Donaldson Elisabeth A, Cohen Joanna E, Villanti Andrea C, Kanarek Norma F, Barry Colleen L, Rutkow Lainie
Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health Baltimore, MD, United States.
Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health Baltimore, MD, United States; Institute for Global Tobacco Control, Baltimore, MD, United States.
Prev Med. 2015 May;74:117-22. doi: 10.1016/j.ypmed.2015.02.013. Epub 2015 Feb 28.
This study examined bill- and state-level factors associated with enactment of adult obesity prevention legislation in US states.
A review of bills in the Rudd Center for Food Policy and Obesity's legislative database identified 487 adult obesity prevention bills, or proposed legislation, introduced between 2010 and 2013. Multilevel models were constructed to examine bill- and state-level characteristics associated with enactment.
From 2010 to 2013, 81 (17%) of obesity prevention bills introduced were enacted across 35 states and the District of Columbia. Bills introduced in 2010 were more likely to be enacted than in 2013 (OR=9.49; 95% CI: 2.61-34.5). Bills focused on access to healthy food, physical activity, general and educational programs, as well as modifying rules and procedures (e.g., preemption) had greater odds of enactment relative to food and beverage taxes (OR=8.18; 95% CI: 2.85-23.4 healthy food; OR=17.3; 95% CI: 4.55-65.7 physical activity; OR=15.2; 95% CI: 4.80-47.9 general; OR=13.7; 95% CI: 3.07-61.5 rules).
The year of bill introduction and overall bill enactment rate were related to adult obesity prevention legislation enactment in states. This study highlights the importance of a bill's topic area for enactment and provides insights for advocates and policymakers trying to address enactment barriers.
本研究调查了与美国各州成人肥胖预防立法颁布相关的法案及州层面因素。
对路德食品政策与肥胖研究中心立法数据库中的法案进行审查，确定了2010年至2013年间提出的487项成人肥胖预防法案或拟议立法。构建多层次模型以研究与法案颁布相关的法案及州层面特征。
2010年至2013年期间，提出的肥胖预防法案中有81项（17%）在35个州和哥伦比亚特区获得颁布。2010年提出的法案比2013年提出的法案更有可能获得颁布（OR=9.49；95%置信区间：2.61-34.5）。相对于食品和饮料税，关注获取健康食品、体育活动、一般及教育项目以及修改规则和程序（如优先权）的法案颁布几率更高（OR=8.18；95%置信区间：2.85-23.4健康食品；OR=17.3；95%置信区间：4.55-65.7体育活动；OR=15.2；95%置信区间：4.80-47.9一般；OR=13.7；95%置信区间：3.07-61.5规则）。
法案提出年份和总体法案颁布率与各州成人肥胖预防立法的颁布相关。本研究突出了法案主题领域对颁布的重要性，并为试图解决颁布障碍的倡导者和政策制定者提供了见解。
