Lessons learned and insights from the implementation of a food and physical activity policy to prevent obesity in Mexican schools: An analysis of nationally representative survey results

Abstract

Obesity is a serious problem among children in Mexico. In 2010, the government implemented a national food and physical activity policy in elementary schools, to prevent obesity. The goal of this study is to assess the implementation of this policy, using the logic model from a descriptive survey with national representativeness at the elementary school level and based on a stratified cluster design. We used a systematic random sampling of schools (n = 122), stratified into public and private. We administered questionnaires to 116 principals, 165 members of the Food and Physical Activity Committees, 132 food school food vendors, 119 teachers, 348 parents. This study evidences a significant deviation in implementation from what had been planned. Our lessons learned are the importance to: base the design/implementation of the policy on a theoretical framework, make programs appealing to stakeholders, select concrete and measurable objective or goals, and support stakeholders during the implementation process.

Institutions, Policy, and Non-Communicable Diseases (NCDs) in Latin America

“…In contrast to what we saw in Brazil, moreover, the SoH and its public primary care system, mainly through Seguro Popular (Popular Insurance) and IMSS, have not developed any programmes to work closely with families and/or schools in order to ensure that SoH programmes are enforced and meet the latter's goals (Gómez, 2018b;Théodore et al, 2018). However, the Congress's decision to impose a soda tax in 2013 has been enforced and thus far has yielded some positive results in reducing the consumption of soda products, though more so in the urban areas (Sanger-Katz, 2017).…”

“…The SoH's efforts to work with the state governments in order to enforce regulations that prevent overweight, obesity, and type-two diabetes, especially among children, such as limiting the sale of sugary/fatty foods in schools and advertising, also appear to fall short of meeting national policy objectives (Théodore et al, 2018); this has mainly been due to the industry's -once again -voluntary agreement with the government and the provision of self-regulation (Barquera et al, 2013) processes, seemingly done to avoid further industrial opposition, placate corporate interests, and maintain political support.…”

Sugary Liquids in the Baby Bottle: Risk for Child Undernutrition and Severe Tooth Decay in Rural El Salvador

“…However, better enforcement of the policy is needed. Prior research has noted that effective implementation of school-based obesity-prevention programs suffers when there is limited integration of the children’s families and school vendors in the program’s efforts [ 47 ]. Additional policies are still needed to limit children’s access to unhealthy foods and beverages sold by vendors near the school grounds [ 18 , 45 ].…”

Condición nutricional y momentos de consumo de alimentos de escolares en centros educativos públicos intervenidos por el Modelo Póngale Vida® en Santo Domingo de Heredia, Costa Rica.

“…Las intervenciones que propician un cambio en la dinámica del ambiente escolar favorecen los cambios en la condición nutricional de las personas escolares, pero se requiere de un esfuerzo más intensivo y permanente para modificar las conductas individuales (Théodore et. al, 2018).…”

“…Es importante que las estrategias en prevención de obesidad infantil sean atractivas, tal como las proponen el Modelo Póngale Vida, adaptadas a las necesidades de cada centro educativo, y otros estudios. Los programas deben ser atractivos para las partes interesadas, seleccionar objetivos concretos y medibles, así como apoyar a docentes, estudiantes y padres o madres de familia durante el proceso de implementación (Théodore et. al, 2018).…”