Table 1.

Gap areas that are limiting study comparisons and proposed solutions

Gap areas	Proposed solutions
Lack of standardization of outcome measures across studies	Create a set of standard outcome measures that are clinically relevant for target populations Create an international outcome measures of program success
Lack of population characterization and adjustment for potential confounding factors	Create stage of change, motivation, and adherence measures Define adherence measures (rate of attendance, compliance with goals, attrition and retention) Define intervention groups based on age of the subject targeted (e.g.: pregnancy, < 2 years old) Define categories of intervention (e.g. parent, electronic) Define insurance type Define social support (e.g. access to food pantry, activities, family/friend) Define economic status
Lack of a clear definition of a real-world study	Define characteristics required for a “real world” RCT Define characteristics required for a “real world” observational study
Lack of studies targeting groups with special needs	Underserved populations Minorities – families of Hispanic ethnicity will account for the majority of population in 2030 Patient with disabilities
Limited use of new technologies to facilitate weight management	Electronic medical record, I-Phone, telemedicine
Lack of dedicated supporting staff	Define the role of supportive staff Develop guidelines to refer patients to supporting staff Reimbursement of supporting staff (e.g. RDs, community workers)
Lack of inter-professional education/training and research	Update and improve Standards for education and training of health professionals (MD, MS, RD, RN, PhD, SW, Psy D, EP, PT, dentist, Pharm D, etc.) in obesity prevention and treatment Conduct outcome research in nutrition and obesity education for health care professionals
Need to define a chronic care model	Develop cost effective models with prevention and treatment of obesity in a continuum of care Include supportive staff (e.g. RD, SW, RN) in the medical home Use of home visits Use current community structures as supportive methods