Kuo Tony, Robles Brenda, Trogdon Justin G, Ferencik Rachel, Simon Paul A, Fielding Jonathan E
Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, California (Drs Kuo and Simon and Ms Robles); Departments of Family Medicine (Dr Kuo) and Pediatrics (Dr Fielding), David Geffen School of Medicine at the University of California, Los Angeles; Departments of Epidemiology (Drs Kuo and Simon) and Health Policy and Management (Dr Fielding), University of California, Los Angeles Fielding School of Public Health; Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (Dr Trogdon); and Georgia Health Policy Center, Georgia State University, Atlanta (Ms Ferencik).
J Public Health Manag Pract. 2016 Jul-Aug;22(4):360-9. doi: 10.1097/PHH.0000000000000334.
Few studies have described the range and health impacts of obesity prevention strategies in local communities supported by the Communities Putting Prevention to Work program.
To address this gap, we reviewed implemented strategies in Los Angeles County (LAC) for 3 program focus areas: physical activity-promotion, health marketing, and creation of healthy food environments. Local context and results from an impact simulation are presented.
Information on population reach and program milestones was synthesized to describe historical and programmatic progress of the obesity prevention efforts during 2010-2012. To forecast health impacts, the Prevention Impacts Simulation Model (PRISM) was used to simulate population health outcomes, including projected changes in obesity burden and health behaviors 30 years into the future.
LAC with more than 9.8 million residents.
Low-income adults and youth who were the intended audiences of the Communities Putting Prevention to Work program in LAC.
Implemented strategies for the 3 focus areas.
Documentation of program reach and PRISM forecasting of obesity rates and health impacts.
Implemented strategies in LAC ranged from best practices in healthy food procurement (estimated reach: 600 000 students, 300 000 meals per day) to completed shared-use agreements (10+ agreements across 5 school districts) to a series of strategically designed health marketing campaigns on healthy eating (>515 million impressions). On the basis of PRISM simulations, these highlighted program activities have the potential to reduce by 2040 the number of youth (-29 870) and adults (-94 136) with obesity, youth (-112 453) and adults (-855 855) below recommended levels of physical activity, and youth (-14 544) and adults (-28 835) who consumed excess junk food, as compared with baseline (2010-2011).
Program context and PRISM-simulated health impacts showed modest but promising results in LAC, which may lead to further population health improvements in the future. Downstream health and behavioral surveillance data are needed to confirm these estimates.
很少有研究描述由“让预防发挥作用社区”项目支持的地方社区肥胖预防策略的范围及其对健康的影响。
为填补这一空白,我们回顾了洛杉矶县(LAC)针对3个项目重点领域实施的策略:促进身体活动、健康营销以及创建健康食品环境。介绍了当地情况及影响模拟的结果。
综合了关于人口覆盖范围和项目里程碑的信息,以描述2010 - 2012年期间肥胖预防工作的历史和项目进展。为预测健康影响,使用预防影响模拟模型(PRISM)来模拟人群健康结果,包括预计未来30年肥胖负担和健康行为的变化。
有超过980万居民的洛杉矶县。
洛杉矶县“让预防发挥作用社区”项目的目标受众——低收入成年人和青少年。
针对3个重点领域实施的策略。
项目覆盖范围的记录以及PRISM对肥胖率和健康影响的预测。
洛杉矶县实施的策略涵盖了从健康食品采购的最佳实践(估计覆盖范围:60万名学生,每天30万份膳食)到已完成的共享使用协议(5个学区达成10多项协议),再到一系列精心设计的关于健康饮食的健康营销活动(超过5.15亿次印象)。基于PRISM模拟,与基线(2010 - 2011年)相比,这些突出的项目活动有可能到2040年减少肥胖青少年(-29870人)和成年人(-94136人)的数量,使低于推荐身体活动水平的青少年(-112453人)和成年人(-855855人)数量减少,以及使食用过量垃圾食品的青少年(-14544人)和成年人(-28835人)数量减少。
项目情况和PRISM模拟的健康影响在洛杉矶县显示出适度但有前景的结果,这可能会在未来进一步改善人群健康。需要下游健康和行为监测数据来证实这些估计。