Advancing Equity in Public Health Nutrition Policy and Practice: Learnings from Applications of the “Getting to Equity” Framework

Background/Objectives. Efforts to curb the obesity epidemic necessarily include policy, systems, and environmental (PSE) changes to mitigate obesity-promoting influences in food, nutrition, and physical activity environments. This study identifies learnings from applications of the Getting to Equity in obesity prevention framework (GTE), which was designed to inform such PSE approaches with a focus on reaching those at greatest need in marginalized and underserved populations. We analyzed published GTE applications to assess contributions to the field in the 9 years since initial publication. Materials and Methods: A citation-based search from January 2017 through January 2026 identified 257 articles citing a GTE description. Articles citing the framework without an application (n=230) were excluded. Qualitative, study-level analyses prioritized articles that applied the GTE during the research process. Results: Analyses included 23 studies (empirical research, reviews, policy analyses, and curricular). Most focused on community-level actions related to childhood obesity prevention (n=4) or aspects of programs and policies related to food access and nutrition security (n=16). We identified examples of GTE applications across all research phases, often complementary to other theories, models, or frameworks. Systems science approaches were used in three empirical studies. Analysis also generated insights about equity considerations related to the respective PSE topics. Conclusions: Unique contributions of the GTE were most evident for structuring qualitative inquiry and interpretation within and across the diverse topics and settings. Findings provided both methodological and content guidance for how to incorporate equity considerations in generating and translating findings to research, policy, and practice recommendations.