Environment obesity prevention Planning C: Politics and Space. As explained above B1 and B2the long duration of policy processes reduced the likelihood of policy adoption. The analysis of the policy process for each policy intervention involved a deductive thematic analytical approach underpinned by multiple political science theories. Interviewees indicated that this created a barrier to policy adoption due to the relatively short-term 4 year political cycles in Victoria, especially considering that there were changes in the governing political party over the course of the policy study period. There was strong evidence from interviews for this effect across the HTV policy process investigations, with examples of internal government staff members facilitating network coordination and negotiation processes with stakeholders to reduce resistance to policy options. State-by-State Reach of Child Nutrition Policies Several federal policies aim to make healthy foods accessible and affordable to children and adults nationwide, and states play a big role in how these policies are implemented.
Unit interventionss for the included diseases were provided to us by the Australian Institute of Health and Welfare for a previous obesity prevention policy interventions [ 16 ] and were inflated from values to values to estimate the healthcare costs-savings resulting from the intervention. In addition, changes to institutional culture to one that supports innovation regarding preventive health is likely to be beneficial in securing adopting of recommended obesity prevention policies [ 68 ].
Downloading and analyzing the data interventiosn will be out obesity prevention policy interventions the scope of this review i. Evaluation of farm-to-school implementation might address whether locally grown foods were delivered to schools and served in cafeterias as intended; cafeteria staff, parent, and student response ie, acceptability ; and the effects on the cost of school lunches ie, affordability.
Findings can, for example, help to distinguish whether disappointing outcomes are due to problems with the policy or with its implementation.
I. Background and Objectives for the Systematic Review
Consequently, this study highlighted the need to improve obesity prevention policy interventions skills of policy makers in effective negotiation and consensus building in order to facilitate timely progression of obesity prevention policy solutions. Estimates for indicate approximately AUD3. View Article Google Scholar 9. Preventing Childhood Obesity: Health in the Balance.
When Sadeghi et al. The analysis of the processes leading to the adoption of each policy intervention revealed numerous interconnected influences on obesity prevention policy processes [ 484951 ]. Future research investigating intervention characteristics that facilitate the durability of effects is also required. Although policy makers, advocates and previous policy studies agree on the importance of evidence in obesity prevention policy, the focus of such discussion has largely been on evidence of the policy problem and effectiveness of policy solutions [ 1897]. When policy actors employed various strategic skills, a number of virtuous system effects were stimulated, such as the development of viable policy solutions that aligned with decision-maker beliefs and government objectives, as well as improved implementation feasibility and stakeholder support. While systems thinking and CLDs have been utilised extensively to understand the causes and complex interdependencies driving obesity prevalence [ 3435 ], and to inform and evaluate obesity prevention initiatives [ 2936 ], the application to policymaking within the obesity prevention context is scarce [ 37 ].
The meta-CLD contained 12 influential feedback loops that provide insight into the complex obesity prevention policy interventions of policy decision-making interfentions the context of HTV. References 1. The presentation of viable and feasible policy solutions was described by participants as important in increasing support for policy interventions from decision-makers, leading to increased obesity prevention policy adoption.
World Health Organization.
Search The CDC. The principal inclusion and exclusion criteria for the systematic literature review will be derived from the identified PICOTS framework see Table 1.
Schlager E. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
Therefore, the aim of the current study was to systematically search controlled trials that evaluated the effectiveness of pediatric obesity prevention policies among children and adolescents and to analyze the effectiveness of these policies on the study outcomes of body mass index BMI and BMI-Z score BMI-Z measurements while considering a possible dose—response association with preventive tools.
Malterud K. World Cancer Research Fund. Report of the commission on ending childhood obesity. Facebook Twitter LinkedIn Syndicate.
Policies interact with other existing and emerging policies to affect outcomes; activities and outputs also may be designed to address the requirements of multiple policies. The framework has limitations. For more information about this message, please visit this page: About CDC. The EPC will complete a disposition of all peer review comments. For example, in implementing new state-level farm-to-school policy, the Department of Education may reallocate resources and draft new rules governing how the policy will be implemented across school districts. What population-based data sources have been used in studies of how programs, policies or built environment changes affect or are associated with obesity prevention and control outcomes?
Models for Communities
Policies may also need to be modified. The same process will be used for all data abstraction activities throughout this review project. This approach is difficult to apply to policy interventions because they involve a continual and often cyclical interplay among inputs, activities, and outputs and because the path to successful outcomes is neither linear nor constant 11,13,
We have limited the data quality assessments to U. Evaluation of farm-to-school implementation might address whether locally grown foods were delivered to schools and served in cafeterias as intended; cafeteria staff, parent, and student response ie, acceptability ; and the effects on the cost of school lunches ie, affordability. The framework is organized according to the 4 standard sections of a logic model: inputs, activities, outputs, and outcomes Changes will not be incorporated into the protocol. Funding from the Centers for Disease Control and Prevention CDC and others is spurring the emergence of promising obesity prevention initiatives, presenting a distinct opportunity to build the body of practice-based evidence. Findings can, for example, help to distinguish whether disappointing outcomes are due to problems with the policy or with its implementation. Division of Nutrition, Physical Activity, and Obesity.
Dashed lines indicate where there was some data to demonstrate an association between factors, however triangulation across data sources or methods could not be achieved. All of the selected policy interventions were adopted in Victoria over the period —, although some policies, such as Menu Kilojoule Labelling Legislation required multiple formal iterations of policy proposals prior to policy adoption, and some aspects of the Land Use Planning Policies e. Effects of a community-oriented obesity prevention programme on indicators of body fatness in preschool and primary school children. Public administration and the promise of evidence-based policy: experience in and beyond Australia.
II. The Key Questions
Department of Health and Human Services. We will describe counts of the number of studies that report each outcome and categories of outcomes of interest. Statements in the report should not be construed as endorsement by the Agency for Healthcare Research and Quality or the U.
PLOS Medicine. The policy system was generally resistant to change, with five balancing loops acting to reinforce the policy status quo. J Med Internet Res. Only four interventions scored high or medium on BMI outcomes; all were programmatic in nature.
Categorical intervwntions continuous risk factors and the calculation obesity prevention policy interventions potential impact fractions. A third category of community-based interventions targets changes in the places where people live, learn, work, and play. As with education in integventions, the sooner we act, the better. The policy interventions selected for inclusion were derived from the broader suite of policies considered for adoption as part of HTV, with selection based on key characteristics of each intervention to ensure heterogeneity e. Train food service staff in healthy food preparation techniques and food safety 379. Food Policy. Although there is evidence to support the beneficial effects of increased PA and diet as a basic and early strategy at any time and for any age against obesity [ 1415 ], no summarized study is available to critically evaluate the effectiveness of different policies with different interventional approaches in prevention of childhood obesity considering the role of setting, age, geographical distribution, and intervention type or strategy.
Cheltenham: Edward Elgar Publishing; Search all BMC articles Search. Nearly one in five children and adolescents are overweight or obese [ 2 ], and the growing prevalence of obesity in youth has led to an alarming increase of
To determine the categories of variables related to obesity and co-outcomes in each data system, we will take the following approach:. The final obesity prevention does not necessarily represent the views of individual reviewers. We recognize imterventions defining the behavioral outcomes of physical activity and dietary change will be challenging because many self-reported instruments have been developed and reported in the literature, 18 with varying degrees of comprehensiveness, validity and reliability. Evaluation of farm-to-school implementation might address whether locally grown foods were delivered to schools and served in cafeterias as intended; cafeteria staff, parent, and student response ie, acceptability ; and the effects on the cost of school lunches ie, affordability.
We will describe the data sources by criteria for population-based data systems, whether obesity prevention policy interventions data source is in the NCCOR registry, and what country, state or community it is from. The summary report will include various data system attributes across the entire list of data systems. For each U. Despite the need for policy action to create healthier environments, little is known about policy approaches that are most effective 2,4,7. Evaluation of farm-to-school implementation might address whether locally grown foods were delivered to schools and served in cafeterias as intended; cafeteria staff, parent, and student response ie, acceptability ; and the effects on the cost of school lunches ie, affordability. The list includes sections related to formative, process, and outcomes evaluation.
The reference lists of all related and available articles inteeventions reviewed to reduce the possibility of missing articles. Introduction The prevalence of overweight and obesity continues to increase internationally with significant obesity prevention policy interventions impacts on morbidity and mortality [ 1 ]. There are many systematic reviews or meta-analysis studies that have been performed in specific settings such as schools only [ 121360 ] or were performed for single-axis interventions such as physical activity only [ 1061 ], diet only [ 13 ] or with limited duration of intervention [ 62 ] or follow-up [ 6364 ] and different age ranges [ 9106064 ]. Canberra: ABS,
For example, incorporating local foods into unhealthy recipes obesity prevention policy interventions a potential unintended consequence of farm-to-school policies. Figure 2. Practitioners cannot anticipate all possible consequences and, therefore, should assess both positive and negative unintended outcomes For example, a state may enact enabling legislation in support of complete streets. We will maintain a list of these excluded articles that used non-validated instruments for diet and physical activity assessments. Email Address.
Offer children physical activity obesity prevention policy interventions before and after school, including competitive sports and noncompetitive activities 123789. Priority-setting decisions are likely to require comparative evidence on the cost-effectiveness of a suite of policy-relevant interventions that have been evaluated using consistent methods [ 13 ]. The list of potential interventions was reviewed annually to ensure all relevant interventions based on emerging evidence and global policy activity were considered for inclusion. This priority-setting study can be used to guide this strategy. Key informant interviews were conducted between December and April
Types of environments: Physical Economic Social Communication. This may result in incomplete coding for a number of data systems. Therefore study questions, design, and methodological approaches do not necessarily represent the views of individual technical and content experts. We will assess how each of the outcomes was measured and the validated reference for instruments not listed in Appendix B see Appendix B for list of commonly used dietary and physical activity instruments. Cancel Continue.
Policy Studies Journal. S3 Appendix. Stat Med. Competing obesiy The authors have declared that no competing interests exist. This was interpreted to be policy interventions the intervention promoted PA in the form of playing may have been more attractive and suitable for the younger children [ 75 ], or maybe it is because of the ease of interventions in this age groups [ 76 ]. Priority setting in health: origins, description and application of the Australian Assessing Cost-Effectiveness initiative.
Dominant interventions resulting in both cost-savings and health gains do not have interpretable ICERs and therefore were ranked by total HALYs gained.
The goal is to identify research gaps in studies designed to evaluate obesity prevention and control. Although it begins to capture the complex and emergent nature of policy making, the framework may yield logic models that oversimplify.
Article Google Scholar Accepted : 27 November
Data will also be aggregated and summarized across various coding schema attributes. The program enables providers to search the NPS database while in the EMR and then "prescribe a nearby park" for high risk, sedentary patients.
Causal Loop Diagrams CLDs are one systems thinking method to help document the feedback mechanisms and interconnections between system components [ 30 ]. Prev Med Rep.
The logic pathways were used to model the intervention costs and the impact of the intervention on one or both risk factors. By better understanding stakeholder motives for their disagreement with proposals, policy entrepreneurs are likely to be better equipped to develop strategies that can reduce resistance to change [ 81 ]. American Journal of Public Health. Public Management Review. These balancing loops including an organisational norm of risk aversion, and the complexities resulting from a whole-of-government policy approach and in-depth stakeholder consultation. The duration of intervention effect varied for program-based interventions according to the characteristics of each intervention.
To determine the categories of variables related to obesity and co-outcomes in each data system, we will take the following approach:. Policy : is broadly defined to include both formal public policies at local, state and federal levels of government, and organizational level policies, such as those implemented by large organizations, worksites or school districts. We will describe types of study designs and analytic methods being used, their frequency of use, and whether they are preferred for certain policies, policies or data sources. On This Page. For example, municipalities may have restrictions on foods served in school cafeterias; policies may need to be modified to allow schools to serve foods grown in school gardens. Inputs related to solutions include content experts, evidence-based approaches, existing state policies, and model policies such as exemplar farm-to-school policies enacted in other states.
Government policy makers and external policy actors that were able to frame policy narratives to align policy proposals to decision-maker beliefs R1 played an important role in reinforcing policy change. Schools can also promote health outside of the classroom, by surrounding students with opportunities to eat healthy and stay active. A search of electronic data bases retrieved 30, records. Give elementary school students daily recess, and schedule recess before lunch 12367. Reducing unhealthy weight gain in children through community capacity-building: results of a quasi-experimental intervention program, Be Active Eat Well.
Peer reviewers do not participate in writing or editing of the final report or other products. Skip interventions to search Skip directly to A to Z list Skip directly to interventioons content. Which experimental and non-experimental methods have been used in studies of how programs, policies or built environment changes affect or are associated with obesity prevention and control outcomes? Although the framework outlines short-term, intermediate, and long-term outcomes, many initiatives will capture change only in short-term outcomes ie, changes to the environment. We will abstract data about the study characteristics e.
The EPC considers all peer review comments on the draft report in preparation of the final report. For Prrvention. To receive email updates about this topic, enter your email address. Although it begins to capture the complex and emergent nature of policy making, the framework may yield logic models that oversimplify. Studies in specific settings that would not be generalizable to a free-living population or community e. The list includes sections related to formative, process, and outcomes evaluation.
These include strategies to facilitate policy interventions and broad-based consultation, both across government sectors and external to government, implemented in ways that do not result in substantial delays in the policy process. DHHS policy documentation, InAustralia spent approximately AUD2 billion on prevention [ 56 ]. Ten interventions targeted population nutrition and addressed BMI as the key risk factor. Sabatier P, Weible C. These inconsistencies might be due to differences in inclusion criteria.
Thinking in systems: a primer. Documents collected and analysed within each Healthy Together Victoria policy study. Virtuous loops involve the magnification of positive change e.
Publication types Research Support, U. Consequently, the data aggregation may not be accomplished across all coding attributes and all data obeisty. Cdc-pdf [PDF Consignment is available and accessible in digital format e. The Spectrum identifies ways that states, and to some extent communities, can support child care and early education facilities to achieve recommended standards and best practices for obesity prevention. Cancel Continue. Changes will not be incorporated into the protocol.
Modelled health benefits of a sugar-sweetened beverage tax across different socioeconomic groups in Australia: A cost-effectiveness and equity analysis. This study, like many previous studies of obesity prevention policy [ 82 — 86 ], highlighted the role of evidence for securing decision-maker support for policy change. Canberra: Commonwealth of Australia; Global nutrition policy review: what does it take to scale up nutrition action? Supporting information. A comparative assessment of the evaluated interventions on the implementation considerations is presented in a league table, ordered by the strength of evidence for BMI outcomes, then by strength of evidence on nutrition or physical activity outcomes, followed by equity considerations. Policy making and collective action: defining coalitions within the Advocacy Coalition Framework.
This study used a combination of political science theory and CLD methods to develop insights interventionz the barriers and enablers to obesity prevention policy change in a way that reflects the underlying dynamics of decision-making. Obesity prevention: a proposed framework for translating evidence into action. The ACE-Obesity Policy model A proportional, multi-state life table Markov cohort model was developed to quantify the relationship between characteristics of the population, risk factor prevalence and obesity related diseases to estimate the longer-term outcomes of obesity prevention initiatives. Oxford: Westview press; A simplified meta-CLD was generated from synthesis of common elements across each of the six policy interventions. Schools can also promote health outside of the classroom, by surrounding students with opportunities to eat healthy and stay active. Case study research: design and methods.
For example, not all data systems provide enough details about their data specifications and thus may lead to missing information. Recommended Community Strategies and Measurements to Prevent Obesity in the United States Cdc-pdf [PDFKB] contains 24 recommended obesity prevention strategies focusing on environmental and policy level change initiatives that can be implemented by local governments and school districts to promote healthy eating and active living. Publication types Research Support, U. CDC guidance on community-level obesity prevention identifies a range of measures that can be used to assess environmental change
The results of the cost-effectiveness analysis are presented in a technical results league table with the interventions ranked by their base case ICER. Ensure that food served at classroom parties and school functions, including fundraisers, meets competitive food standards 34 Incorporate nutrition education into school meal programs 13 Click through the PLOS taxonomy to find articles in your field. Characteristics of studies that were not included in the meta-analysis with the exclusion reasons are shown in Additional file 1 : Table S6. Jackson H, Shiell A. The study articulated the complexity of obesity prevention policy decision-making processes, with multiple interconnected feedback loops influencing the progress of policy proposals.
Hire licensed PE teachers and offer them ongoing training 345. Fan J, Gijbels I. Weight changes were converted to changes in BMI using the average height by age and sex for those aged 18 years and over. A related reinforcing loop was the alignment of policy proposals to other government objectives R2 by policy actors.
The results of this phase will inform Key Questions 1 through 5. Peer reviewers do not participate in writing or editing of the final report or other products. We plan to use the draft evidence report as a starting point for this key question, and will follow a process similar to that laid out by Saldanha et al. Steps in an evaluation: Engage stakeholders Describe the policy initiative Focus the evaluation Gather credible evidence Justify conclusions Disseminate and use findings Phases of evaluation: Formative Process Outcome.
Public health practitioners can work for years to raise awareness of a public health problem and potential solutions and, following enactment of new policy, can work still obrsity to assist with its full implementation. Policies also should be cost-effective; in other words, they should use resources in ways that contribute to improvements that are equal to or greater than alternative policies or programs. The U. Well-executed experimental studies provide unbiased estimates of the effect of the intervention on the outcome because the intervention assignment is under the control of the investigator and randomly assigned to some study participants and withheld from others. Solid lines depict components that apply to the current state of policy. See Appendix A for definitions of terms. Studies will be excluded if they do not report any of these outcomes see Table 1 and Appendix B.
Here is a summary of obesity prevention recommendations for school prevemtion and the school food environment, based on a review of expert guidance from the Centers for Disease Control and Prevention, the Institute of Medicine, the World Health Organization, the School Nutrition Association, the American Heart Association, and others. Association of childhood obesity with risk of early all-cause and cause-specific mortality: a Swedish prospective cohort study.
The data synthesis will obesity prevention policy interventions involve various denominators of data systems thus limiting the generalizability of some of the findings. By reviewing interventions, Center TRT staff have identified challenges in policy evaluation, such as identifying the start and end points of policy interventions, documenting processes and successes, and fully measuring success following policy enactment.
All diseases were causally related to BMI and five were related to physical activity colorectal cancer, breast cancer, type 2 diabetes, ischaemic heart disease, and stroke.
The goal of this project is not to analyze or prioritize the gaps identified by the TEP. Further development is needed to assess how well the framework accommodates these types of real-world complexity.
The framework is designed for use by practitioners working as partners and evaluators in public policy initiatives legislation, regulations, or funding allocations at ovesity obesity prevention policy interventions or local level. Skip directly to search Skip directly to A to Z list Skip directly to site content. The instrument also needs to be at least hypothetically randomized. Public health practitioners can work for years to raise awareness of a public health problem and potential solutions and, following enactment of new policy, can work still longer to assist with its full implementation.
Studies with a clearly defined comparison group either prior to the policy, or a defined group without exposure to the policy or program. In addition to using obezity Obesity prevention policy interventions tool to provide an overall risk of bias assessment, we will assess risk of bias concerns unique to each of the study designs and analytic methods employed. We will describe the data source identified in KQ1 for each of the variables and instruments e. As the emphasis on preventing obesity has grown, so have calls for interventions that extend beyond individual behaviors and address changes in environments and policies. Studies will be excluded if they do not report any of these outcomes see Table 1 and Appendix B. In addition, experimental studies are not always feasible or ethical.
School food environments and policies in US public schools. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Annual Review of Public Health.
If we need to amend this protocol, we will give the date of each amendment, describe the change and give the rationale in this section. Components of process: Problem Solutions to problems Politics. To reverse the obesity epidemic, places and practices need to support healthy eating and active living in many settings. What obesity measures, dietary and physical behaviors, and other outcomes have been assessed in studies of how programs, policies or built environment changes affect or are associated with obesity prevention and control? The results of this phase will inform Key Questions 1 through 5. This program illustrates how the linkage of data sources enables the implementation of a program.
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Strategies for the prevention policy interventions control of obesity in the school setting: systematic review and meta-analysis. Interventions targeted at children were modelled under the assumption that the BMI change resulting from the intervention was maintained over the lifetime of the affected population. The identification of balancing feedback dynamics that contribute to policy resistance helped to highlight characteristics of organisational and policy systems that can be altered to better support obesity prevention policy change. Regulatory interventions tended to rank higher on their cost-effectiveness results, driven by lower implementation costs. Thinking in systems: a primer. CMAJ Open.
The framework obeaity a feedback loop from maintenance to formulation to indicate that policy making is cyclical; modifications strengthen policies over time. Surgeon General's Call To Action To Prevent and Decrease Overweight and Obesity was published in and marked a turning point to raise public health awareness about obesity. We will abstract data about the study characteristics e. Inthe U. Individual-level interventions are resource-intensive and have limited potential for lasting success as long as environments promote unhealthy behaviors and limit access to healthy foods and safe opportunities for physical activity 3,4.
Inconsistencies in data abstraction will obwsity resolved by a consensus approach involving the research assistants and the expert reviewer. Obesity prevention policy interventions without reference for validation or use of a validated instrument see Appendix B for list of commonly used validated instruments to measure diet or physical activity. We will describe types of study designs and analytic methods being used, their frequency of use, and whether they are preferred for certain policies, policies or data sources. Intermediate outcomes also refer to changes in social norms related to obesity and the behaviors that prevent it
Studies without an English-language data dictionary such studies will be identified, but we will not attempt to extract information obsity the data in the studies. We will not evaluate the strength of evidence for a particular comparison or outcome as we are not assessing the comparative effectiveness obesity prevention policy interventions interventions in this review. Articles will be selected through independent screening by two screeners based on the inclusion and exclusion criteria described in PICOTS Table 1. Practitioners can respond to this challenge by iteratively revising their logic model to fit progressive stages in the policy-making process to identify the emergence of new inputs, activities, and outputs over time Definition adapted from Craig, Email Address. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
Schools and obesity prevention: creating school environments and policies to promote healthy eating and physical activity. CLDs can be a useful heuristic tool to highlight virtuous or vicious reinforcing feedback dynamics [ 31 ], and identify leverage points by which strategies came to be implemented to alter system behaviour [ 3233 ].
Interventions 3 shows the most commonly encountered types of non-experimental study designs and specific bias concerns. We will describe the data sources by criteria for population-based data systems, whether the data source is in the NCCOR registry, and what country, state or community it is from.
Moreover, organisational rules meant that substantial consultation processes within each organisational unit were required before formally proposing the policy to decision-makers. Another finding in the current study was a small but non-significant change in BMI-Z score in intervention groups e.
In conclusion, the obesity prevention policies in short-term periods of less than 2 years, in rather early age of school with approaches of change in both of diet and physical activity, could be more effective in prevention of childhood obesity. Implementation Sci.
A search strategy will be developed for PubMed, and will be used as a guide to develop search strategies in the other search engines see Appendix Pokicy. Adoption is less applicable to mandatory policies. If consensus is not attainable for a specific case, it will be discussed among the rest of the review team and resolved by a majority vote. Solid lines depict components that apply to the current state of policy. After data have been abstracted, an independent data abstraction expert will review a random sample for quality assurance.
Systematic review of community-based interventions obesity prevention studies. The next iteration of the Dietary Guidelinesobessity will coverwill for the first time include standards for pregnant women, infants, and toddlers. Changes in weight status, quality of life and behaviours of South Australian primary school children: results from the Obesity Prevention and Lifestyle OPAL community intervention program. The intervention costs were mostly concentrated in the first three years of implementation. The Assessing Cost-Effectiveness ACE methodology was developed as a priority-setting tool to facilitate evidence-based decision-making. Implement Sci. The prevalence of overweight and obesity continues to increase internationally with significant concomitant impacts on morbidity and mortality [ 1 ].
The Centers for Disease Control and Prevention CDC and others obesity prevention funding the implementation and evaluation of new obesity prevention policies, presenting a distinct opportunity to learn from these practice-based initiatives and build the body of evidence-based approaches. Dotted lines depict potential future activities, outputs, and outcomes. Email Address. On This Page. Studies without reference for validation or use of a validated instrument see Appendix B for list of commonly used validated instruments to measure diet or physical activity.
International journal of environmental research and public health. Preventjon exclusion and inclusion criteria are shown in Table 1. Click through the PLOS taxonomy to find articles in your field. Current Obesity Reports. Analysis to produce a meta-CLD. For example, targeted or hybrid consultation approaches [ ] could be considered, along with the establishment of clear parameters and processes for responding to feedback [ 7077 ].
We will describe obesity prevention policy of study designs and analytic methods being used, pprevention frequency of use, and whether they are preferred for certain policies, policies or data sources. E-mail: jleeman email. The disposition of comments for systematic reviews and technical briefs will be published three months after the publication of the evidence report. The Centers for Disease Control and Prevention CDC and others are funding the implementation and evaluation of new obesity prevention policies, presenting a distinct opportunity to learn from these practice-based initiatives and build the body of evidence-based approaches. Facebook Twitter LinkedIn Syndicate. As demonstrated in the review, 16 few studies included BMI or weight as a primary outcome.
Procedia—Social and Behavioral Sciences. Obesity among intervenions and adolescents is a leading cause of health and contributes to cardiovascular disease, cerebrovascular disease, and metabolic diseases [ 1 ]. You can also search for this author in PubMed Google Scholar. In addition to the economic evidence, the study aimed to also provide a qualitative assessment of implementation considerations likely to be important to decision-makers [ 12 ]. J Epidemiol Community Health. Details of the six selected policy processes investigated are provided in Table 1.
Figure 2. Dotted lines depict potential future activities, outputs, and outcomes. After a policy is enacted, additional inputs include the administrative structures, staffing, and material resources necessary to implement the policy and the systems that will be employed for policy monitoring and enforcement. The final report does not necessarily represent the views of individual reviewers.
For KQ2 we will qualitatively describe the methods currently used to link these data systems see KQ2 data abstraction. Changes in the Built Environment : Built environments are the totality of places built or designed by humans, including buildings, grounds around buildings, layout of communities, transportation infrastructure, and parks and trails. We will not evaluate the strength of evidence for a particular comparison or outcome as we are not assessing the comparative effectiveness of interventions in this review. We will first create a list of data sources by study. The U. Potential incompleteness of the data abstraction may introduce errors and consequently biases in these findings.
To improve nutrition, schools can include healthier food offerings in the cafeteria and eliminate marketing of unhealthy foods. All of the selected policy interventions were interfentions in Victoria over the period —, although some policies, such as Menu Kilojoule Labelling Legislation required multiple formal iterations of policy proposals prior to policy adoption, and some aspects of the Land Use Planning Policies e. However, seven virtuous reinforcing loops helped overcome policy resistance for several policy proposals. Seven of the eleven dominant interventions and six of the top eight interventions were regulatory interventions.
The EPC considers all peer review comments on the draft report in preparation of the final report.
This study used a limited societal perspective and therefore costs accruing to various government sectors, private companies and individuals were included in the analyses. Impact of an after-school physical activity program on obesity in children.
The framework is designed for use by practitioners working obesity prevention policy interventions partners and evaluators in public policy initiatives legislation, regulations, or funding allocations at the state or local level. Short-term outcomes are changes to the environment that promote healthier foods and increase physical activity.
Download citation. In addition, stakeholder groups were given the opportunity to learn, at an early stage of the process, about how the proposed policy was likely to impact them [ 5859 ].
As demonstrated in the review, 16 few studies included BMI or weight as a primary outcome. Short-term outcomes are changes to the environment that promote healthier foods and increase physical activity. What are the risks of bias in studies of how programs, policies or built environment changes affect or are associated with obesity prevention and control outcomes? Policy : is broadly defined to include both formal public policies at local, state and federal levels of government, and organizational level policies, such as those implemented by large organizations, worksites or school districts.
See below for additional data abstraction elements by KQ. Evaluation may also assess the extent to which policies followed model policy guidance from organizations with expertise in obesity prevention policy eg, National Policy and Legal Analysis Network to Prevent Childhood Obesity. Engaging stakeholders, raising awareness, and advocating for change are essential activities throughout the policy-making process 9. The following resources are designed to assist schools and program coordinators to inform stakeholders and school health services staff on obesity factsengaging students and managing chronic health conditions. CDC guidance on community-level obesity prevention identifies a range of measures that can be used to assess environmental change Practitioners can draw on the Center TRT framework to identify and adapt components to include in their progressive logic models.