations, such as people with diabetes, rather than selected samples; and addressing behavioral health are strengths of peer support that can help achieve health care that is efficient and of high quality. Challenges for policy makers going forward include encouraging workforce development, balancing quality control with maintaining key features of peer support, and ensuring that underresourced organizations can develop and manage peer support programs.