title: Translation of obesity practice guidelines: measurement and evaluation.
abstract: OBJECTIVE
  A public health nurse (PHN) in the Midwestern United States (U.S.) led a collaborative system-level intervention to translate the Institute of Clinical Systems Improvement (ICSI) Adult Obesity Guideline into interprofessional practice. This study (1) evaluated the extent of guideline translation across organizations and (2) assessed the Omaha System as a method for translating system-level interventions and measuring outcomes.
  
  
  METHODS
  This retrospective, mixed methods study was conducted with a purposeful sample of one administrator (n = 10) and two to three clinicians (n = 29) from each organization (n = 10).
  
  
  METHODS
  Omaha System Problem Rating Scale for Outcomes Knowledge, Behavior, and Status (KBS). KBS ratings gathered from semi-structured interviews and Omaha System documentation were analyzed using standard descriptive and inferential statistics and triangulated findings with participant quotes.
  
  
  RESULTS
  KBS ratings and participant quotes revealed intervention effectiveness in creating sustained system-level changes. Self-reported and observed KBS ratings demonstrated improvement across organizations. There was moderate to substantial agreement regarding benchmark attainment within organizations. On average, self-reported improvement exceeded observer improvement.
  
  
  CONCLUSIONS
  System-level PHN practice facilitator interventions successfully translated clinical obesity guidelines into interprofessional use in health care organizations. The Omaha System Problem Rating Scale for Outcomes reliably measured system-level outcomes.
authors.affiliation: Health Initiatives and Evaluation, Otter Tail County Public Health and PartnerSHIP 4 Health, Fergus Falls, Minnesota.
authors.forename: Kristin J
authors.initials: KJ
authors.lastname: Erickson
authors.affiliation: School of Nursing Affiliate Faculty, Institute for Health Informatics, University of Minnesota School of Nursing, Minneapolis, Minnesota.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Monsen
authors.affiliation: School of Public Health, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Ingrid S
authors.initials: IS
authors.lastname: Attleson
authors.affiliation: Clinical Outcomes Research Center, University of Minnesota, Minneapolis, Minnesota.
authors.forename: David M
authors.initials: DM
authors.lastname: Radosevich
authors.affiliation: Institute for Clinical Systems Improvement, Bloomington, Minnesota.
authors.forename: Gary
authors.initials: G
authors.lastname: Oftedahl
authors.affiliation: Institute for Clinical Systems Improvement, Bloomington, Minnesota.
authors.forename: Claire
authors.initials: C
authors.lastname: Neely
authors.affiliation: Public Health Department, Otter Tail County, Fergus Falls, Minnesota.
authors.forename: Diane R
authors.initials: DR
authors.lastname: Thorson
mesh_terms: D000328:Adult; D019985:Benchmarking; D003299:Cooperative Behavior; D006801:Humans; D015146:Midwestern United States; D009765:Obesity / Q000628:therapy*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D017410:Practice Guidelines as Topic / Q000592:standards*; D011637:Public Health Nursing; D012189:Retrospective Studies; D018875:Vocabulary, Controlled
keywords: Omaha system; adult; health care reform; health promotion; obesity; practice guidelines as topic; primary health care; program evaluation; public health practice; public-private sector partnerships; standardized terminology