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Media Relations

What gets measured gets changed

As a public health student, I have memorized the phrase "what gets measured gets changed." Measurement and evaluation are too often overlooked in public health programs, resulting in unanswered questions about the efficacy of public health efforts. By tracking the actual results of health initiatives, health professionals can determine when a program is on the right track, and when the investment is not producing the intended changes in health status.

In my personal fitness quest, I am trying to take this advice to heart. I am not only recording what I eat (process evaluation) but also charting my weight -- with an actual graph -- on a daily basis (outcome evaluation).

I was prompted to begin this process when I noticed my weight had jumped five pounds above my usual upper limit. But after three weeks of record-keeping I'm not sure I can draw any clear associations between what I eat and what I weigh. The graph drops and then rises, rises some more and then drops again. After days when I think I've really kept my intake in check, I wake up two pounds heavier, and when I went out of town for a wedding, I came back weighing three pounds less.

I think the problem is that I have taken this maxim too literally, expecting that measurement alone would somehow, magically, bring my weight back down. Unfortunately, like so many public health professionals before me, I am operating without a clear plan (formative evaluation), so it is difficult to know where I have missed the mark.

I suppose it's time to bite the obsessive bullet and set a calorie limit for myself. I have avoided that level of self-monitoring because it seemed extreme to the point of being pathological. But perhaps knowing precisely how much energy I am taking in is just as reasonable as reviewing my credit card statement in relation to my paycheck. What goes in needs to bear some relationship to what gets spent or there are going to be problems.

It's not the five pounds itself. It's the upward slope of the graph. Follow that line over the course of decades, and I know from my public health classes you reach things like heart diseases and diabetes. I am trying to practice early intervention before five pounds turns into something much more difficult to reverse.

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