设计健康食品伙伴关系：来自澳大利亚食品与健康对话的经验教训。
Designing a Healthy Food Partnership: lessons from the Australian Food and Health Dialogue.
作者信息
Jones Alexandra, Magnusson Roger, Swinburn Boyd, Webster Jacqui, Wood Amanda, Sacks Gary, Neal Bruce
机构信息
The George Institute for Global Health, Level 10, KGV Building, Missenden Rd, Camperdown, NSW, 2050, Australia.
The Charles Perkins Centre, University of Sydney, Sydney, Australia.
出版信息
BMC Public Health. 2016 Jul 27;16:651. doi: 10.1186/s12889-016-3302-8.
BACKGROUND
Poor diets are a leading cause of disease burden worldwide. In Australia, the Federal Government established the Food and Health Dialogue (the Dialogue) in 2009 to address this issue, primarily through food reformulation. We evaluated the Dialogue's performance over its 6 years of operation and used these findings to develop recommendations for the success of the new Healthy Food Partnership.
METHODS
We used information from the Dialogue website, media releases, communiqués, e-newsletters, materials released under freedom-of-information, and Parliamentary Hansard to evaluate the Dialogue's achievements from October 2013 to November 2015, using the RE-AIM (reach, efficacy, adoption, implementation and maintenance) framework. We also engaged closely with two former Dialogue members. Our findings update a prior assessment done in October 2013.
RESULTS
Little data is available to evaluate the Dialogue's recent achievements, with no information about progress against milestones released since October 2013. In the last 2 years, only one additional set of sodium reduction targets (cheese) was agreed and Quick Service Restaurant foods were added as an area for action. Some activity was identified in 12 of a possible 137 (9 %) areas of action within the Dialogue's mandate. Independent evaluation found targets were partially achieved in some food categories, with substantial variation in success between companies. No effects on the knowledge, behaviours or nutrient intake of the Australian population or evidence of impact on diet-related disease could be identified.
CONCLUSIONS
The new Healthy Food Partnership has similar goals to the Dialogue. While highly laudable and recognised globally as cost-effective, the mechanism for delivery in Australia has been woefully inadequate. Strong government leadership, adequate funding, clear targets and timelines, management of conflict of interest, comprehensive monitoring and evaluation, and a plan for responsive regulation in the event of missed milestones will be required if the new Healthy Food Partnership is to achieve its urgent public health goals.
背景
不良饮食是全球疾病负担的主要原因。在澳大利亚，联邦政府于2009年设立了食品与健康对话组织（以下简称“对话组织”）来解决这一问题，主要方式是食品配方改良。我们评估了对话组织在其6年运营期间的表现，并利用这些结果为新的健康食品伙伴关系的成功制定建议。
方法
我们利用对话组织网站、新闻稿、公报、电子通讯、信息公开获取的材料以及议会记录中的信息，采用RE-AIM（覆盖范围、效果、采用情况、实施情况和维持情况）框架评估对话组织在2013年10月至2015年11月期间的成就。我们还与两位前对话组织成员密切合作。我们的研究结果更新了2013年10月进行的先前评估。
结果
几乎没有数据可用于评估对话组织最近的成就，自2013年10月以来没有发布关于里程碑进展的信息。在过去两年中，仅商定了另外一组钠减量目标（奶酪），并将速食餐厅食品列为一个行动领域。在对话组织任务规定的137个可能行动领域中，有12个（9%）确定了一些活动。独立评估发现，某些食品类别部分实现了目标，各公司之间的成功程度差异很大。未发现对澳大利亚人口的知识、行为或营养摄入有影响，也没有证据表明对与饮食相关疾病有影响。
结论
新的健康食品伙伴关系与对话组织有类似目标。虽然其目标值得高度称赞且在全球被认为具有成本效益，但澳大利亚的实施机制却严重不足。如果新的健康食品伙伴关系要实现其紧迫的公共卫生目标，将需要强有力的政府领导、充足的资金、明确的目标和时间表、利益冲突管理、全面的监测和评估，以及在未达到里程碑时的应对监管计划。
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