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Author Jones, Ellen Shea
Title Understanding state policy to prevent childhood obesity: A qualitative analysis of facilitators and barriers
book jacket
Descript 136 p
Note Source: Dissertation Abstracts International, Volume: 71-06, Section: B, page: 3627
Adviser: Jessica Bailey
Thesis (Ph.D.)--The University of Mississippi Medical Center, 2010
Obesity is a serious health problem in the United States. Public health experts point to obesity prevention and control as a strategy to reduce the burden of diabetes, cardiovascular disease, some cancers, gout, stroke, and osteoarthritis. One promising approach to obesity prevention is through public policies and environmental changes. Policy changes are important at the state level for at least three reasons. First, polices have the potential to promote healthy behavior or reduce unhealthy behavior. An example might be access to healthy beverages in school buildings while restricting sugary, high calorie beverages. Secondly, policy initiatives can impact the resources devoted to address obesity prevention and control. The formation of statewide task forces, dedication of funds for state and local programs, and media campaigns are examples of policy changes in recent legislation. Lastly, the public attention afforded by policy initiatives often influences social norms
The need for state level policy approaches is exemplified by the sheer number of obesity bills that have been introduced in state legislatures since the turn of the century. In response to the childhood obesity epidemic, many states have introduced and adopted legislation that aims to prevent or reduce obesity. Recent research at the state level has focused on inventories of legislation, effectiveness of legislation, and predictors of introduction and enactment. Other research has focused on how policy makers seek and acquire information. The objective of this study was to examine qualitative factors that serve as facilitators and/or barriers to state childhood obesity policy introduction and enactment
Telephone interviews with state legislators and staff were conducted in eight states. The states were selected based on childhood obesity rates as well as number of legislative bills passed to address childhood obesity. Both non-modifiable (legislative factors and legislator factors) and modifiable factors (bill content, political context, and public support) were included in the interview questions. A framework emerged from the data. This framework supports the premise that state policy makers are influenced by a convergence of many modifiable and non-modifiable factors. A summary of the four theories is presented below: (1) Non-modifiable factors including Legislator Factors and Legislative Factors influence rates of policy enactment. Generally, those who agreed to do interviews were likely to have a health related background and to have children at home or mention grandchildren. Legislators in states with high legislation were more likely to be Democrats. Unique Legislative factors (longer session, no term limits for legislators, senate not controlled by Republicans, Democratic Governor, and available legislative staff) also serve as facilitators to state childhood obesity policy. Half the states with high legislation had a Public Health Institute. All of the states with high legislation had a Prevention Research Center. (2) Data from respondents about Bill Content demonstrate that legislators are uncomfortable with evidence around childhood obesity policy and results that may be expected. (3) Political Context was the overriding influence related to childhood obesity policy expressed by respondents. Specifically, legislators did not articulate a clear reason to act or clear costs/benefits (both fiscal and political). Respondents were not convinced that policy results can be demonstrated in a timeframe or manner that is politically beneficial. Two other negative forces are present as part of political context. The first is a perception of opposition to childhood obesity policy that is well organized and effective. The second is the pervasive issue (in 2010) of state budget shortfalls. (4) Legislators and staff do not perceive a consensus of support around obesity policy. A gap exists between philosophical support for child health and political action related to obesity. The lack of a social movement related to obesity prevents the development and recognition of champions for state policy. Further, existing messages about childhood obesity focus on statistics rather than clear policy actions
Results from this qualitative study provide a more robust understanding of state level policy interventions to address childhood obesity and improve public health. This dissertation includes recommendations for further study and steps that should be considered by practitioners, advocates and policy makers
School code: 0805
Host Item Dissertation Abstracts International 71-06B
Subject Health Sciences, Nutrition
Health Sciences, Public Health
Political Science, General
Alt Author The University of Mississippi Medical Center
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