Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Irving Medical Center, 622 W. 168th Street, New York, NY, 100032, USA.
UC Berkeley School of Public Health, 2121 Berkeley Way, Berkeley, CA, USA.
Matern Child Health J. 2022 Jan;26(1):193-204. doi: 10.1007/s10995-021-03255-8. Epub 2021 Oct 7.
To examine perceptions of Sugar-sweetened beverage (SSB) policies and programs focused on the first 1000 days-gestation through age 2 years-among community stakeholders in Washington Heights and the South Bronx, two neighborhoods in New York City with disproportionately high prevalence of childhood obesity.
A multilevel framework informed interview guide development. Using purposeful sampling, we recruited study participants who were (1) able to speak English or Spanish and (2) resided or employed in Washington Heights or the South Bronx. Participants included community leaders (local government officials, community board members, and employees from community- and faith-based organizations) as well as community members. Trained research staff conducted semi-structured in-depth interviews. Using immersion/crystallization and template style coding, the study team performed thematic analysis until no new relevant themes emerged.
Among the 19 female study participants, perceived facilitators to SSB policy and program implementation included sustained partnerships with broad coalitions; continual education and clear messaging; and increased accessibility to healthier beverages. Perceived barriers included systems-level challenges accessing programs that support healthy beverage options, and individual-level lack of access to affordable healthy beverages. Acceptable potential intervention strategies included messaging that emphasizes health in pregnancy and infancy; policies that require healthy beverages as the default option in restaurants; and policies that remove SSBs from childcare settings. Some strongly favored SSB excise taxes while others opposed them, but all participants supported reinvestment of SSB tax revenue into health resources among marginalized communities.
A multi-pronged approach that incorporates engagement, access, equitable reinvestment of revenue, and continual clear messaging may facilitate implementation of policies and programs to reduce SSB consumption in the first 1000 days.
在纽约市两个儿童肥胖率过高的社区——华盛顿高地和南布朗克斯，调查社区利益相关者对关注妊娠至 2 岁前 1000 天的含糖饮料（SSB）政策和计划的看法。
采用多层次框架制定访谈指南。通过目的性抽样，我们招募了能够说英语或西班牙语且居住或在华盛顿高地或南布朗克斯工作的研究参与者。参与者包括社区领袖（当地政府官员、社区委员会成员和社区及信仰组织的员工）以及社区成员。经过培训的研究人员进行了半结构化深入访谈。研究小组采用沉浸/结晶和模板样式编码，进行主题分析，直到没有新的相关主题出现。
在 19 名女性研究参与者中，实施 SSB 政策和计划的促进因素包括与广泛联盟的持续合作；持续的教育和明确的信息传递；以及增加获得更健康饮料的机会。被认为的障碍包括系统层面获取支持健康饮料选择的项目的挑战，以及个人层面获得负担得起的健康饮料的机会有限。可接受的潜在干预策略包括强调妊娠和婴儿期健康的信息传递；要求餐馆将健康饮料作为默认选项的政策；以及将 SSB 从儿童保育场所移除的政策。一些人强烈赞成 SSB 消费税，而另一些人则反对，但所有参与者都支持将 SSB 税收收入重新投资于边缘化社区的健康资源。
一种多管齐下的方法，包括参与、获取、公平地重新投资收入和持续清晰的信息传递，可能有助于实施政策和计划，以减少前 1000 天的 SSB 消费。
