	The Current Nutrition Monitoring Program

This chapter first provides background information on the National Nutrition Monitoring and Related Research Program. Then, the objectives, scope, and methodology of our review of current and potential approaches to achieving a model program are described. Table 1.2 lists specific activities managed by the Departments of Agriculture and Health and Human Services, which have major responsibilities for the five areas. The activities are organized around six objectives, which are to • provide for a comprehensive NNMRRP through continuous and coordinated data collection; improve the comparability and quality of data across the NNMRRP; improve the research base for nutrition monitoring; • develop and strengthen state and local capacity for continuous and coordinated nutrition monitoring data collection that complements national nutrition surveys; improve methodologies to enhance comparability of NNMRRP data across federal, state, and local levels; and improve the quality of state and local nutrition monitoring data. This panel met to help us identify promising approaches to critical elements of a nutrition monitoring system. Similarly, to provide information on subpopulation groups, national surveys could be supplemented by such means as the surveillance systems and oversampling or the national surveys could be abandoned and their resources dedicated to special studies of specific groups. The Selected Features

An ideal federal nutrition monitoring program would have a coordinated set of activities that provides data on a continuous basis, covers important population groups, and supports state and local monitoring activities. In contrast, an ongoing survey could consist of a core set of questions and rotating modules of questions that address the needs of specific users. Their suggestions for improving the availability of data on subpopulation groups and small geographic areas included different sampling strategies for different populations, contracts with states and localities to gather information on geographically-based populations, and indirect estimation to support inferences about subpopulation groups and small geographic areas. Potential Options

In addition to the state-based surveillance systems, we reviewed two other approaches to providing continuous data. Special Studies: the HHANES Model

An alternate approach to covering subpopulations is conducting a special study. The NNMRRP currently assists states through the state-based surveillance systems, which provide technical and other assistance to states.
Why GAO Did This Study

Pursuant to a congressional request, GAO examined a model nutrition monitoring system and potential approaches to incorporating it into the National Nutrition Monitoring and Related Research Program (NNMRRP).

What GAO Found

GAO found that: (1) a model nutrition program would have a coordinated set of activities, provide data continuously, generate reliable subpopulation and small geographic area, and support state and local monitoring activities; (2) although NNMRRP has elements of a model program, other strategies may lead to improved nutrition monitoring capabilities; (3) alternate approaches to coordination may not provide any clear advantages to the current structure; (4) the current state-based surveillance systems cannot meet certain information needs; (5) alternative approaches to achieving a model program are to attach modules of nutrition-related questions to other ongoing surveys or to field a core set of questions continuously, supplemented periodically by questions of emerging interest; (6) current approaches to providing information on subpopulations and small geographic areas are to oversample selected groups as part of the national surveys and to collect data on specific high-risk groups through the surveillance systems, which could be complemented by special studies and indirect estimation; and (7) to support state and local monitoring activities, the Department of Health and Human Services provides technical and financial assistance for state-based surveillance systems, but community-based data collection might provide more relevant data to localities.