Dinour Lauren M
The Graduate Center, City University of New York, NY, USA
Health Educ Behav. 2015 Apr;42(1 Suppl):76S-86S. doi: 10.1177/1090198114568303.
Competitive foods in schools have historically been scrutinized for their ubiquity and poor nutritional quality, leading many states to enact legislation limiting the availability and accessibility of these items. Evaluations of these policy approaches show their promise in improving the healthfulness of school food environments, considered an important strategy for reducing childhood obesity. Yet little is known about the decision-making processes by which such legislation is formed and adopted. Using a comparative case study design, this study describes and analyzes the policy formation processes surrounding five state-level competitive food bills introduced in 2009-2010. Data for each case were drawn from multiple key informant interviews and document reviews. Case studies were conducted, analyzed, and written independently using a standard protocol and were subsequently compared for recurring and unique themes. Abbreviated case studies and summary tables are provided. Results indicate that bill cost is a major barrier to achieving strong, health-promoting policy change. Additionally, findings reveal that supporters of stronger competitive food policies often concede to changes that weaken a bill in order to neutralize opposition and achieve stakeholder buy-in. These challenges suggest that continued research on the development, implementation, and evaluation of public health policies can contribute to the advancement of new strategies for effective health promotion.
学校中的竞争性食品长期以来因其无处不在和营养质量差而受到审查，这导致许多州颁布立法，限制这些食品的供应和获取。对这些政策方法的评估表明，它们有望改善学校食品环境的健康状况，而这被视为减少儿童肥胖的一项重要战略。然而，对于形成和通过此类立法的决策过程却知之甚少。本研究采用比较案例研究设计，描述并分析了2009 - 2010年提出的五项州级竞争性食品法案的政策形成过程。每个案例的数据均来自多个关键信息提供者访谈和文件审查。案例研究采用标准方案独立进行、分析和撰写，随后对反复出现和独特的主题进行比较。提供了简略的案例研究和汇总表。结果表明，法案成本是实现强有力的、促进健康的政策变革的主要障碍。此外，研究结果显示，更强有力的竞争性食品政策的支持者往往会为了消除反对意见并获得利益相关者的认可而同意对法案进行削弱。这些挑战表明，对公共卫生政策的制定、实施和评估进行持续研究有助于推进有效的健康促进新战略。
