Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA.
EQUIDE Research Institute for Equitable Development, Universidad Iberoamericana, Mexico City, Mexico.
Obes Rev. 2021 Jun;22 Suppl 3(Suppl 3):e13247. doi: 10.1111/obr.13247. Epub 2021 May 5.
Progress has been made in the development and widespread implementation of effective interventions to address childhood obesity, yet important challenges remain. To understand how the United States and Latin American countries achieved success in implementing obesity policies and programs (PAPs) and identify improvement opportunities using implementation science principles. We identified three comparative case studies: (1) front-of-food package labeling (Mexico and Chile); (2) Open Streets/play streets (Colombia and the United States); and (3) the Baby-Friendly Hospital Initiative (Brazil and the United States). Information from multiple sources (e.g., scientific and gray literature and key informant interviews) was synthesized to describe barriers, facilitators, and progress of PAPs across RE-AIM framework dimensions. Evidence-based advocacy along with political will and evidence of scalability and impact were key for successful launch and implementation of all PAPs. Diverse adaptations of PAP design and implementation had to be done across contexts. Stronger process and impact monitoring and evaluation systems that track equity indicators are needed to maximize the population benefits of these PAPs. Implementation science offers an important contribution toward addressing knowledge gaps, enhancing obesity policy dialogue, and producing transferable lessons across the Americas and, therefore, should be used for research and evaluation during PAP development and throughout the implementation and maintenance phases.
在开发和广泛实施有效的干预措施以解决儿童肥胖问题方面已经取得了进展,但仍面临重要挑战。为了了解美国和拉丁美洲国家如何成功实施肥胖政策和计划(PAP),并利用实施科学原则确定改进机会。我们确定了三个比较案例研究:(1)食品包装正面标签(墨西哥和智利);(2)开放街道/游戏街道(哥伦比亚和美国);(3)婴儿友好医院倡议(巴西和美国)。从多个来源(例如,科学和灰色文献以及关键知情人访谈)综合信息,以描述 RE-AIM 框架维度内所有 PAP 的障碍,促进因素和进展。循证宣传以及政治意愿和可扩展性及影响证据是所有 PAP 成功启动和实施的关键。必须根据不同的情况对 PAP 的设计和实施进行多样化的调整。需要更强的过程和影响监测以及评估系统,以跟踪公平指标,从而最大限度地发挥这些 PAP 的人群效益。实施科学为解决知识差距,加强肥胖政策对话以及在美洲各地提供可转移的经验教训做出了重要贡献,因此应在 PAP 的开发以及实施和维护阶段的研究和评估中使用。