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利用自然实验评估零售食品和饮料政策及干预措施的最佳实践。

Best practices for using natural experiments to evaluate retail food and beverage policies and interventions.

作者信息

Taillie Lindsey Smith, Grummon Anna H, Fleischhacker Sheila, Grigsby-Toussaint Diana S, Leone Lucia, Caspi Caitlin Eicher

机构信息

Carolina Population Center, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, Chapel Hill, North Carolina, USA.

Office of Nutrition Research, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA.

出版信息

Nutr Rev. 2017 Dec 1;75(12):971-989. doi: 10.1093/nutrit/nux051.

Abstract

Policy and programmatic change in the food retail setting, including excise taxes on beverages with added-caloric sweeteners, new supermarkets in food deserts, and voluntary corporate pledges, often require the use of natural experimental evaluation for impact evaluation when randomized controlled trials are not possible. Although natural experimental studies in the food retail setting provide important opportunities to test how nonrandomized interventions affect behavioral and health outcomes, researchers face several key challenges to maintaining strong internal and external validity when conducting these studies. Broadly, these challenges include 1) study design and analysis; 2) selection of participants, selection of measures, and obtainment of data; and 3) real-world considerations. This article addresses these challenges and different approaches to meeting them. Case studies are used to illustrate these approaches and to highlight advantages and disadvantages of each approach. If the trade-offs required to address these challenges are carefully considered, thoughtful natural experimental evaluations can minimize bias and provide critical information about the impacts of food retail interventions to a variety of stakeholders, including the affected population, policymakers, and food retailers.

摘要

食品零售环境中的政策和规划变革,包括对添加热量甜味剂的饮料征收消费税、在食品荒漠地区开设新超市以及企业自愿承诺,在无法进行随机对照试验时,往往需要采用自然实验评估来进行影响评估。尽管食品零售环境中的自然实验研究为测试非随机干预如何影响行为和健康结果提供了重要机会,但研究人员在开展这些研究时面临着维持强大内部和外部有效性的几个关键挑战。总体而言,这些挑战包括:1)研究设计与分析;2)参与者的选择、测量方法的选择以及数据的获取;3)现实世界的考量。本文探讨了这些挑战以及应对挑战的不同方法。通过案例研究来说明这些方法,并突出每种方法的优缺点。如果仔细考虑应对这些挑战所需的权衡,经过深思熟虑的自然实验评估可以最大限度地减少偏差,并为包括受影响人群、政策制定者和食品零售商在内的各种利益相关者提供有关食品零售干预影响的关键信息。

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