Policy, Systems, and Environmentally Oriented School-Based Obesity Prevention: Opportunities and Challenges

Fagen, Michael C.; Asada, Yuka; Welch, Sarah B; Dombrowski, Rachael D.; Gilmet, Kelsey; Welter, Christina R.; Stern, Lori; Barnett, Gina Massuda; Mason, Maryann

doi:10.1080/10852352.2014.881175

Cited by 31 publications

(35 citation statements)

References 14 publications

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“…This suggests that it may be helpful to engage parents so they model and support healthy eating and PA as well as limiting screen time in the home environment. Similarly, the community environment can support advertising and promotional messages that stress the importance of healthy eating and PA, as well as limiting sedentary screen time [ 23 ]. Further research is needed to understand how these multiple environments—school, home, and community—can work together and incorporate a variety of approaches to increase healthy eating and physical activity and limit sedentary behaviors.…”

Section: Discussionmentioning

confidence: 99%

Associations of Physical Activity and Sedentary Behaviors with Dietary Behaviors among US High School Students

et al. 2015

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Background. Physical activity (PA), sedentary behaviors, and dietary behaviors are each associated with overweight and obesity among youth. However, the associations of PA and sedentary behaviors with dietary behaviors are complex and not well understood. Purpose. To describe the associations of PA and sedentary behaviors with dietary behaviors among a representative sample of US high school students. Methods. We analyzed data from the 2010 National Youth Physical Activity and Nutrition Study (NYPANS). Using logistic regression models which controlled for sex, race/ethnicity, grade, body weight status, and weight management goals, we compared dietary behaviors among students who did and did not meet national recommendations for PA and sedentary behaviors. Results. Students who participated in recommended levels of daily PA (DPA) and muscle strengthening PA (MSPA) were more likely than those who did not to eat fruits and vegetables. Students who exceeded recommended limits for television (TV) and computer/video game (C/VG) screen time were less likely than those who did not to consume fruits and vegetables and were more likely to consume fast food and sugar-sweetened beverages. Conclusions. Researchers may want to address PA, sedentary behaviors, and dietary behaviors jointly when developing health promotion and obesity prevention programs for youth.

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Section: Discussionmentioning

confidence: 99%

Associations of Physical Activity and Sedentary Behaviors with Dietary Behaviors among US High School Students

et al. 2015

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“…Several studies examined multiple domains of food environment policy in one study rather than a single domain only. Food provision (79 %) was the most common food environment domain examined [ 33 , 35 , 42 , 43 , 45 , 47 , 49 , 52 , 55 , 59 , 60 , 62 , 68 , 70 , 72 – 74 , 76 – 80 ], followed by food promotion [ 42 , 52 , 62 , 71 , 79 – 81 ].…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen studies focused specifically at national or federal-level policy [ 35 , 36 , 45 , 47 , 49 , 52 , 55 , 59 , 60 , 68 , 71 , 74 , 76 , 79 ], seven focused at state level [ 33 , 53 , 73 , 77 , 78 , 80 , 81 ] and five focused at subnational level, i.e. provincial [ 43 ], county [ 70 ], district [ 72 ] and local [ 69 , 75 ] levels. Two assessed the policies at both national and local/subnational levels [ 42 , 62 ].…”

Section: Resultsmentioning

confidence: 99%

“…School was the most targeted setting to assess the policy implementation process (61 %) [ 33 , 35 , 43 , 47 , 52 , 55 , 59 , 60 , 68 , 70 – 74 , 76 , 78 , 81 ] while some studies (18 %) focused on policies in various settings in a single study such as workplaces, schools, hospitals, childcare centres and communities [ 42 , 53 , 62 , 69 , 80 ]. One study examined specifically at community level [ 45 ].…”

Section: Resultsmentioning

confidence: 99%

“…Key issues which were frequently observed as barriers or facilitators of policy implementation were support for infrastructure and/or resources such as financial and human resources [ 33 , 35 , 36 , 42 , 47 , 49 , 53 , 55 , 59 , 60 , 68 – 72 , 74 , 75 , 77 ], stakeholders’ engagement in the policy implementation process and partnerships [ 35 , 36 , 43 , 47 , 59 , 60 , 68 – 71 , 74 , 77 , 80 ], monitoring and evaluation mechanisms for implementation and enforcement issues (such as stakeholders’ resistance and negotiation with private sectors) [ 36 , 49 , 55 , 59 , 60 , 68 , 70 , 71 , 76 , 77 , 80 , 81 ], coordination mechanisms and leadership and implementation governance [ 35 , 36 , 42 , 47 , 49 , 70 , 75 , 76 , 79 , 80 ], role of implementers [ 35 , 72 , 75 , 76 , 79 ], and policy communications among stakeholders [ 42 , 70 , 72 ]. Other influential factors identified include organizational capacity [ ...…”

Section: Resultsmentioning

confidence: 99%

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A review of methods and tools to assess the implementation of government policies to create healthy food environments for preventing obesity and diet-related non-communicable diseases

et al. 2015

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BackgroundPolicies to create healthy food environments are recognized as critical components of efforts to prevent obesity and diet-related non-communicable diseases. There has not been a systematic review of existing methods and tools used to assess the implementation of these government policies. The purpose of this study was to review methods and tools used for assessing the implementation of government policies to create healthy food environments.The study conducted a systematic literature search. Multiple databases as well as the grey literature were searched. All study designs and review papers on assessing the implementation of government policies to create healthy food environments were included. A quality assessment of the methods and tools identified from relevant studies was carried out using the following four criteria: comprehensiveness, relevance, generalizability and feasibility. This quality assessment was completed by two independent reviewers.ResultsThe review identified 52 studies across different policy areas, levels and settings. Self-administered questionnaires and policy checklists were most commonly applied to assess the extent of policy implementation, whereas semi-structured interviews were most commonly used to evaluate the implementation process. Measures varied widely, with the existence of policy implementation the aspect most commonly assessed. The most frequently identified barriers and facilitators for policy implementation were infrastructure support, resources and stakeholder engagement. The assessment of policy implementation on food environments was usually undertaken in combination with other policy areas, particularly nutrition education and physical activity. Three tools/methods were rated ‘high’ quality and 13 tools/methods received ‘medium’ quality ratings.ConclusionsHarmonization of the available high-quality methods and tools is needed to ensure that assessment of government policy implementation can be compared across different countries and settings and over time. This will contribute to efforts to increase government accountability for their actions to improve the healthiness of food environments.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-016-0379-5) contains supplementary material, which is available to authorized users.

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Increasing Children’s Physical Activity During the School Day

Hatfield

Chomitz

2015

Curr Obes Rep

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Insufficient levels of daily physical activity (PA) among children in the USA and worldwide have profound implications for pediatric obesity and children's health and well-being more generally. Public health recommendations highlight the central role that schools play in providing equitable opportunities for PA for all children. This review identifies evidence-based approaches for increasing children's PA throughout the school day and discusses multilevel factors that support implementation of such approaches. Opportunities to increase school-day PA span not only in-school time (e.g., quality recess and physical education, classroom activity breaks) but also time before school (e.g., active commuting initiatives) and after school (e.g., intramural and interscholastic sports programs). For such approaches to impact children's PA, dimensions of implementation such as adoption, fidelity, penetration, implementation costs, and sustainability are critical. Multilevel factors that influence implementation include policies, school environment and organizational factors, teacher and classroom factors, child and family characteristics, and attributes of the PA approach itself. Research and field observations reinforce the importance of understanding challenges specific to working with schools, including multiple stakeholders, competing priorities, limited facilities and staff capacity, and heterogeneity of students. Thus, while schools hold promise as promoters and equalizers of PA engagement for all children, more research is needed on the levers that influence implementation of effective school-based PA policies and programs.

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Policy, Systems, and Environmentally Oriented School-Based Obesity Prevention: Opportunities and Challenges

Cited by 31 publications

References 14 publications

Associations of Physical Activity and Sedentary Behaviors with Dietary Behaviors among US High School Students

Associations of Physical Activity and Sedentary Behaviors with Dietary Behaviors among US High School Students

A review of methods and tools to assess the implementation of government policies to create healthy food environments for preventing obesity and diet-related non-communicable diseases

Increasing Children’s Physical Activity During the School Day

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