Journal of Public Health Policy

, Volume 30, Supplement 1, pp S161–S176 | Cite as

Preventing Childhood Obesity through State Policy: Qualitative Assessment of Enablers and Barriers

  • Elizabeth A Dodson
  • Chris Fleming
  • Tegan K Boehmer
  • Debra Haire-Joshu
  • Douglas A Luke
  • Ross C Brownson
Schools and Youth

Abstract

As the prevalence of obesity rapidly climbs among youth in the United States, public health practitioners and policymakers seek effective means of slowing and reversing these trends. Recently, many state laws and regulations addressing childhood obesity have been introduced and enacted. Understanding determinants of such legislation may inform the development and passage of future policies. For this study, key-informant interviews were conducted with 16 legislators and staffers from 11 states in 2005–2006 to examine qualitative factors that enable and impede state-level childhood obesity prevention legislation. Commonly cited factors positively influencing the passage of childhood obesity prevention legislation included national media exposure, introduction of the policy by senior legislators, and gaining the support of key players including parents, physicians, and schools. Noteworthy barriers included powerful lobbyists of companies that produce unhealthy foods and misconceptions about legislating foods at schools. Although the total number of informants was modest, their valuable insights provide policymakers and practitioners with a set of enablers and barriers to be considered when pursuing state-level policy.

Keywords

children legislators obesity policy 

References

  1. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM . Prevalence of overweight and obesity in the United States, 1999–2004. JAMA. 2006;295 (13):1549–1555.CrossRefGoogle Scholar
  2. Young LR, Nestle M . Portion sizes and obesity: responses of fast-food companies. J Public Health Policy. 2007;28 (2):238–248.CrossRefGoogle Scholar
  3. Brownson RC, Haire-Joshu D, Luke DA . Shaping the context of health: a review of environmental and policy approaches in the prevention of chronic diseases. Annu Rev Public Health. 2006;27:341–370.CrossRefGoogle Scholar
  4. Schmid TL, Pratt M, Witmer L . A framework for physical activity policy research. J Phys Act Health. 2006;3 (Suppl. 1):S20–S29.CrossRefGoogle Scholar
  5. Mackey DS, Hine RJ . Use the law to address obesity? J Public Health Policy. 2006;27 (4):433–439.CrossRefGoogle Scholar
  6. Nestle M, Jacobson MF . Halting the obesity epidemic: a public health policy approach. Public Health Rep. 2000;115 (1):12–24.CrossRefGoogle Scholar
  7. Turnock B . Public Health: What it is and How it Works. 2nd edition. Gaithersburg, MD: Aspen Publishers; 2001.Google Scholar
  8. Boehmer TK, Brownson RC, Haire-Joshu D, Dreisinger ML . Patterns of childhood obesity prevention legislation in the United States. Prev Chronic Dis. 2007;4 (3):A56.Google Scholar
  9. Boehmer TK, Luke D, Haire-Joshu D, Bates H, Brownson RC . Preventing childhood obesity through state policy: predictors of bill enactment. Am J Prev Med. 2008;34 (4):333–340.CrossRefGoogle Scholar
  10. Brownson RC, Royer C, Ewing R, McBride TD . Researchers and policymakers: travelers in parallel universes. Am J Prev Med. 2006;30 (2):164–172.CrossRefGoogle Scholar
  11. Sabatier P, Weible C . Theories of the Policy Process. 2nd edition. Boulder, CO: Westview Press; 2007.Google Scholar
  12. Cawley J, Liu F . Correlates of state legislative action to prevent childhood obesity. Obesity (Silver Spring). 2008;16 (1):162–167.CrossRefGoogle Scholar
  13. Weissert CS, Weissert WG . State legislative staff influence in health policy making. J Health Polit Policy Law. 2000;25 (6):1121–1148.CrossRefGoogle Scholar
  14. Kingdon JW . Agendas, Alternatives, and Public Policies. 2nd edition. New York: Longman; 2003.Google Scholar
  15. Ulin PR, Robinson ET, Tolley EE . Qualitative Methods in Public Health. San Francisco, CA: Jossey-Bass; 2005.Google Scholar
  16. Childhood Obesity Policy Qualitative Interview Script. Prevention Research Center, St. Louis University School of Public Health; 2006. Available at http://prc.slu.edu/cops.htm, accessed 2 November 2008.
  17. Hesse-Biber SN, Leavy P . The Practice of Qualitative Research. Thousand Oaks, CA: Sage Publications; 2006.Google Scholar
  18. Miles MB, Huberman AM . Qualitative Data Analysis. 2nd edition. Thousand Oaks, CA: Sage Publications; 1994.Google Scholar
  19. Snyder A, Falba T, Busch S, Sindelar J . Are state legislatures responding to public opinion when allocating funds for tobacco control programs? Health Promot Pract. 2004;5 (3 Suppl.):35S–45S.CrossRefGoogle Scholar
  20. Economos CD, Brownson RC, DeAngelis MA, Novelli P, Foerster SB, Foreman CT, et al. What lessons have been learned from other attempts to guide social change? Nutr Rev. 2001;59 (3 Pt 2):S40–S56; discussion S57–S65.Google Scholar
  21. Mercer SL, Green LW, Rosenthal AC, Husten CG, Khan LK, Dietz WH . Possible lessons from the tobacco experience for obesity control. Am J Clin Nutr. 2003;77 (4 Suppl.):1073S–1082S.Google Scholar
  22. West R . What lessons can be learned from tobacco control for combating the growing prevalence of obesity? Obes Rev. 2007;8 (Suppl. 1):145–150.CrossRefGoogle Scholar
  23. Klesges LM, Dzewaltowski DA, Glasgow RE . Review of external validity reporting in childhood obesity prevention research. Am J Prev Med. 2008;34 (3):216–223.CrossRefGoogle Scholar
  24. Institute of Medicine. Preventing Childhood Obesity: Health in the Balance. Washington, DC: National Academies Press; 2005.Google Scholar
  25. Kumanyika S, Brownson RC, editors. Handbook of Obesity Prevention: A Resource for Health Professionals. New York: Springer; 2007.CrossRefGoogle Scholar
  26. Schilling J, Keyes SD . The promise of Wisconsin's 1999 Comprehensive Planning Law: land-use policy reforms to support active living. J Health Polit Policy Law. 2008;33 (3):455–496.CrossRefGoogle Scholar
  27. Clark TW . The Policy Process: A Practical Guide for Natural Resource Professionals. New Haven: Yale University; 2005.Google Scholar

Copyright information

© Palgrave Macmillan 2009

Authors and Affiliations

  • Elizabeth A Dodson
    • 1
    • 2
  • Chris Fleming
    • 1
    • 3
  • Tegan K Boehmer
    • 1
    • 4
  • Debra Haire-Joshu
    • 1
    • 5
    • 6
  • Douglas A Luke
    • 1
    • 7
  • Ross C Brownson
    • 1
    • 8
  1. 1.Research was conducted at Saint Louis University School of Public HealthSt. LouisUSA
  2. 2.Prevention Research Center in St. Louis, George Warren Brown School of Social Work, Washington University in St. LouisSt. LouisUSA
  3. 3.Mathematica Policy Research, Inc.WashingtonUSA
  4. 4.National Center for Environmental Health, Centers for Disease Control and PreventionAtlantaUSA
  5. 5.Center for Obesity Prevention and Policy Research, George Warren Brown School of Social Work, Washington University in St. LouisSt. LouisUSA
  6. 6.School of Medicine, Washington University in St. LouisSt. LouisUSA
  7. 7.Center for Tobacco Policy Research, George Warren Brown School of Social Work, Washington University in St. LouisSt. LouisUSA
  8. 8.Department of SurgerySiteman Cancer Center, School of Medicine, Washington University in St. LouisSt. LouisUSA

Personalised recommendations