McKinnon Robin A, Orleans C Tracy, Kumanyika Shiriki K, Haire-Joshu Debra, Krebs-Smith Susan M, Finkelstein Eric A, Brownell Kelly D, Thompson Joseph W, Ballard-Barbash Rachel
National Cancer Institute, Bethesda, Maryland 20892, USA.
Am J Prev Med. 2009 Apr;36(4):351-7. doi: 10.1016/j.amepre.2008.11.017. Epub 2009 Feb 11.
The rise in obesity levels in the U.S. in the past several decades has been dramatic, with serious implications for public health and the economy. Experiences in tobacco control and other public health initiatives have shown that public policy may be a powerful tool to effect structural change to alter population-level behavior. In 2007, the National Cancer Institute convened a meeting to discuss priorities for a research agenda to inform obesity policy. Issues considered were how to define obesity policy research, key challenges and key partners in formulating and implementing an obesity policy research agenda, criteria by which to set research priorities, and specific research needs and questions. Themes that emerged were: (1) the embryonic nature of obesity policy research, (2) the need to study "natural experiments" resulting from policy-based efforts to address the obesity epidemic, (3) the importance of research focused beyond individual-level behavior change, (4) the need for economic research across several relevant policy areas, and (5) the overall urgency of taking action in the policy arena. Moving forward, timely evaluation of natural experiments is of especially high priority. A variety of policies intended to promote healthy weight in children and adults are being implemented in communities and at the state and national levels. Although some of these policies are supported by the findings of intervention research, additional research is needed to evaluate the implementation and quantify the impact of new policies designed to address obesity.
在过去几十年里,美国肥胖水平的上升十分显著,这对公众健康和经济产生了严重影响。烟草控制及其他公共卫生倡议的经验表明,公共政策可能是推动结构性变革以改变人群行为的有力工具。2007年,美国国家癌症研究所召开了一次会议,讨论肥胖政策研究议程的优先事项。会议探讨的问题包括如何界定肥胖政策研究、制定和实施肥胖政策研究议程的主要挑战及关键合作伙伴、确定研究优先事项的标准,以及具体的研究需求和问题。会议形成的主题有:(1)肥胖政策研究尚处于萌芽阶段;(2)有必要研究因基于政策的努力应对肥胖流行而产生的“自然实验”;(3)超越个体行为改变的研究的重要性;(4)在多个相关政策领域开展经济研究的必要性;(5)在政策领域采取行动的总体紧迫性。展望未来,对自然实验进行及时评估尤为重要。社区、州和国家层面正在实施各种旨在促进儿童和成人健康体重的政策。尽管其中一些政策得到了干预研究结果的支持,但仍需开展更多研究来评估新政策的实施情况并量化其对解决肥胖问题的影响。