Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Department of Health Services, School of Public Health, University of Washington at Seattle, Seattle, Washington.
Am J Prev Med. 2018 Jun;54(6):821-824. doi: 10.1016/j.amepre.2018.01.041. Epub 2018 Apr 12.
The purpose of this study is to examine general time trends in childhood obesity legislative activity in all 50 states (overall and by health equity focus) and whether the Voices for Healthy Kids Campaign (Voices) was associated with increased legislative activity.
LexisNexis State Capital was used to identify bills related to childhood obesity from 2012 to 2016. Linear and linear probability models were used to assess general time trends and regression-based difference-in-difference models to assess whether time trends differed for states that received a Voices grant. The data were analyzed in 2017.
A total of 989 bills were introduced (Year 1=304, Year 2=364; Year 3=321), and a total of 93 bills were enacted (Year 1=34, Year 2=24, Year 3=35) after baseline. The mean number of bills introduced (baseline=4.3, Year 1=6.6, Year 2=7.3, Year 3=7.0, p=0.007), and the average state enactment rate (baseline=11%, Year 1=16%, Year 2=8%, Year 3=27%, p-trend=0.02) increased significantly. States with Voices grantees introduced 2.1 more bills than non-grantee states (p=0.04). The estimated difference over time in bill enactment and health equity focus did not differ by Voices grantee status.
Childhood obesity bill introduction and enactment increased between 2013 and 2016. The evidence-based advocacy supported by Voices appears to be significantly associated with greater increases in state-level bill introduction, but not enactment of legislation to address childhood obesity.
本研究旨在考察全美 50 个州（整体及按健康公平重点）儿童肥胖立法活动的总体时间趋势，以及“健康儿童之声”（Voices）运动是否与立法活动的增加有关。
使用 LexisNexis 州议会数据库，从 2012 年至 2016 年确定与儿童肥胖相关的法案。使用线性和线性概率模型评估总体时间趋势，并使用基于回归的差分差异模型评估是否 Voices 拨款州的时间趋势有所不同。数据分析于 2017 年进行。
共提出 989 项法案（第 1 年 304 项，第 2 年 364 项，第 3 年 321 项），基线后共颁布 93 项法案（第 1 年 34 项，第 2 年 24 项，第 3 年 35 项）。提出的法案数量呈上升趋势（基线=4.3，第 1 年=6.6，第 2 年=7.3，第 3 年=7.0，p=0.007），各州颁布法案的平均比率（基线=11%，第 1 年=16%，第 2 年=8%，第 3 年=27%，p 趋势=0.02）也显著上升。拥有 Voices 赠款的州比非赠款州提出的法案多 2.1 项（p=0.04）。在法案颁布和健康公平重点方面，随时间的差异估计在 Voices 赠款状态之间没有差异。
2013 年至 2016 年间，儿童肥胖法案的提出和颁布有所增加。Voices 支持的循证宣传似乎与州一级法案提出的显著增加密切相关，但与解决儿童肥胖问题的立法颁布无关。
