National policies to prevent obesity in early childhood: Using policy mapping to compare policy lessons for Australia with six developed countries

Abstract

Interventions for obesity prevention in early childhood (first 5 years of life) are likely to have a significant preventive health impact. This mapping review identified recommended policy options for the Australian Federal Government (AFG) by comparing countries with similar population, income, and language to Australia. Policies were mapped in six countries using two matrices. The first matrix examined policy context, describing obesity prevention governance. The second matrix examined policy content, compared with global recommendations. Policies were grouped into downstream (healthcare), midstream (lifestyle and settings), and upstream (determinants of health, including food and built environments). Results identified variance in obesity governance across the six countries including policy coherence, leadership, institutional drivers, and overlapping responsibility across different levels of government.While countries tended to have more downstream or midstream policies, upstream policies were more likely when countries had invested in system-wide approaches to obesity such as developing a national obesity strategy, having separate food/nutrition and physical activity plans, and a dedicated preventive health agency.This study recommends a range of initiatives for the AFG to strengthen policies for the prevention of obesity in early childhood, including prioritising the development of a national food/nutrition strategy.

Obesity prevention in the early years: A mapping study of national policies in England from a behavioural science perspective

“…The emphasis on education and the limited action targeting automatic motivation indicates a reliance on policies primarily focusing on individual level change. 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]. A recent systems-mapping exercise examined how local authorities in England address obesity using the 'Action Mapping Tool' [18].…”

“…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. Tools to support implementation include the Food EPI, an established method using expert consensus to provide policy ratings and identifies gaps and policy priorities [28] and surveillance plans [19]. The Foresight systems map was used to identify risk factors for childhood obesity as it is a comprehensive review of the evidence; however it was developed in 2007 so may not capture recent research.…”

“…Therefore, there are a range of periods and settings where policy levers may potentially be applied during the early life course. National obesity policy has tended to focus on individual responsibility and locally-led actions [ 16 – 19 ]. However, a comprehensive mapping of existing policies in England to intervene during the critical early years part of the life course, and whether they target appropriate behaviours or behavioural influences has not been conducted to the authors’ knowledge.…”

Obesity prevention in the early years: a mapping study of national policies in England from a behavioural science perspective

“…those primarily relying on individual level change). There has also been mapping work undertaken of obesity policies across countries which included England (19). However, a comprehensive mapping of existing policies in England to intervene during the critical early years part of the lifecourse, and whether they target appropriate behaviours or behavioural influences has not been conducted to the authors' knowledge.…”

“…An example of such an upstream action is the price of food which can have a huge impact on people's purchasing decisions, with less healthy foods typically costing less and being consumed more by lower SES groups than healthier foods (29); a lack of activity here may result in other policies having limited influence.The emphasis on education and the limited action targeting automatic motivation indicates a reliance on policies primarily focusing on individual level change. 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). A recent systems-mapping exercise examined how local authorities in England address obesity using the 'Action Mapping Tool'(18).…”