Advertisement

Sign up for our daily newsletter

Advertisement

Obesity prevention strategy uk map – Obesity Prevention in Scotland: A Policy Analysis Using the ANGELO Framework

Aronne, L.

Lucas Cox
Tuesday, November 26, 2019
Advertisement
  • Interventions and policies were systematically coded using the BCW.

  • Reprints and Permissions. We are committed to acting collectively to prevent overweight and obesity, both to contribute to achieving our purpose of sustainable economic growth, and also towards achieving a healthier Scotland.

  • It is therefore hardly surprising that there have been significant efforts in recent years to identify and develop effective population-wide interventions to stabilise and eventually reverse this worrying statistic.

  • Interventions and policies were systematically coded using the BCW.

Cookies on GOV.UK

An additional obesiry obesity prevention strategy uk map actions were identified in COP2. ISBN Williams A. For the current analysis we considered the 62 policies and programmes of the Scottish Government's Route Map Action Plan from the perspective of the ANGELO framework to assess balance and spread of the proposed and on-going intervention measures according to predominant domain sscale and underlying focus i. Table 2.

Pragmatic controlled trial to prevent childhood obesity in maternity and child health care clinics: pregnancy and infant weight outcomes the VACOPP study. It will take only 2 minutes to fill in. Any data collected is anonymised. Obesity: why be concerned?

Karger GmbH, Freiburg. The fundamental drivers of the obesity epidemic. In addition, this is a fast moving field, the Childhood Obesity Obesity prevention strategy uk map Chapter 3 was published as part of the Prevention Green Paper after the mapping work was completed and therefore not included [ 42 ], neither was the most recent policy paper addressing obesity [ 40 ]. National Center for Biotechnology InformationU. A systematic review and meta-analysis estimating the population prevalence of comorbidities in children and adolescents aged 5 to 18 years. James WP. Distribution by both intervention scale and focus was more even with just over half of all policies

Accessibility links

To help us improve GOV. Increasing the provision of preventive care by community healthcare services: a stepped wedge implementation trial. The risks rise with weight levels and are greatest for obese individuals. Google Scholar

Kirk SF, et al. Opinion pieces and editorials were prevenion included. View author publications. We believe that this document supports a compelling case for action and presents a clear Route Map to prevent overweight and obesity in Scotland. Screening for and management of obesity in adults: U. Contents Close. PDF1.

Assessment and lifestyle management of patients with obesity: clinical recommendations from systematic reviews. Opinion pieces and editorials were not included. Increasing preventive care by primary care nursing and allied health clinicians : a non-randomized, controlled trial. Inclusion and exclusion criteria As the aim of the review was to highlight clinical interventions as well as issues relating to implementation, papers were included if they fell into any of the following categories: 1 Evaluation of a specific hospital or community health based obesity prevention intervention; 2 Clinical guidelines featuring obesity prevention; 3 Systematic or scoping reviews of health service based obesity prevention or 4 Empirical description of obesity prevention within a health setting. But if we are to prevent overweight and obesity we must increase the scale and range of our activities. Any data collected is anonymised.

Wiggers J, et al. Similar results were obtained within a community mental health setting, concluding that even when clinical guidelines explicitly direct clinicians to incorporate preventive care into interactions, rates of care given around issues such as fruit and vegetable intake or physical activity remain low [ 16 ]. Table 4 Scope of literature by category. It will take only 2 minutes to fill in. However, the evidence of what education strategies are most effective, particularly in relation to increasing assessment and referral across all risk factors, is limited [ 52 ]. Durant NH, et al.

Was this helpful?

Lancet London, England. The full coding is provided in S1 File. Support Center Support Center.

  • Highmark foundation obesity conference 2016 combined, however, with other action plan policies, such as a statutory approach to food labelling AP 1. The Route-Map also acknowledged that, while there was much work that was already being done the total investment in obesity prevention programmes and activities by the Scottish Government estimated to be in the range of GBP millon between andthe relevant initiatives and programmes had largely developed independently of each other without overall co-ordination [ 4 ].

  • A qualitative study. Overweight and obese adults have low intentions of seeking weight-related care: a cross-sectional survey.

  • Interventions and policies were systematically coded using the BCW. The policy scoping was done via online searches, it is possible that there are additional policy actions not identified with this approach.

  • Brown WV, et al.

  • There is much overlap with many of the policy actions; for example, healthier foods in schools could help to address food abundance, food exposure, palatability of food offerings, and energy density.

  • The studies identified by this review focussed on a linear approach to implementing guidelines or examined the perspectives of just one clinical team or group within a system.

It is also worth highlighting however that reformulation is an area where there has been a track record of moderate success already in the UK with reductions in salt content [ 17 ]. In addition, this is obesity prevention strategy uk map fast moving field, the Childhood Obesity Plan Chapter 3 was published as part of the Prevention Green Paper after the mapping work was completed and therefore not included [ 42 ], neither was the most recent policy paper addressing obesity [ 40 ]. Towards local implementation of Dutch health policy guidelines: a concept-mapping approach. Foresight variables and policy actions were considered in terms of COM-B and the BCW to determine approaches likely to be effective for obesity prevention and treatment.

The searches were undertaken in May A retrospective summary. Nutr Rev. Also allocated within the socio-cultural domain, policy measures to improve diet based on information and awareness raising, even if appropriately targeted APs 1. Addressing some practices of the food industry, by seriously considering macro-level policies which would impact on diet, specifically around targeting the low cost and easy accessibility of energy-dense, nutritionally poor food choices, would be a fitting bold next step. For example, actions for food literacy included policies for clearer food labelling and education within the Healthy Child Programme.

Accessibility links

A group of 12 papers Category 4 provided general descriptions of obesity prevention interventions within health settings. It originated as a smoking cessation tool but has been adapted for use with obesity. Lifestyle strategies for weight control: experience from the Finnish Diabetes Prevention Study. Kable A, et al.

This indicates that Government has implemented many actions in England map address early years obesity. Londib: Government Office for Science; The ANGELO grid and the above type of policy analysis are a convenient and appropriate framework um assess and monitor efforts over time to achieve this particular balance of emphasis. The Route-Map also acknowledged that, while there was much work that was already being done the total investment in obesity prevention programmes and activities by the Scottish Government estimated to be in the range of GBP millon between andthe relevant initiatives and programmes had largely developed independently of each other without overall co-ordination [ 4 ]. Borgmeier I, Westenhoefer J. Each variable was coded, by considering how it could influence energy balance behaviours using COM-B; one or more components of capability, opportunity or motivation were assigned. Smoke-free legislation and hospitalizations for acute coronary syndrome.

Public Health Nutrition. Of note, a greater emphasis on restricting of unhealthy food advertising was observed with the mapping of COP2 policy actions suggesting a move to more upstream action. A recent study found that, for addressing obesity, governments from developed countries tended to concentrate on policy levers addressing individual-level change rather than the environment, even in countries such as England with a strong policy focus on childhood obesity [ 19 ]. What are the attitudes, beliefs, perceptions and values? The majority of Foresight variables identified as being amenable to change through increasing physical capability related to physical activity e. Finally, the slight excess in activity-related measures over dietary measures for both scales of intervention 17 versus 14 for both macro-level and micro-level policies serves as a reminder that activity- or exercise-orientated interventions are often easier to implement or promote since they generally do not pose a challenge to commercial interests such as food companies or retailers. Addressing some practices of the food industry, by seriously considering macro-level policies which would impact on diet, specifically around targeting the low cost and easy accessibility of energy-dense, nutritionally poor food choices, would be a fitting bold next step.

Background

What is required in the long term is transformational change in society to address the threat to individual and collective wellbeing posed by weight gain and obesity. The type of change we need to make are analogous to those required to mitigate and adapt to climate change in terms of scale and complexity. Moyer VA, U. All the primary study papers Category 1 concluded that there is a role for health professionals in the provision of prevention advice and five of these seven studies discussed providing specific training to support this role [ 1213151617 ].

Obesity prevention strategy uk map two action plan items, AP 2. Davis B, Carpenter C. Personal and environmental correlates of active travel and physical prevemtion in a deprived urban population. When the domain structure is put to one side and overall macro-scale interventions are tallied alongside overall micro-scale interventions, one finding that affords some reassurance as to the overall balance of the entire programme is that 31, or exactly half of the 62 proposed measures are at the macro-scale level and the other half operate at the micro-scale of intervention. References 1.

Availability of data and materials Not applicable. However, the evidence of what education strategies are most effective, particularly in relation to increasing assessment and referral across all risk factors, is limited [ strategy ]. The study concluded that prevention may need to be delivered within a different model of care [ 16 ]. UK We use some essential cookies to make this website work. Databases were searched for articles published in English between and and screened against inclusion and exclusion criteria. Olson CM, et al. In studies which reported that clinicians did provide advice, in most cases patients could recall that advice but these papers did not report on whether the people receiving the advice changed their behaviour or on the long term retention of that advice [ 11121315 ].

Introduction

Was this helpful? James WP. Clark M, Brownell R. From the perspective of the overall policy mix however, the distribution is not heavily skewed in terms of either scale of intervention or predominant focus i.

Schauer GL, et al. This framework is frequently utilised in preventive care and though most commonly used in primary care, is one shrategy is applicable to a range of health services. Lindstrom, J. By clinicians not discussing weight and lifestyle with people before it becomes a significant problem there is a missed opportunity to prevent illness development based on known risk factors. Table 1 Scope of literature by category.

ALSO READ: Ppt On Obesity Diet Management

In the last few months we have seen that excess weight puts individuals at risk of worse outcomes from coronavirus COVID How can maternity services be developed to effectively address maternal obesity? Patient provider communication about the health effects of obesity. Any data collected is anonymised. Download PDF. Aveyard P, et al.

However, the evidence of what education strategies are most effective, particularly in relation to increasing assessment map referral across all risk factors, is limited [ 52 ]. Metrics details. A successful approach will require cross-portfolio and cross-sector collaboration and investment to make deep, sustainable changes to our living environment in order to shift it from one that promotes weight gain to one that supports healthy choices and healthy weight for all. Prevention of chronic disease in the 21st century: elimination of the leading preventable causes of premature death and disability in the USA. It will take only 2 minutes to fill in.

Availability of data and materials Not applicable. London; However, targeted training does not automatically change practice. Analysis has been framed with the 5As framework [ 9 ] which is utilised as a preventative healthcare tool to identify risk factors for chronic disease.

Conclusions This review highlights that whilst a population health approach is important to address the complexity of obesity, it is important that the remit of health services is extended beyond medical treatment to incorporate obesity prevention through screening and referral. Mustila T, et al. Royal Australian College of General Practitioners. This produced references, which on initial scan appeared to highlight more relevant documents. Int J Obes. Overweight and obesity pose real risks to the health of the population in Scotland and its ability to meet its overarching purpose of sustainable economic growth because of the burden of disease that accompanies overweight and obesity.

ALSO READ: St Columcille Hospital Obesity

Distribution by both intervention scale and focus was more even with just over half of all policies With sugared beverages for example, large-scale longitudinal surveys as well as price sensitivity analyses have highlighted reduced consumption after price increases in high-risk groups alongside the expected attendant health benefits [ 15 ]. We also use non-essential cookies to help us improve our websites. Where a particular programme clearly had distinct and separate contributions from more than one category e. Of the total policy score of

James WP. Adjusting or applying a policy lever should significantly impact on strategy map system, and in this case influence behaviours or determinants of behaviour related to child obesity [ 14 ]. Micro-scale interventions within the socio-cultural domain to promote physical activity are well documented with the Action Plan e. All authors declare that we have no conflicts of interest, commercial or otherwise, in relation to the work presented. We identified opportunities to further develop policy actions focused on enablement, persuasion, incentivisation, restriction, and coercion. J Public Health Policy.

Was this helpful?

Such a move would also constitute a more genuinely comprehensive preventioon approach to tackling obesity prevention at the population level, around the need for which there is now a clear universal consensus. Public Health Nutrition. The levels of overweight and obesity in Scotland are a serious concern. Smoke-free legislation and hospitalizations for acute coronary syndrome. Changing the future of obesity: science, policy, and action.

A scoping review [ 10 ] was conducted to map evidence and identify gaps in the extent, range, and nature of research undertaken in relation to the role of health services in obesity prevention. In all, 43 articles were included for review. Changing the health system to implement effective action for the prevention of obesity therefore calls for an examination of the issues through a systems lens rather than taking a simple problem-solution driven approach. Jackson C, et al. BMC Pediatr. Brexit Check what you need to do. Obesity: overview of an epidemic.

Obesity prevention strategy uk map mortaility preevntion chronic disease. Prevention and management of excessive gestational weight gain: a survey of overweight and obese pregnant women. The purpose of this scoping review is to examine what the published literature indicates about the role of hospital and community based health services in adult obesity prevention in order to map the evidence and identify gaps in existing research. Ann Intern Med.

Among the activity-orientated measures, it is notable that they are evenly split between macro-level and micro-level scale. The objective is to obfsity gaps and where further policy actions could most effectively focus. With sugared beverages for example, large-scale longitudinal surveys as well as price sensitivity analyses have highlighted reduced consumption after price increases in high-risk groups alongside the expected attendant health benefits [ 15 ]. We also examined whether there were opportunities for developing or implementing policy.

The Economic Domain As a whole, interventions which are classified under the economic domain have a relatively low representation at just 5. For a behaviour to occur, pbesity must be sufficient Capability physical and psychological ; Opportunity physical and social ; obsity Motivation reflective obesity prevention strategy uk map automatic. Domain Scale micro-environment e. A recent study found that, for addressing obesity, governments from developed countries tended to concentrate on policy levers addressing individual-level change rather than the environment, even in countries such as England with a strong policy focus on childhood obesity [ 19 ]. Coercion, restriction and incentivisation approaches were rarely used. Such a move would also constitute a more genuinely comprehensive policy approach to tackling obesity prevention at the population level, around the need for which there is now a clear universal consensus. The ANGELO framework categorizes all societal and environmental drivers and, by extension, their potential target intervention points of obesity across the four domains of: physical, economic, legislative and socio-cultural environments.

The primary aim of analysis was to determine the main factors in delivering adult obesity prevention within a health setting. SW developed the results section prevfntion edited the initial drafts of the manuscript. Much of this cost is avoidable. Assessment and lifestyle management of patients with obesity: clinical recommendations from systematic reviews. National Health and Medical Research Council, editor. This represents the most comprehensive summary of the evidence of the causes of obesity in the UK population and demonstrates that there are many behavioural and societal factors that combine into a " complex web of societal and biological factors that have, in recent decades, exposed our inherent human vulnerability to weight gain ".

Ann Epidemiol. Also allocated within the socio-cultural domain, policy measures to improve diet based on information and awareness raising, even if appropriately targeted APs 1. A pilot study comparing the physical activity levels of children at independent and state schools in Sheffield, United Kingdom.

Darmon N, Drewnowski A. Policy actions were scoped systematically from available literature, including any health or non-health policies which could impact on map balance behaviours. Obesity in pregnancy; Where are we, where should we go? Foresight: Tackling Obesities: Future Choices. Such micro-level measures are also most effective when implemented in combination with supportive measures around knowledge and skills as demonstrated in community-based projects [ 8 ].

Only one of the papers obeesity obesity prevention in maternity care settings reported on a specific intervention. In this research we present a review of published literature investigating the role of hospital and community based health services in adult obesity prevention. You can change your cookie settings at any time. Aust J Prim Health. Evidence scan: Complex adaptive systems. Assessment and lifestyle management of patients with obesity: clinical recommendations from systematic reviews. Much of this cost is avoidable.

The type of change we need to make are analogous to those required to mitigate and adapt to climate change in terms of scale and complexity. A successful approach will require cross-portfolio and cross-sector collaboration and investment to make deep, sustainable changes to our living pgevention in order to shift it from one that promotes weight gain to one that supports healthy choices and healthy weight for all. When discussions do occur, they are more likely to be with people who are already obese [ 2428 ] or who have more frequent health encounters indicating that they have more complex health problems [ 29 ]. This framework is frequently utilised in preventive care and though most commonly used in primary care, is one which is applicable to a range of health services. Any data collected is anonymised.

Obesity prevention strategy uk map of the papers included in the review focused on a particular life stage or um of patients. Davis TC, et al. It did not consider supporting people to set their own goals around their weight or risk factors. For practical reasons, the scope was limited to articles published in English between and November. Importantly it should be acknowledged that systems are often nested within other systems with their own dynamics at play. Fam Community Health.

  • Understanding how local authorities in England address obesity: A wider determinants of health perspective. Abstract Background Evidence indicates that early life is critical for determining future obesity risk.

  • The delivery of preventive care to clients of community health services. As the aim of the review was to highlight clinical interventions as well as issues relating to implementation, papers were included if they fell into any of the following categories: 1 Evaluation of a specific hospital or community health based obesity prevention intervention; 2 Clinical guidelines featuring obesity prevention; 3 Systematic or scoping reviews of health service based obesity prevention or 4 Empirical description of obesity prevention within a health setting.

  • Author information Article notes Copyright and License information Disclaimer. In simple terms, the four domains are: .

  • It is also worth highlighting however that reformulation is an area where there has been a track record of moderate success already in the UK with reductions in salt content [ 17 ]. Overall Categorisation by Scale and Intervention Focus When the domain structure is put to one side and overall macro-scale interventions are tallied alongside overall micro-scale interventions, one finding that affords some reassurance as to the overall balance of the entire programme is that 31, or exactly half of the 62 proposed measures are at the macro-scale level and the other half operate at the micro-scale of intervention.

  • London: The Children's Food Campaign; We identified numerous gaps in the coverage of policy actions to target these Foresight variables, with less than half having any actions.

Intervention types. The Scottish Government has to date demonstrated considerable political courage and innovative flair in the public health policy arena, being one of the first jurisdictions to successfully introduce a smoking ban in public places [ 33 ] and more recently obesity prevention its continued commitment to the implementation of an alcohol minimum unit pricing policy [ 34 ]. Our approach in that review was first to identify a policy categorisation system that could be used as a purposive sampling framework in order to organise and summarise the most promising research in each aspect of prevention. Do obesity-promoting food environments cluster around socially disadvantaged schools in Glasgow, Scotland? Four additional policy actions were identified but not included as they either fed into other policies update of Nutrient Profile Modelwere planned for the future Healthy Rating Scheme for primary schools; suite of digital applications for healthy eating or were not a specific policy action healthy marketing strategy. There is substantial policy activity to address early years obesity but much is focused on education. The number of policy actions assigned to each intervention type and policy category is shown in Figs 3 and 4 respectively.

Health literacy: taking action to improve safety and quality. It will also map to widening health inequalities uo more of Scotland's population develop long-term conditions as a result of obesity and overweight. However, the effect of obesity is much wider than the costs directly related to health issues and it has been estimated that healthcare costs are a minority of costs to society of obesity. Royal Australian College of General Practitioners. LR reviewed the analysis. For practical reasons, the scope was limited to articles published in English between and November. Hide this message.

This suggests that a sharper policy focus on pregnancy and early childhood could be useful for improving the effectiveness of obesity prevention efforts and for addressing health inequalities. In simple terms, the four domains are:. Interrater reliability: the kappa statistic. Obesity Reviews.

Contribution of food prices and diet cost to socioeconomic prevemtion in diet quality and health: a systematic review and analysis. A systematic review and meta-analysis estimating the population map of comorbidities in children and adolescents aged 5 to 18 years. Data Availability: All relevant data are within the manuscript and its Supporting Information files. Please review our privacy policy. The coding generated for objectives 1 and 2 was used. Evidence also suggests that children of lower SES have greater exposure to several early life risk factors for obesity, including pre-pregnancy maternal obesity and diabetes, low birth weight and poorer early life nutrition [ 11 ].

ALSO READ: United Mine Workers Of America Journal Of Obesity

Article Google Scholar 7. J Adv Nurs. Table 2 Scope of literature by category. Category 3: Clinical Guidelines Full size table. Health professionals may also not feel sufficiently confident to raise the issue of weight because of the social meanings attached or lack of knowledge [ 35383951 ].

  • There were a many policies addressing environmental change, with regards to both the food and physical activity environment. Department of Health and Social Care, Crown copyright;

  • London; Bartlem K, et al.

  • In particular, insight into the implementation of NICE guidelines would be useful, especially for public health guidelines where there may not be the same accountability as the clinical guidelines, which are included in service commissioning processes. James WP.

  • We also use cookies set by other sites to help us deliver content from their services. Another concluded that assisting people to set goals related to weight management achieves better outcomes than linking goals to more general improvements in health [ 20 ].

Evidence scan: Complex adaptive systems. Phelan S. Home Publications. What were you doing? Correspondence to Claire Pearce. Manag Healthc Exec. This publication outlines actions the government will take to tackle obesity and help adults and children to live healthier lives.

In relation to increasing psychological capability, there were opportunities to strengthen policies through training and enablement. A focus on strengthening existing policy recommendations to facilitate implementation, especially those targeting upstream actions, may be useful. Sturm R, Datar A. The voucher's coverage was also recently extended to include frozen fruit and vegetables as well as dietary supplements.

Tackling obesities: future choices. In particular, insight into the implementation of Obesity prevention strategy uk map guidelines lbesity be useful, especially for public health guidelines where there may not be the same accountability as the clinical guidelines, which are included in service commissioning processes. Overweight and obesity brings with it a risk of disease and a cost to society that will directly impact on our ability to achieve sustainable economic growth. Getting health reform right: a guide to improving performance and equity by Marc J. The COM-B model goes onto identify reflective motivation including self-conscious intentions and making evaluations and automatic motivation including emotional responses, impulses, and inhibitions.

  • For example, the Scottish Government previously stipulated that by there should be a minimum of two hours of physical education per week for lower high-school pupils S1-S4 AP 2.

  • Is this page useful?

  • Greater London Authority Council. What the UK public believes causes obesity, and what they want to do about it: a cross-sectional study.

  • This Route Map is intended to guide the allocation of resources to the prevention of obesity at a local as well as a national level. Hide this message.

Support Center Support Center. Data Availability: All relevant data are within the obesity prevention strategy uk map and its Supporting Information files. We believe that this document supports a compelling case for action and presents a clear Route Map to prevent overweight and obesity in Scotland. We would like to gratefully acknowledge the contribution of Professor Geraldine McNeill, Chair in Public Health Nutrition at the University of Aberdeen, for her very helpful comments on the draft manuscript. A third assessor RG examined discordant allocations. Edinburgh:

  • Karger GmbH, Freiburg.

  • There is also an issue with judgements being made in relation to who might benefit from prevention along with a negative view of the effectiveness of prevention, compounded by a view that preventing obesity is a matter of personal responsibility and choice [ 2538 ].

  • London: Government Office for Science;

  • Choose a reason for your feedback Please select a reason It wasn't detailed enough It's hard to understand It's incorrect It needs updating There's a broken link It wasn't what I was looking for Other Please select a reason It needs updating There's a spelling mistake It's hard to understand There's a broken link Other.

Priority actions for addressing the obesity epidemic in Obesity prevention strategy uk map. The Scottish Government has to date demonstrated considerable political courage and innovative flair in the public health policy arena, being one of the first jurisdictions to successfully introduce a smoking ban in public prevdntion [ 33 ] prrvention more recently by its continued commitment to the implementation of an alcohol minimum unit pricing policy [ 34 ]. The ANGELO framework provides a useful tool for policy makers to monitor progress towards an appropriately balanced policy mix. Ideally, the selected framework would be able to accommodate research at different levels of maturity e. At the stage where a consensus had been reached about the allocations of each policy measure, the points totals were tallied across domains and the spread of measures compared with what might be seen as ideally based on the findings of our earlier review which also employed the ANGELO framework [ 5 ].

Was this helpful? Tackling obesity: empowering adults and children to live healthier lives HTML. Four clinical guidelines were included Category 3 ; two specific to the Australian context [ 941 ], one from the United States [ 42 ] and one from the United Kingdom [ 43 ]. Brien SE, et al. The studies identified by this review focussed on a linear approach to implementing guidelines or examined the perspectives of just one clinical team or group within a system. The next step of the 5As framework is providing intervention aimed at assisting people to set goals to self-manage lifestyle changes.

Canberra: AIHW; Heslehurst N, et al. Two of the systematic reviews concluded that successful obesity prevention needs to srategy the provision of or conference 2016 to intensive, multicomponent behavioural interventions which aim to support weight loss and management [ 2123 ]. Wiggers J, et al. There is a need for research to be undertaken which, using a systems approach, examines the opportunities and threats to prevention from the perspective of a range of players within the system and considers how these perspectives might be influenced by policy and guidelines, as well as each other.

The uptake of prevention may also be impacted by a view that obesity is an issue of lifestyle choice and personal responsibility obesity prevention strategy uk map therefore not the responsibility sttategy health services unless linked to the treatment of a specific clinical condition [ 3538 ]. The empirical studies were therefore analysed to identify the clinical areas where prevention may have the most significant impact and the specific elements key to working with these clinical groups. Evidence scan: Complex adaptive systems. This report presents the visual representations of the obesity system map developed to understand the wide range of different factors that influence levels of obesity and how they interact. Consequently, a search for solutions means identifying multiple causes as well as multiple points for intervention and being aware of unintended consequences [ 257 ].

An analysis of policy levers used to implement mental health reform in Australia — A third assessor RG examined discordant allocations. The objectives were to: 1 identify and describe the key factors relevant to obesity prevention in the early years; 2 identify and describe relevant English national policy; 3 systematically map the identified policies onto the key factors relevant to obesity prevention; and 4 identify gaps and where further policy actions could be most effectively focused. Introduction Rates of overweight and obesity in children have increased worldwide since the s, and despite a slowing recently, it remains an important public health issue with serious consequences for health [ 12 ].

All the primary study papers Category 1 concluded that there preventikn a role for health professionals in the provision of prevention advice and five of these seven studies discussed providing specific training to support this role [ 1213151617 ]. Analysis has been framed with the 5As framework [ 9 ] which is utilised as a preventative healthcare tool to identify srrategy factors for chronic disease. As well as lacking confidence or knowledge about how to integrate prevention into clinical care, health professional judgements about who might benefit from prevention and negative views about effectiveness of prevention hinder the implementation of practice guidelines. Overweight and obese adults have low intentions of seeking weight-related care: a cross-sectional survey. This should include teaching techniques to ensure health professionals clarify their patient has understood information, [ 12 ] as this is a significant element in someone being able to adopt and follow preventive care advice [ 45 ]. Whilst there are obesity prevention guidelines which highlight the need to apply a framework such as the 5As, this fundamentally linear tool is designed to work within a traditional health care approach which focusses on the diagnosis and treatment of acute disease.

Physical capability refers to physical skill, strength or stamina and is best prevenfion upon with training or enablement, whilst psychological capability refers map knowledge and psychological skills and is best acted upon with education, training and enablement. The majority of Foresight variables identified as being amenable to change through increasing physical capability related to physical activity e. McHugh ML. An improved understanding of the current policy landscape and whether actions are appropriately targeted has potential to provide insight on whether resources are being appropriately allocated.

  • Tr-training; En-enablement; Ed-education; Re-restriction; Env-environmental restructuring; Mo-modelling; Per-persuasion; Inc-incentivisation; Co-coercion; Mapping : Grey- not applicable COM-B construct not relevant for that variable ; Green- policy actions identified; Red- no policy actions identified, Orange -uncertain.

  • This review highlights that whilst a population health approach is important to address the complexity of obesity, it is important that the remit of health services is extended beyond medical treatment to incorporate obesity prevention through screening and referral.

  • Any data collected is anonymised. Within the results and discussion section, Action Plan policy options are preceded by the letters AP and italicised, e.

  • The disadvantage of many of the survey based studies was the reliance on self-reported weight and height.

  • Open in a separate window.

Of course these striking parallels are unlikely to have arisen by deliberate design, since the package of measures as a whole has come together over a u, of years with different policies at different stages of development and having different origins. The evidence also suggests that the provision of obeeity information, although important, is not sufficient and that to make the changes necessary we have to reshape our living environment from one that promotes weight gain to one that supports healthy choices. Contents Close. A systematic review. If combined, however, with other action plan policies, such as a statutory approach to food labelling AP 1. Nutritional standards in schools guidance [ 21 ] has in contrast been followed up by complimentary policies and initiatives to encourage pupils to stay on-site during lunch time [ 22 ] AP 1. Grant awarded to RMV The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

  • Am J Public Health.

  • However, the effect of obesity is much wider than the costs directly related to health issues and it has been estimated that healthcare costs are a minority of costs to society of obesity.

  • Childhood obesity: a plan for action, Chapter 2 England;

  • In relation to increasing psychological capability, there were opportunities to strengthen policies through training and enablement.

  • As the aim of the review was to highlight clinical interventions as well as issues obesity prevention strategy uk map to implementation, papers prevfntion included if they fell into any of the following categories: 1 Evaluation of a specific hospital or community health based obesity prevention intervention; 2 Clinical guidelines featuring obesity prevention; 3 Systematic or scoping reviews of health service based obesity prevention or 4 Empirical description of obesity prevention within a health setting.

  • Table 5 Scope of literature by category.

Micro-scale interventions within the socio-cultural domain to promote physical activity are well documented with the Action Plan e. Borgmeier I, Westenhoefer J. Within the COM-B model, opportunity comprises physical and social aspects. Williams A. An analysis of policy levers used to implement mental health reform in Australia —

We identified a substantial amount of activity aiming to address early years obesity but scope for strengthening actions, especially upstream policies acting on the environment and systems and those targeting psychological factors contributing to obesity stress, self-esteem, use of food for non-nutritive purposes. The spread of policies across the four sub-categories of the domain is also the most even, with 6. This suggests that an individual-orientated approach is a common theme throughout both national and local obesity policy. Butland B. Obes Rev. Discussion This scoping and mapping exercise identified where there were policies in place in England to target risk factors for obesity, and whether the methods employed were appropriate according to a behavioural science perspective, and where there was scope for additional actions. Department of Health and Social Care, Crown copyright;

In addition, this is a fast moving field, the Childhood Obesity Plan Chapter 3 was published as part of the Prevention Green Paper after the mapping work was prevdntion and therefore not included [ 42 ], neither was the most recent policy paper addressing obesity [ 40 ]. Policies and programmes which are orientated towards physical surroundings and amenities have a strong preponderance towards operating through increased opportunities for physical activity, as opposed to dietary measures. Effects of worksite health promotion interventions on employee diets: a systematic review. Data Availability: All relevant data are within the manuscript and its Supporting Information files.

  • Where a particular programme clearly had distinct and separate contributions from more than one category e. Lancet London, England.

  • Specific to maternity services, clinicians acknowledge that weight gain in pregnancy is an issue but do not perceive that their patients see it as a problem [ 30 ].

  • Health Economics. This indicates that Government has implemented many actions in England to address early years obesity.

  • Tr-training; En-enablement; Ed-education; Re-restriction; Env-environmental restructuring; Mo-modelling; Per-persuasion; Inc-incentivisation; Co-coercion; Mapping : Grey- not applicable COM-B construct not relevant for that variable ; Green- policy actions identified; Red- no policy actions identified, Orange -uncertain.

Hernandez-Boussard, T. As with similar studies looking at the adult population more generally [ 28 ], it hk found that older adults were more likely to receive lifestyle advice if they were already obese or had a number of chronic conditions [ 29 ]. Much of this cost is avoidable. How can maternity services be developed to effectively address maternal obesity?

The remainder of the results relate straregy these policy actions. Policies and programmes which are orientated towards physical surroundings and amenities have a strong preponderance towards operating through increased opportunities for physical activity, as opposed to dietary measures. But if we are to prevent overweight and obesity we must increase the scale and range of our activities. In simple terms, the four domains are:. Conclusions There is substantial policy activity to address early years obesity but much is focused on education. Darmon N, Drewnowski A.

Scotland has one of the strategy map levels of obesity in OECD countries with over a million adults and overchildren atrategy. Indeed, support or sponsorship of sporting events or health campaigns is often seen as a diversion tactic by food and beverage companies, the London Olympics sponsorship deals [ 30 ] and the UK Governments Change4Life campaign [ 31 ] being two high-profile examples. England: Public Health England;

Psychiatr Serv. Papers were also excluded if they described obesity or associated disease but did not focus on strategy with a goal of prevention or if the focus was on population health initiatives that were not obedity the remit of health services, such as introducing food taxes. There is a need for research to be undertaken which, using a systems approach, examines the opportunities and threats to prevention from the perspective of a range of players within the system and considers how these perspectives might be influenced by policy and guidelines, as well as each other. Article Google Scholar 7. Another concluded that assisting people to set goals related to weight management achieves better outcomes than linking goals to more general improvements in health [ 20 ].

  • References 1.

  • Methods Databases were searched for articles published in English between and and screened against inclusion and exclusion criteria.

  • We identified a substantial amount of activity aiming to address early years obesity but scope for strengthening actions, especially upstream policies acting on the environment and systems and those targeting psychological factors contributing to obesity stress, self-esteem, use of food for non-nutritive purposes. Poston L.

  • For each of these categories, the focus of the intervention was on services for adults.

  • This allowed behavioural targets and policies to be systematically described in detail, allowing the identification of gaps and opportunities for further policy development.

However, targeted training does not automatically change practice. Report a problem with this page. Kremers S, et al. The next step of the 5As framework is providing intervention aimed at assisting people to set goals to self-manage lifestyle changes.

Article Google Scholar McElwaine KM, et al. In the last few months we have seen that excess weight puts individuals at risk of worse outcomes from coronavirus COVID Qual Prim Care. Blame, shame, and lack of support: a multilevel study on obesity management. J Adv Nurs.

Mastellos N, et al. Metrics details. Obesity prevention: recommended strategies and challenges. Stratifying patients for weight loss counseling.

  • Strateegy the domain structure is put to one side and overall macro-scale interventions are tallied alongside overall micro-scale interventions, one finding that affords some reassurance as to the overall balance of the entire programme is that 31, or exactly half of the 62 proposed measures are at the macro-scale level and the other half operate at the micro-scale of intervention. Obes Rev.

  • Pearce, C.

  • It is now relatively well established however that environmental improvements such as expansion of the national cycle network AP 2.

  • However, the effect of obesity is much wider than the costs directly related to health issues and it has been estimated that healthcare costs are a minority of costs to society of obesity.

  • This obesity prevention strategy uk map that Government has implemented many actions preventiob England to address early years obesity. The aim of this study was to use a behavioural science approach to identify and categorise the policy levers being used in England that have potential to influence obesity across the early life course here considered to be pregnancy and 0—5 yearsidentify how these interface with energy balance behaviours behaviours related to energy intake or expenditureand identify areas where further policy actions could focus.

Brien Obeslty, et al. J Adv Nurs. Tol J, et al. Is this page useful? Community-based service provision for the prevention and management of maternal obesity in the north east of England: a qualitative study. Databases were searched for articles published in English between and and screened against inclusion and exclusion criteria. Is this page useful?

Analysis commenced with an examination of intervention type, sample size, setting and duration. Int J Ment Health Nurs. Consequently, a search for solutions means identifying multiple causes as well as multiple points for intervention and being aware of unintended consequences [ 257 ]. Jackson C, et al.

Sidebar1?
Sidebar2?