Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, 55414, USA.
Am J Prev Med. 2010 Jan;38(1):9-16. doi: 10.1016/j.amepre.2009.08.031.
With the epidemic of childhood obesity, there is national interest in state-level school policies related to nutrition and physical activity, policies adopted by states, and relationships to youth obesity.
This study develops a comprehensive state-level approach to characterize the overall obesity prevention policy environment for schools and links the policy environments to youth obesity for each state.
Using 2006 School Health Policies and Programs Study (SHPPS) state data, qualitative and quantitative methods were used (2008-2009) to construct domains of state-level school obesity prevention policies and practices, establish the validity and reliability of the domain scales, and examine their associations with state-level obesity prevalence among youth aged 10-17 years from the 2003 National Survey of Children's Health.
Nearly 250 state-level obesity prevention-policy questions were identified from the SHPPS. Three broad policy topic areas containing 100 food service and nutrition (FSN) questionnaire items; 146 physical activity and education (PAE) items; and two weight assessment (WA) items were selected. Principal components analysis and content validity assessment were used to further categorize the items into six FSN, ten PAE, and one WA domain. Using a proportional scaled score to summarize the number of policies adopted by states, it was found that on average states adopted about half of the FSN (49%), 38% of the PAE, and 17% of the WA policies examined. After adjusting for state-level measures of ethnicity and income, the average proportion of FSN policies adopted by states was correlated with the prevalence of youth obesity at r =0.35 (p=0.01). However, no correlation was found between either PAE or WA policies and youth obesity (PAE policies at r =0.02 [p=0.53] and WA policies at r =0.16 [p=0.40]).
States appear to be doing a better job adopting FSN policies than PA or WA policies, and adoption of policies is correlated with youth obesity. Continued monitoring of these policies seems to be warranted.
随着儿童肥胖症的流行，国家对与营养和身体活动相关的州级学校政策、各州通过的政策以及这些政策与青少年肥胖的关系产生了浓厚的兴趣。
本研究制定了一种全面的州级方法，用于描述学校肥胖预防政策环境，并将这些政策环境与各州的青少年肥胖状况联系起来。
利用 2006 年学校健康政策和计划研究（SHPPS）的州数据，采用定性和定量方法（2008-2009 年）构建州级学校肥胖预防政策和实践领域，建立领域量表的有效性和可靠性，并检查其与 2003 年全国儿童健康调查中 10-17 岁青少年的州级肥胖患病率之间的关系。
从 SHPPS 中确定了近 250 个州级肥胖预防政策问题。从 146 个身体活动和教育（PAE）项目中选择了三个广泛的政策主题领域，包含 100 个食品服务和营养（FSN）问卷项目；和两个体重评估（WA）项目。主成分分析和内容有效性评估用于进一步将项目分类为六个 FSN、十个 PAE 和一个 WA 领域。使用比例评分来总结各州通过的政策数量，发现各州平均通过了大约一半的 FSN（49%）、38%的 PAE 和 17%的 WA 政策。在调整了州级种族和收入措施后，各州通过的 FSN 政策比例与青少年肥胖的流行程度相关，相关系数为 r =0.35（p=0.01）。然而，没有发现 PAE 或 WA 政策与青少年肥胖之间存在相关性（PAE 政策 r =0.02[p=0.53]和 WA 政策 r =0.16[p=0.40]）。
各州在通过 FSN 政策方面似乎比 PA 或 WA 政策做得更好，政策的通过与青少年肥胖有关。似乎有必要继续监测这些政策。
