State-level policies, demographics and behaviors associated with youth obesity

描述（由申请人提供）：从1980年到2000年，尽管有许多公共卫生干预措施旨在教育青少年健康饮食和体育活动的好处，但美国青少年的肥胖人数增加了两倍。在目睹针对其他公共卫生问题（如烟草、自行车头盔、安全带）的公共政策采纳取得成功后，肥胖研究人员和政策制定者已将政策作为一种干预工具加以推广。在过去十年中，针对青少年肥胖的州法案和决议数量大幅增加；然而，对于这些政策是否对饮食、活动或体重指数有影响，我们知之甚少。NHANES最近的一份报告显示，1999年至2006年间，全国青少年肥胖的平均患病率没有显著上升。经过几十年的持续增长，这种没有变化的情况表明，过去十年实施的政策可能正在产生积极的影响。在这项研究中，我们将使用多层次模型来检查各州内和各州高中生的BMI和体重相关行为的趋势。然后，我们将研究州一级高中政策与体重指数和体重相关行为之间的关系。这项工作的数据将来自青少年危险行为监测（YRBS）和学校健康计划和政策研究（SHPPS）。本研究的目的是：目的1：检查2001- 2007年青少年BMI时间趋势在各州之间的差异，并确定导致异质性的人口统计学和行为变量。目的2：估计2001- 2007年与人口和行为变化相关的青少年BMI州内变化的比例。目的3：确定2000- 2006年国家层面营养和身体活动政策的变化是否与2007年青少年营养和身体活动行为有关。目的4：确定2000- 2006年国家层面营养和体育活动相关政策的变化是否与2007年青少年BMI和肥胖患病率相关。鉴于肥胖流行病对美国年轻人当前和未来健康的破坏性影响之巨大，令人惊讶的是，评估大规模政策影响的工作做得如此之少。据我们所知，这将是第一个将YRBS数据与SHPPS数据合并的研究，以估计州一级政策对青少年体重相关行为和肥胖的影响。

DESCRIPTION (provided by applicant): Obesity among youth tripled in the United States from 1980 to 2000 despite numerous public health interventions designed to educate youth about the benefits of a healthy diet and physical activity. After witnessing the success of public policy adoption targeting other public health issues (e.g. tobacco, bike helmets, seat belts) obesity researchers and policymakers have promoted policy as an intervention tool. The number of state bills and resolutions targeting youth obesity increased substantially in the past decade; however, very little is known about whether these policies have an effect on diet, activity, or BMI. A recent report from NHANES showed that there was no significant increase in average national prevalence of youth obesity between 1999 and 2006. This absence of change, after decades of consistent increases, suggests that policies implemented in the past decade could be having a positive effect. In this research we will use multi-level modeling to examine trends in BMI and weight-related behaviors in high school students within and across states. We will then examine associations between study state level policies for high schools and BMI and weight-related behaviors. Data for this work will be from the Youth Risk Behavior Surveillance (YRBS) and the School Health Programs and Policies Study (SHPPS). The Aims of the research are: Aim 1: To examine between-state differences in youth BMI time trends from 2001-07 and identify demographic and behavioral variables that contribute to the heterogeneity. Aim 2: To estimate the proportion of within-state changes in youth BMI from 2001-07 that is associated with demographic and behavioral changes. Aim 3: To determine if changes in state-level nutrition and physical activity policies from 2000-06 are associated with youth nutrition and physical activity behaviors in 2007. Aim 4: To determine if changes in state-level nutrition and physical activity related policies from 2000-06 are associated with youth BMI and obesity prevalence in 2007. Given the enormity of the destructive effects of the obesity epidemic on the current and future health of American youth, it is surprising that so little work has been done to evaluate the effects of large scale policies. To our knowledge, this will be the first study to merge data from the YRBS to that from SHPPS to estimate the impact of state-level policies on weight-related behaviors and obesity in youth. PUBLIC HEALTH RELEVANCE: We will study state policies effecting high schools to estimate their effects on adolescent behavior and BMI. This will be the most comprehensive study on this topic to date and will advance the field of obesity policy research; a field that has strong potential to impact the health of our youth, but has only just begun.