Trends in Presentations of Environmental and Policy Studies Related to Physical Activity, Nutrition, and Obesity at Society of Behavioral Medicine, 1995–2010: a Commentary to Accompany the Active Living Research Supplement to Annals of Behavioral Medicine
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KeywordsPhysical Activity Obesity Policy Research Behavioral Medicine Ecological Model
Active Living Research was funded by The Robert Wood Johnson Foundation in 2001 with a primary mission of building evidence on the role of environmental and policy factors in shaping physical activity, with the goal of contributing to new approaches to promoting physical activity that would have broad reach and sustainable effects . The assumption was that little research was being done at that time on environmental and policy factors, because physical activity research was based on theories and models that emphasized psychological and social influences on behavior [e.g., 2, 3, 4], leading to interventions largely targeted to individuals and small groups. Active Living Research was explicitly based on ecological models that embody the concept of multiple levels of influence on behaviors, including built environments and policies. Though ecological models have a long history in psychology and health promotion, they had not been applied frequently in research [5, 6]. A defining principle of ecological models is that because behavior is influenced by intrapersonal (e.g., biological, psychological, and affective), interpersonal (e.g., social support and culture), built environment (e.g., access to resources), and policy (e.g., from government and industry) variables, interventions are likely to be most effective when they change presumed mediators at all of these levels . A key indicator that ecological models are being applied would be measurement or manipulation of policy and physical environment variables that are not specified by the more traditional “psychosocial” models [2, 3, 4]. During the 1990s, authors noted that ecological models were not being widely applied in health behavior research or interventions [8, 9], except for tobacco control .
Active Living Research is now part of The Robert Wood Johnson Foundation’s commitment to reverse the rise in childhood obesity by 2015. Several ecological models have been developed since the early 2000s that are specific to obesity, nutrition, and physical activity [11, 12, 13, 14, 15], and these models are guiding major initiatives in obesity prevention in the USA [16, 17, 18] and internationally [11, 19]. There appears to be a consensus reached by authoritative groups that multi-level interventions emphasizing policy and environmental changes are required to control the global obesity epidemic.
However, it is unclear as to the extent to which the evidence base to support environmental and policy interventions in obesity, nutrition, and physical activity is growing. An early indicator of scientific progress is presentations at scientific conferences. To explore recent trends in the application of ecological models to obesity-related topics, abstracts of papers presented at Society of Behavioral Medicine conferences over a 15-year period were systematically coded. Society of Behavioral Medicine is an appropriate scientific conference for such an analysis because it is a venue for leading behavioral research on obesity, physical activity, and nutrition.
Operational definitions used to code content of abstracts in Annals of Behavioral Medicine conference supplements
Inclusion and exclusion criteria
Topics included: accelerometry, aerobic activity, exercise, fitness, pedometers, physical activity, physical inactivity, sedentary, and specific activities (e.g., walking, running, and swimming)
Topics included: diet, dietary intake, dietary recall, eating, food choices, food consumption, food frequency, food reinforcement, and nutrition
Topics included: BMI, body composition, eating disorders only if related to obesity, obesity prevention, overweight, maladaptive eating, weight control, and weight management
Topics included: access, aesthetics, availability, built environment, connectivity, density, environment intervention, facilities, food environment, incivilities, infrastructure, land use, neighborhood environment, nutrition/menu labeling, policy, proximity, sidewalks, signage, walkability, and zoning
Topics excluded: food choices studied but no measure or modification of environment or availability, specific setting studied but no measure or modification of environment, and social environment only (including crime)
This content analysis of abstracts presented at Society of Behavioral Medicine conferences found that studies of environmental and policy factors related to physical activity, nutrition, and obesity were rare in 1995 but more than tripled since then. There was very little change from 1995 to 2000, so virtually all of the increase in environmental and policy studies occurred since 2000. This increase in environmental and policy studies occurred while the number of abstracts covering physical activity, nutrition, or obesity remained fairly stable, indicating a shift toward the application of ecological models.
The timing of the peak periods of increase for environmental and policy research in physical activity and nutrition could be related to publication of major reports and initiation of research programs targeting these topic areas. The percent of physical activity abstracts including environmental or policy content increased most between 2000 and 2005, which included widely publicized special issues on this topic in September 2003 from the American Journal of Health Promotion and American Journal of Public Health, as well as the first dedicated funding for this type of research from Centers for Disease Control and Prevention’s (CDC) Active Community Environments program  and Active Living Research . The Institute of Medicine  published recommendations for a multi-level approach to childhood obesity prevention in 2004, and the Healthy Eating Research program  announced its first Call for Proposals in 2005, coinciding with the 2005–2010 period of greatest increase in environment and policy research in nutrition presented at Society of Behavioral Medicine. The low rates of environmental and policy abstracts 1995–2000 support the rationale for Active Living Research’s and Healthy Eating Research’s missions to increase environmental and policy research in their areas.
Among study limitations, the content of abstracts was coded for only one scientific organization, so it cannot be determined whether similar trends could be found in other scientific outlets. However, Society of Behavioral Medicine is one of very few conferences that appears to be equally relevant to investigators presenting physical activity, nutrition, and obesity research, allowing comparable analyses. Another limitation is that not all research that was presented will be published and fully available to inform intervention development, and relevant research that was published was not presented at the Society of Behavioral Medicine conference.
It is clear that environmental and policy research on physical activity has become much more common in Society of Behavioral Medicine presentations. Thus, it is fitting that the present supplement to Annals of Behavioral Medicine is devoted to bringing some of the best new research in this field to Annals readers. The Society of Behavioral Medicine has supported the evolution of physical activity research as it has broadened to include more environmental and policy topics informed by ecological models. This supplement is evidence of the Society’s continued support of the “new” field of active living research.
In conclusion, health behavior researchers appear to be responding to calls for more environmental and policy research that can inform multi-level intervention approaches to control obesity and improve eating and physical activity behaviors [11, 16, 17, 18, 19]. Between 2000 and 2010, the proportion of physical activity, nutrition, and obesity presentations that included environmental or policy content presented at the Society of Behavioral Medicine conference substantially increased. These findings suggest a scientific paradigm shift, with increasing use of multi-level ecological models in the obesity, nutrition, and physical activity fields. One interpretation of the findings is that early dedicated funding for this type of research from Active Living Research, Healthy Eating Research, and CDC’s Active Community Environments program may have played a role in the increase in environmental and policy research on the topics presented here. The public health significance of the increase in studies of environment and policy factors is that an evidence base is being built that can inform more comprehensive, multi-level interventions to produce sustainable population-wide improvements in physical activity, nutrition, and obesity.
This work was supported by Active Living Research, a national program of The Robert Wood Johnson Foundation.
Conflicts of Interest
Dr. Sallis is Director of Active Living Research. The other authors of this commentary declare no conflicts of interest.
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