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国家预防幼儿肥胖政策:利用政策图谱比较澳大利亚与六个发达国家的政策经验。

National policies to prevent obesity in early childhood: Using policy mapping to compare policy lessons for Australia with six developed countries.

机构信息

Charles Perkins Centre, Prevention Research Collaboration, Faculty of Health and Medicine, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.

NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood, Sydney, New South Wales, Australia.

出版信息

Obes Rev. 2019 Nov;20(11):1542-1556. doi: 10.1111/obr.12925. Epub 2019 Aug 13.

Abstract

Interventions for obesity prevention in early childhood (first 5 years of life) are likely to have a significant preventive health impact. This mapping review identified recommended policy options for the Australian Federal Government (AFG) by comparing countries with similar population, income, and language to Australia. Policies were mapped in six countries using two matrices. The first matrix examined policy context, describing obesity prevention governance. The second matrix examined policy content, compared with global recommendations. Policies were grouped into downstream (healthcare), midstream (lifestyle and settings), and upstream (determinants of health, including food and built environments). Results identified variance in obesity governance across the six countries including policy coherence, leadership, institutional drivers, and overlapping responsibility across different levels of government. While countries tended to have more downstream or midstream policies, upstream policies were more likely when countries had invested in system-wide approaches to obesity such as developing a national obesity strategy, having separate food/nutrition and physical activity plans, and a dedicated preventive health agency. This study recommends a range of initiatives for the AFG to strengthen policies for the prevention of obesity in early childhood, including prioritising the development of a national food/nutrition strategy.

摘要

预防儿童早期(生命的头 5 年)肥胖的干预措施可能会对预防健康产生重大影响。本映射综述通过比较与澳大利亚人口、收入和语言相似的国家,确定了澳大利亚联邦政府(AFG)的建议政策选择。使用两个矩阵在六个国家/地区对政策进行了映射。第一个矩阵检查了肥胖预防治理的政策背景。第二个矩阵检查了政策内容,与全球建议进行了比较。政策被分为下游(医疗保健)、中游(生活方式和环境)和上游(健康决定因素,包括食物和建筑环境)。研究结果发现,六个国家/地区在肥胖治理方面存在差异,包括政策一致性、领导力、机构驱动因素以及不同级别政府之间的重叠责任。虽然各国往往有更多的下游或中游政策,但当各国投资于肥胖的系统方法时,上游政策更有可能,例如制定国家肥胖战略、制定单独的食品/营养和身体活动计划以及专门的预防保健机构。本研究为 AFG 推荐了一系列举措,以加强预防儿童早期肥胖的政策,包括优先制定国家食品/营养战略。

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