PRC Network Produces Journal Supplement on Nutrition and Obesity Policy Research
The Nutrition and Obesity Policy Research and Evaluation Network (NOPREN), a network of Prevention Research Centers (PRCs), produced a supplement to the American Journal of Preventive Medicine examining policies and processes that promote healthy eating.1 Funded by CDC’s Division of Nutrition, Physical Activity, and Obesity, NOPREN members study the impact of and gaps in policies and processes aimed at creating environments that support healthy food, beverage, and physical activity choices. Since 1980, the prevalence of obesity among children and adolescents has almost tripled,2 and policy and environmental approaches may help reverse the trend.
The September 2012 supplement, entitled “Evaluating Policies and Processes for Promoting Healthy Eating: Findings from the Nutrition and Obesity Policy Research and Evaluation Network (NOPREN),” is available free of charge on the NOPREN website. The supplement features findings and case studies from PRC research described below.
Researchers at the Harvard University PRC reviewed policies that affect access to drinking water during meal and snack time in Massachusetts public schools. They found that in the 2008-2009 school year, more than 90% of school districts did not address access to free drinking water in their wellness policies. The researchers also estimated costs of three water-delivery options—commercial bottled water dispensers, dispensers attached to tap water, and water fountains or bottle fillers directly connected to school plumbing. They found that even in schools that would need to install additional plumbing to make drinking water available in meal areas, water fountains cost less than the other options in the long run.
In “food insecure” areas—areas with few or no grocery stores or other merchants or markets selling fresh food—convenience stores may be residents’ main resource for food and beverages. Researchers at the Texas A&M Health Science Center PRC trained promotoras (community health workers) to document the assortment of healthy and less-healthy foods and beverages in convenience stores along the Texas-Mexico border. Product assortment (i.e., product presence and variety) is used to influence consumer purchases.3 Researchers found that 192 convenience stores along the Texas-Mexico border provided a greater assortment of less-healthy foods and beverages than healthier choices. The findings highlight areas of opportunity to influence consumers’ food and beverage choices in "food insecure” neighborhoods through programs that help increase the assortment of healthy items in convenience stores.
In March 2011, New Orleans enacted the Fresh Food Retailer Initiative to provide low-interest loans to retailers that locate in underserved neighborhoods and commit to selling fresh fruits and vegetables. To highlight factors that enabled and impeded the initiative’s enactment, Tulane University PRC researchers conducted interviews of 22 people who had firsthand experience with the initiative, including representatives from the private sector, nonprofit organizations, and government. The findings included facilitators that might be applicable to similar initiatives in other locations. For example, data and information describing the problem of food access in New Orleans was presented and communicated in plain language. The findings also highlighted the importance of having key advocates, broad-based support, a clear objective, and a well-defined problem when policy is being formulated.
In Washington State, the King County Board of Health required chain restaurants with 15 or more locations to include nutrition information on menus and menu boards, starting January 2009. To inform nutrition policy development in other settings, University of Washington PRC researchers and colleagues described the process that led to the regulation. Using a framework developed by policy scientists, the researchers described how the process involved two coalitions, the public health coalition and the restaurant industry coalition. Each coalition had opposing core beliefs, such as industry freedom versus the consumer’s right to know. The researchers identified elements that helped the coalitions move beyond their opposing beliefs to reach compromises. Those elements included the political landscape and expert-based information that board of health staff had been receiving for several years before beginning work on the menu labeling requirement.
Harvard University PRC researchers developed the Out of School Nutrition and Physical Activity Initiative (OSNAP) to help after-school programs identify sustainable ways to improve their nutrition and physical activity policies and environments. To measure OSNAP’s impact on the provision of water to children during after-school snack time, PRC researchers randomized 20 Boston after-school programs into a group using OSNAP or a control group not using the intervention (but the following school year would be offered the intervention). The 10 after-school programs implementing OSNAP served, per day per child, an average of 3.6 ounces more water and 60.9 fewer beverage calories than the ten control programs. OSNAP may be helpful as programs implement federal regulations that require water availability in eating areas providing federally funded lunches and snacks.
The public health community is increasingly looking at policy and environmental approaches as promising ways to combat the obesity problem in the United States. Policy briefs—concise summaries of research findings—can be an effective way for researchers and public health practitioners to communicate information to policymakers. Researchers at the St. Louis PRC analyzed 100 briefs concerning obesity to determine whether proper communication and dissemination techniques were being used and to develop guidelines that would make policy briefs more effective. The mean length of the briefs analyzed was five pages, but 25% of the briefs had 7-18 pages. Most briefs had no tables and nearly half had no figures, although tables and figures are helpful ways to convey ideas concisely. The researchers suggest that briefs
- be one-to-two pages long;
- contain tables, figures, and photographs; and
- include references and contact information.
Additionally, the researchers said that authors of briefs should target dissemination rather than merely placing the briefs on a website and should evaluate dissemination to measure the briefs’ impact.
For more information on other PRC projects relating to obesity, physical activity, and nutrition, go to the Research Projects page and search Health Topics for “Obesity and overweight,” “Nutrition and physical activity for adults,” and “Nutrition and physical activity for youth.”
1 Ascher WL, Blanck, HM, Cradock, AL, editors. Evaluating policies and processes for promoting healthy eating: Findings from the Nutrition and Obesity Policy Research and Evaluation Network (NOPREN). American Journal of Preventive Medicine 2012 Sep;Suppl:S85–S152. Available at http://nopren.org/noprensupplement2012.html.
2 Centers for Disease Control and Prevention. Data and Statistics: Obesity Rates Among All Children in the United States. http://www.cdc.gov/obesity/childhood/data.html. Accessed Sept. 14, 2012.
3 Glanz K, Bader MDM, Iyer S. Retail grocery store marketing strategies and obesity: an integrative review. American Journal of Preventive Medicine 2012;42(5):503–12.