Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, California, USA.
Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA.
BMJ Open. 2017 Jan 13;7(1):e012654. doi: 10.1136/bmjopen-2016-012654.
Since 2010, federal and local agencies have invested broadly in a variety of nutrition-focused policy, systems and environmental change (PSE) initiatives in Los Angeles County (LAC). To date, little is known about whether the public supports such efforts. We address this gap in the literature by examining predictors of support for a variety of PSEs.
Voters residing in LAC (n=1007) were randomly selected to participate in a cross-sectional telephone survey commissioned by the LAC Department of Public Health. The survey asked questions about attitudes towards the obesity epidemic, nutrition knowledge and behaviours, public opinions about changing business practices/government policies related to nutrition, and sociodemographics. A factor analysis informed outcome variable selection (ie, type of PSEs). Multivariable regression analyses were performed to examine predictors of public support. Predictors in the regression models included (primary regressor) community economic hardship; (control variables) political affiliation, sex, age, race and income; and (independent variables) perceptions about obesity, perceived health and weight status, frequency reading nutrition labels, ease of finding healthy and unhealthy foods, and food consumption behaviours (ie, fruit and vegetables, non-diet soda, fast-food and sit-down restaurant meals).
3 types of PSE outcome variables were identified: promotional/incentivising, limiting/restrictive and business practices. Community economic hardship was not found to be a significant predictor of public support for any of the 3 PSE types. However, Republican party affiliation, being female and perceiving obesity as a serious health problem were.
These findings have implications for public health practice and community planning in local health jurisdictions.
自 2010 年以来，联邦和地方机构广泛投资于各种以营养为重点的政策、系统和环境变化（PSE）举措，以改善洛杉矶县（LAC）的营养状况。迄今为止，人们对公众是否支持这些努力知之甚少。我们通过研究支持各种 PSE 的预测因素来填补这一文献空白。
从洛杉矶县随机选择选民（n=1007）参与由洛杉矶县公共卫生部委托进行的横断面电话调查。该调查询问了有关肥胖流行、营养知识和行为、公众对改变与营养相关的商业实践/政府政策的看法，以及社会人口统计学等问题的态度。通过因素分析确定了因变量（即 PSE 类型）的选择。多变量回归分析用于检验公众支持的预测因素。回归模型中的预测因素包括（主要回归因子）社区经济困难；（控制变量）政治派别、性别、年龄、种族和收入；以及（自变量）对肥胖的看法、感知健康和体重状况、阅读营养标签的频率、寻找健康和不健康食物的难易程度以及食物消费行为（即水果和蔬菜、非节食苏打水、快餐和坐式餐厅用餐）。
确定了 3 种 PSE 结果变量：促进/激励、限制/限制和商业实践。社区经济困难并不是公众支持这 3 种 PSE 类型的重要预测因素。然而，共和党党派归属、女性和认为肥胖是一个严重的健康问题是。
这些发现对地方卫生部门的公共卫生实践和社区规划具有重要意义。
