Improving the adoption and sustainability of evidence-based policies: A life course approach to reducing diet-related NCDs in adolescents

在世界范围内，人们越来越超重或肥胖(OO)，甚至是儿童。超重或肥胖是一个严重的健康问题，可能导致许多疾病(称为非传染性疾病或非传染性疾病)，降低一个人的生活质量，甚至过早死亡。其中许多死亡发生在低收入和中等收入国家。导致超重和肥胖的一个重要因素是食用经过深度加工的食品，通常被称为“垃圾食品”。患有OO的儿童更容易患上非传染性疾病，这种情况会持续到以后的生活。因此，世界卫生组织和其他关注健康的组织认为，政府应该优先制定政策，防止年轻人成为OO。在南非，与经济状况相似的国家相比，儿童的OO比率很高。事实上，南非儿童在儿童期有患高血压或糖尿病的风险，在晚年有许多非传染性疾病的风险。虽然南非政府已经采取措施，通过征收含糖饮料税和限制食物中的盐分含量来改善儿童的健康，但这个问题仍然存在。这表明，食品政策目前并没有发挥应有的作用。这些政策的执行似乎存在差距。因此，重要的是要调查这种差距的性质。这项研究将考察南非旨在减少非传染性疾病的食品政策的各个方面，以找出问题所在，特别是当它们影响到城市和农村省份10-14岁和15-19岁的儿童时，并提出解决这些差距的建议。这项研究将在四年(2023-2027)期间进行，使用名为探索、准备、实施、持续(EPIS)框架的现有实施研究工具，该框架分为四个阶段：阶段1-探索：我们将审查所有旨在改善饮食，特别是儿童饮食的政策。阶段2-准备：我们将与儿童接触，政策制定者和执行者以及家长和其他有兴趣确定现有政策的优点和缺点，以及它们是否正在按应有的方式实施的人。第三阶段-实施：然后我们将制定干预战略，以克服已确定的弱点或利用现有优势。我们将对这些战略进行成本计算，然后与所有关键利益相关者按优先顺序对它们进行排序。阶段4-可持续性：最后，我们将考虑这些战略是否具有长期实施的潜力。这项研究的主要成果是一份成本估算和优先考虑的干预措施清单，这些干预措施将减少南非青少年的OO和非传染性疾病。

People, world-wide, are increasingly becoming overweight or obese (OO), even children. Being overweight or obese is a serious health concern and can lead to many diseases (called non-communicable diseases or NCDs) which reduce the quality of one's life or even untimely death. Many of these deaths occur in low- and middle-income countries. One important contributor to overweight and obesity is eating highly processed foods, often termed 'junk food'. Children who are OO are more vulnerable to developing NCD's and this continues into later in life. Therefore, the World Health Organisation, and other organisations concerned with health, believe that governments should prioritise policies that prevent young people become OO. In South Africa, the rate of OO amongst children is high compared to countries with similar economic circumstances. Indeed, South African children are at risk of developing high blood pressure or diabetes during childhood and numerous NCD's later in life. While the South African government has taken steps to improve children's health through a sugary beverage tax, and limiting the salt content of food, the problem persists. This shows that food policies are currently not working as they should. It seems that there is a gap in the implementation of those policies. It is therefore important to investigate the nature of this gap. This study will look at various aspects of South African food policies aimed at decreasing NCD's, to identify the problem, particularly as they effect children aged 10-14 years old and 15-19 years old in an urban and rural province and make recommendations to resolve these gaps.The study will be conducted over four years (2023-2027), using an existing implementation research tool called the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, which has four phases:Phase 1 - Exploration: We will review all South African policies aimed at improving diets and in particular those of children.Phase 2 - Preparation: We will engage with children, policy makers and enforcers as well as parents and other people with an interest to identify the strengths and weaknesses of existing policies, and whether they are being implemented as they should be. Phase 3 - Implementation: We will then develop intervention strategies to overcome identified weaknesses or harness existing strengths. We will cost these strategies and then with all the key stakeholders rank them in order of priority.Phase 4 - Sustainability: Finally, we will consider whether these strategies have the potential to be implemented in the long term. The main outcome of the study is a costed and prioritised list of interventions that will decrease OO of adolescents and decrease NCDs in South Africa.