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Johnson AW, Redelfs AH, Christensen W, Spruance LA. State Legislation Related to School Nutrition: Predictors of Bill Passage From 2010-2019. J Nutr Educ Behav 2024:S1499-4046(24)00048-4. [PMID: 38639692 DOI: 10.1016/j.jneb.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVE This study aimed to discover the prevalence of school nutrition state legislation and to identify the correlates of enactment. DESIGN, SETTING, AND PARTICIPANTS An online legislative database, Legiscan, was used to collect bills related to school nutrition from the US from 2010 to 2019. Bills were coded and compiled into a study database with state-level dietary variables (obesity prevalence, fruit, and vegetable intake, sugar-sweetened beverage consumption), community variables (percent White, poverty), and bill-characteristic variables (party affiliation in legislature, strength of language, party of governor, school gardens, vegetable intake, and other salient variables). Multivariable models were built to examine predictors of bill enactment. RESULTS Of the 462 bills introduced, 38.7% (n = 156) were enacted. In a multivariable model, the strength of bill language, political party affiliation, implementation of school gardens, and vegetable intake were the variables associated with bill passage. Bills with strong language were less likely to be enacted (P <0.001). Bills introduced by Democrats were more likely to be enacted (P = 0.01). CONCLUSION AND IMPLICATION This study showed a better understanding of legislative support for child nutrition via policy surveillance of bills and their correlates of enactment. This information can be used to prioritize advocacy efforts and identify ways research can better inform policy.
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Affiliation(s)
| | - Alisha H Redelfs
- Department of Public Health, Brigham Young University, Provo, UT
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Nau T, Bellew W, Giles-Corti B, Bauman A, Smith BJ. The Built Environment and Population Physical Activity: Methods for Mapping the Relevant Laws. J Phys Act Health 2023; 20:157-68. [PMID: 36640775 DOI: 10.1123/jpah.2022-0279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 11/13/2022] [Accepted: 11/14/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND The development of policies that promote and enable physical activity (PA) is a global health priority. Laws are an important policy instrument that can enable enduring beneficial outcomes for individuals, organizations, and environments through multiple mechanisms. This article presents a systematic process for mapping laws relevant to PA, which can be used to understand the role of laws as a powerful PA policy lever. METHODS Building on methods used in public health law research, we developed a protocol for scientific mapping of laws influencing the built environment for PA in Australia. The MonQcle online legal research platform was used for data coding, analysis, and presentation. RESULTS We describe the 10 key stages of legal mapping that we applied to examine state and territory laws that influence walking and cycling in Australia. CONCLUSIONS Law is a neglected element of policy research for PA. There is a need for accessible legal data to drive the design, investment, and implementation of legal interventions to improve population PA. Legal mapping is a first step toward evaluation of such laws for PA. This paper provides a practical case study and guidance for the 10 stages in legal mapping of laws that influence the built environment for PA.
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Nau T, Smith BJ, Bauman A, Bellew B. Legal strategies to improve physical activity in populations. Bull World Health Organ 2021; 99:593-602. [PMID: 34354314 PMCID: PMC8319864 DOI: 10.2471/blt.20.273987] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 04/05/2021] [Accepted: 04/20/2021] [Indexed: 12/25/2022] Open
Abstract
The World Health Assembly has adopted the World Health Organization’s (WHO) recommended target of achieving a 15% reduction in physical inactivity by 2030. The WHO Global Action Plan on Physical Activity provides a framework for countries to achieve this, using a systems-based approach to address the social and environmental determinants of physical inactivity. Lack of progress in many countries indicates a need to identify new ways of addressing this public health priority. WHO continues to highlight the importance of legislative and regulatory measures within the multicomponent and multisectoral action needed to reduce physical inactivity. Yet research into the role of law for addressing physical inactivity has been limited, in contrast to the legal approaches to other major noncommunicable disease risk factors such as smoking and alcohol use. Conceptual frameworks for public health law offer a method for mapping and understanding the determinants, mechanisms and outcomes of law-making for the promotion of physical activity within populations. We describe the development and application of a framework that aligns legal strategies with the WHO Global Plan policy objectives. This new framework – the Regulatory Approaches to Movement, Physical Activity, Recreation, Transport and Sport – can help policy-makers to use the untapped potential of legal interventions to support or strengthen a whole-system response for promoting physical activity. The framework illustrates the role of legal interventions to improve physical activity and identifies opportunities for research to advance understanding, implementation and evaluation of legal responses to this issue.
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Affiliation(s)
- Tracy Nau
- The Australian Prevention Partnership Centre, Prevention Research Collaboration, University of Sydney, Charles Perkins Centre Level 6, John Hopkins Drive, Camperdown NSW 2006, Sydney, NSW, Australia
| | - Ben J Smith
- The Australian Prevention Partnership Centre, Prevention Research Collaboration, University of Sydney, Charles Perkins Centre Level 6, John Hopkins Drive, Camperdown NSW 2006, Sydney, NSW, Australia
| | - Adrian Bauman
- The Australian Prevention Partnership Centre, Prevention Research Collaboration, University of Sydney, Charles Perkins Centre Level 6, John Hopkins Drive, Camperdown NSW 2006, Sydney, NSW, Australia
| | - Bill Bellew
- The Australian Prevention Partnership Centre, Prevention Research Collaboration, University of Sydney, Charles Perkins Centre Level 6, John Hopkins Drive, Camperdown NSW 2006, Sydney, NSW, Australia
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An R, Liu J, Liu R. State laws governing school physical education in relation to attendance and physical activity among students in the USA: A systematic review and meta-analysis. J Sport Health Sci 2021; 10:277-287. [PMID: 32961302 PMCID: PMC8167326 DOI: 10.1016/j.jshs.2020.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/13/2020] [Accepted: 08/21/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND This study systematically synthesized and quantified the relationship linking state laws governing school physical education (PE) to PE attendance and physical activity (PA) in class and throughout the day and week among students in the USA. METHODS A keyword search was performed in PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Academic Search Complete, and EconLit. Meta-analyses were performed to estimate the effects of state PE laws. RESULTS A total of 17 studies were included in the review, and five contributed to the meta-analyses. A total of 8 studies used nationally representative school- or student-level data, three focused on multiple states, and the remaining six examined the PE laws of a single state. The presence and strength of state PE laws were positively associated with PE attendance and the frequency and duration of PA during PE classes and throughout the school day. Compared to those residing in states with weak or no PE laws, students in states with strong PE laws had an additional 0.2 days (95% confidence interval (95%CI): 0.1-0.4) of PE attendance per week and spent an additional 33.9 min (95%CI: 22.7-45.0) participating PE classes per week. State PE laws affected girls' PA more than boys'. Different aspects of state PE laws tended to affect students' PE attendance differently. Disparities in the implementation of state PE laws existed across schools. CONCLUSION Future studies should adopt objective measures on PE and PA participation and examine the roles schools and districts play in mediating the effect of state PE laws on students' PE attendance and PA.
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Affiliation(s)
- Ruopeng An
- Brown School, Washington University, St. Louis, MO 63130, USA
| | - Jianxiu Liu
- Department of Physical Education, Tsinghua University, Beijing 100084, China.
| | - Ruidong Liu
- Department of Physical Education, Tsinghua University, Beijing 100084, China
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Maximova K, Raine KD, Czoli C, O'Loughlin J, Minkley J, Tisdale K, Bubela T. Monitoring progress toward United Nations commitments: characteristics of Canadian legislation to promote tobacco control, physical activity and healthy eating. A descriptive study. CMAJ Open 2019; 7:E745-E753. [PMID: 31836632 PMCID: PMC6910139 DOI: 10.9778/cmajo.20190049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Legal interventions are important mechanisms for chronic disease prevention. Since Canadian laws to promote physical activity and healthy eating are growing, we compared the characteristics of legal interventions targeting physical activity and healthy eating with tobacco control laws, which have been extensively described. METHODS We reviewed 718 federal, provincial and territorial laws promoting tobacco control, physical activity and healthy eating captured in the Prevention Policies Directory between spring 2010 and September 2017. We characterized the legislation with regard to its purpose, tools to accomplish the purpose, responsible authorities, target location, level of coerciveness and provisions for enforcement. RESULTS Two-thirds (67.9%) of tobacco control legislation had a primary chronic disease prevention purpose (explicit in 5.3% of documents and implicit in 62.6%), and 29.5% had a secondary chronic disease prevention purpose. One-quarter (27.0%) of physical activity legislation had a primary chronic disease prevention purpose (explicit in 8.8% of documents and implicit in 18.1%), and 53.0% had a secondary chronic disease prevention purpose. In contrast, 69.3% of healthy eating legislation had no chronic disease prevention purpose. Tobacco control legislation was most coercive (restrict or eliminate choice), and physical activity and healthy eating legislation was least coercive (provide information or enable choice). Most tobacco control legislation (85.8%) included provisions for enforcement, whereas 47.4% and 24.8% of physical activity and healthy eating laws, respectively, included such provisions. Patterns in responsible authorities, target populations, settings and tools to accomplish its purpose (e.g., taxation, subsidies, advertising limits, prohibitions) also differed between legislation targeting tobacco control versus physical activity and healthy eating. INTERPRETATION Legislative approaches to promote physical activity and healthy eating lag behind those for tobacco control. The results serve as a baseline for building consensus on the use of legislation to support approaches to chronic disease prevention to reduce the burden of chronic disease in Canadians.
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Affiliation(s)
- Katerina Maximova
- School of Public Health (Maximova, Raine), University of Alberta, Edmonton, Alta; School of Epidemiology and Public Health (Czoli), University of Ottawa, Ottawa, Ont.; School of Public Health (O'Loughlin), University of Montreal, Montréal, Que.; Faculty of Law (Minkley), University of Alberta, Edmonton, Alta.; Canadian Partnership Against Cancer (Tisdale), Toronto, Ont.; Faculty of Health Sciences (Bubela), Simon Fraser University, Vancouver, BC
| | - Kim D Raine
- School of Public Health (Maximova, Raine), University of Alberta, Edmonton, Alta; School of Epidemiology and Public Health (Czoli), University of Ottawa, Ottawa, Ont.; School of Public Health (O'Loughlin), University of Montreal, Montréal, Que.; Faculty of Law (Minkley), University of Alberta, Edmonton, Alta.; Canadian Partnership Against Cancer (Tisdale), Toronto, Ont.; Faculty of Health Sciences (Bubela), Simon Fraser University, Vancouver, BC
| | - Christine Czoli
- School of Public Health (Maximova, Raine), University of Alberta, Edmonton, Alta; School of Epidemiology and Public Health (Czoli), University of Ottawa, Ottawa, Ont.; School of Public Health (O'Loughlin), University of Montreal, Montréal, Que.; Faculty of Law (Minkley), University of Alberta, Edmonton, Alta.; Canadian Partnership Against Cancer (Tisdale), Toronto, Ont.; Faculty of Health Sciences (Bubela), Simon Fraser University, Vancouver, BC
| | - Jennifer O'Loughlin
- School of Public Health (Maximova, Raine), University of Alberta, Edmonton, Alta; School of Epidemiology and Public Health (Czoli), University of Ottawa, Ottawa, Ont.; School of Public Health (O'Loughlin), University of Montreal, Montréal, Que.; Faculty of Law (Minkley), University of Alberta, Edmonton, Alta.; Canadian Partnership Against Cancer (Tisdale), Toronto, Ont.; Faculty of Health Sciences (Bubela), Simon Fraser University, Vancouver, BC
| | - John Minkley
- School of Public Health (Maximova, Raine), University of Alberta, Edmonton, Alta; School of Epidemiology and Public Health (Czoli), University of Ottawa, Ottawa, Ont.; School of Public Health (O'Loughlin), University of Montreal, Montréal, Que.; Faculty of Law (Minkley), University of Alberta, Edmonton, Alta.; Canadian Partnership Against Cancer (Tisdale), Toronto, Ont.; Faculty of Health Sciences (Bubela), Simon Fraser University, Vancouver, BC
| | - Kendall Tisdale
- School of Public Health (Maximova, Raine), University of Alberta, Edmonton, Alta; School of Epidemiology and Public Health (Czoli), University of Ottawa, Ottawa, Ont.; School of Public Health (O'Loughlin), University of Montreal, Montréal, Que.; Faculty of Law (Minkley), University of Alberta, Edmonton, Alta.; Canadian Partnership Against Cancer (Tisdale), Toronto, Ont.; Faculty of Health Sciences (Bubela), Simon Fraser University, Vancouver, BC
| | - Tania Bubela
- School of Public Health (Maximova, Raine), University of Alberta, Edmonton, Alta; School of Epidemiology and Public Health (Czoli), University of Ottawa, Ottawa, Ont.; School of Public Health (O'Loughlin), University of Montreal, Montréal, Que.; Faculty of Law (Minkley), University of Alberta, Edmonton, Alta.; Canadian Partnership Against Cancer (Tisdale), Toronto, Ont.; Faculty of Health Sciences (Bubela), Simon Fraser University, Vancouver, BC
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Gray CL, Messer LC, Rappazzo KM, Jagai JS, Grabich SC, Lobdell DT. The association between physical inactivity and obesity is modified by five domains of environmental quality in U.S. adults: A cross-sectional study. PLoS One 2018; 13:e0203301. [PMID: 30161196 PMCID: PMC6117021 DOI: 10.1371/journal.pone.0203301] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 08/18/2018] [Indexed: 01/29/2023] Open
Abstract
Physical inactivity is a primary contributor to the obesity epidemic, but may be promoted or hindered by environmental factors. To examine how cumulative environmental quality may modify the inactivity-obesity relationship, we conducted a cross-sectional study by linking county-level Behavioral Risk Factor Surveillance System data with the Environmental Quality Index (EQI), a composite measure of five environmental domains (air, water, land, built, sociodemographic) across all U.S. counties. We estimated the county-level association (N = 3,137 counties) between 2009 age-adjusted leisure-time physical inactivity (LTPIA) and 2010 age-adjusted obesity from BRFSS across EQI tertiles using multi-level linear regression, with a random intercept for state, adjusted for percent minority and rural-urban status. We modelled overall and sex-specific estimates, reporting prevalence differences (PD) and 95% confidence intervals (CI). In the overall population, the PD increased from best (PD = 0.341 (95% CI: 0.287, 0.396)) to worst (PD = 0.645 (95% CI: 0.599, 0.690)) EQI tertile. We observed similar trends in males from best (PD = 0.244 (95% CI: 0.194, 0.294)) to worst (PD = 0.601 (95% CI: 0.556, 0.647)) quality environments, and in females from best (PD = 0.446 (95% CI: 0.385, 0.507)) to worst (PD = 0.655 (95% CI: 0.607, 0.703)). We found that poor environmental quality exacerbates the LTPIA-obesity relationship. Efforts to improve obesity through LTPIA may benefit from considering this relationship.
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Affiliation(s)
- Christine L. Gray
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Oak Ridge Institute for Science and Education at the U.S. Environmental Protection Agency, USEPA Human Studies Facility, Chapel Hill, North Carolina, United States of America
| | - Lynne C. Messer
- School of Public Health, Oregon Health & Sciences University-Portland State University, Portland, Oregon, United States of America
| | - Kristen M. Rappazzo
- National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, USEPA Human Studies Facility, Chapel Hill, North Carolina, United States of America
| | - Jyotsna S. Jagai
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Shannon C. Grabich
- Oak Ridge Institute for Science and Education at the U.S. Environmental Protection Agency, USEPA Human Studies Facility, Chapel Hill, North Carolina, United States of America
| | - Danelle T. Lobdell
- National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, USEPA Human Studies Facility, Chapel Hill, North Carolina, United States of America
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Abstract
OBJECTIVES A number of states have enacted regulations to increase physical activity in children attending child care, but most were not evaluated. In 2010, Massachusetts (MA) enacted a new regulation requiring 60 minutes of light, moderate, and vigorous physical activity (LMVPA) for children in child care; we conducted a prospective evaluation. We hypothesized that MA centers would comply with the regulation at follow-up, resulting in increases in children's LMVPA. METHODS We evaluated compliance with the regulation in MA using Rhode Island (RI) as the comparison. We measured physical activity in a longitudinal sample of 20 centers and cross-sectional samples of 180 children per state three times before and three times after the regulation took effect. We assessed physical activity using the Observation System for Recording Activity in Preschoolers. We conducted difference-in-differences tests to evaluate changes in LMVPA in MA compared with RI from baseline to follow-up. RESULTS Children were active for at least 60 minutes of LMVPA in over 80% of centers at baseline and follow-up in MA and RI. Nevertheless, LMVPA increased in both states. In multivariable adjusted regressions, LMVPA increased from baseline to follow-up [MA estimate 38.1 minutes; confidence interval (CI): 28.6, 47.5; p ≤ 0.0001; and RI estimate 42.7 minutes; CI: 35.2, 50.1; p ≤ 0.0001]. The average difference-in-differences estimate indicated no difference in MA compared with RI (estimate -4.6 minutes; CI: -16.6, 7.5; p = 0.46) since LMVPA increased comparably in both states. CONCLUSIONS Although LMVPA increased in MA, we observed similar changes in RI. Thus, other factors could have influenced children's physical activity.
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Affiliation(s)
- Sara E. Benjamin Neelon
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | - Brian Neelon
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC
| | - Matthew W. Gillman
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
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Zaganjor H, Bishop Kendrick K, Warnock AL, Onufrak S, Whitsel LP, Ralston Aoki J, Kimmons J. Food Service Guideline Policies on State Government-Controlled Properties. Am J Health Promot 2016; 32:1340-1352. [PMID: 27630113 DOI: 10.1177/0890117116667117] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Food service guideline (FSG) policies can impact millions of daily meals sold or provided to government employees, patrons, and institutionalized persons. This study describes a classification tool to assess FSG policy attributes and uses it to rate FSG policies. DESIGN Quantitative content analysis. SETTING State government facilities in the United States. PARTICIPANTS Participants were from 50 states and District of Columbia in the United States. MEASURES Frequency of FSG policies and percentage alignment to tool. ANALYSIS State-level policies were identified using legal research databases to assess bills, statutes, regulations, and executive orders proposed or adopted by December 31, 2014. Full-text reviews were conducted to determine inclusion. Included policies were analyzed to assess attributes related to nutrition, behavioral supports, and implementation guidance. RESULTS A total of 31 policies met the inclusion criteria; 15 were adopted. Overall alignment ranged from 0% to 86%, and only 10 policies aligned with a majority of the FSG policy attributes. Western states had the most FSG policies proposed or adopted (11 policies). The greatest number of FSG policies were proposed or adopted (8 policies) in 2011, followed by the years 2013 and 2014. CONCLUSION The FSG policies proposed or adopted through 2014 that intended to improve the food and beverage environment on state government property vary considerably in their content. This analysis offers baseline data on the FSG landscape and information for future FSG policy assessments.
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Affiliation(s)
- Hatidza Zaganjor
- 1 Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Amy Lowry Warnock
- 3 Policy Research, Analysis, and Development Office, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stephen Onufrak
- 1 Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Joel Kimmons
- 1 Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
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