The impact of natural experiments on child obesity: A systems science approach

描述(申请人提供)：长期目标是减少儿童肥胖症的流行，这已被世界卫生组织宣布为21世纪的主要公共卫生挑战之一。这项拟议研究的直接目的是评估与肥胖相关的干预措施和政策对整个洛杉矶县社区儿童早期肥胖风险的影响，洛杉矶县是一个拥有1000万人口的社会人口多元化地区。来自加州大学洛杉矶分校和加州大学伯克利分校的一个跨学科团队将与洛杉矶县公共卫生部(LACDPH)、公共卫生基金会企业WIC(PHFE WIC)[美国最大的地方机构妇女、婴儿和儿童补充营养援助计划(WIC)]和加州食品政策倡导者(CFPA)建立合作伙伴关系，为此目的使用系统科学方法开发新的评估研究方法。这项拟议的研究将通过以下方式挑战和改变目前评估研究方法的范式：(1)使用来自大型行政数据库的结果数据(学龄前儿童的肥胖状况)；(2)开发一种方法，用于追溯量化社区为解决肥胖或肥胖相关行为(饮食和体力活动)所做的努力的影响；以及(3)率先结合使用因果推理方法和系统科学方法进行分析。提供结果数据的行政数据库自2003年以来一直由PHFE WIC维护；该数据库包含每年从大约200,000名2至5岁的WIC参与者中收集的身高和体重数据。这些数据最近进行了有效性评估，并表明与加州大学洛杉矶分校的一个研究小组所做的测量高度相关。量化与肥胖相关的社区干预措施和政策对儿童早期肥胖的影响的方法将使用LACDPH收集的现有数据以及在LACDPH和CFPA(两个组织非常了解社区为解决洛杉矶县儿童肥胖问题所做的努力)帮助下确定的主要信息者的访谈信息，以制定一个指数；制定这一指数将借鉴在烟草控制领域开展类似工作的研究小组的经验。因果推断方法可能代表着流行病学方法学发展最快的进步，它的应用与系统科学方法相结合分析数据将改变评价研究方法论的现有范式，从而能够评估可能时变的干预措施的计划外混合的影响。

DESCRIPTION (provided by applicant): The long-term goal is to reduce the prevalence of child obesity, which has been declared one of the major public health challenges of the 21st century by the World Health Organization. The immediate purpose of the proposed study is to evaluate the impact of obesity-related interventions and policies on early childhood obesity risk in communities throughout Los Angeles County, a socio-demographically diverse region with a population of 10 million. An interdisciplinary team from UCLA and UC Berkeley will form partnerships with the Los Angeles County Department of Public Health (LACDPH), Public Health Foundation Enterprises WIC (PHFE WIC) [the largest local agency Supplemental Nutrition Assistance Program for Women, Infants and Children (WIC) in the country], and California Food Policy Advocates (CFPA) to develop new evaluation research methodology using systems science approaches, for this purpose. The proposed study will challenge and shift current paradigms in evaluation research methodology by (1) using outcome data (obesity status in preschool-aged children) from a large administrative database; (2) developing a methodology for retrospectively quantifying the impact of community efforts to address obesity or obesity-related behaviors (diet and physical activity), and (3) pioneering the combined use of causal inference methods and systems science approaches for the analysis. The administrative database providing the outcome data has been maintained by PHFE WIC since 2003; it contains height and weight data gathered from about ~ 200,000 two to five year old WIC participants each year. These data have recently been evaluated for validity and shown to correlate highly with measurements taken by a research team from UCLA. The methodology for quantifying the impact of obesity-related community interventions and policies on early childhood obesity will use existing data gathered by LACDPH as well as information from interviews with key informants identified with the help of LACDPH and CFPA (two organizations highly knowledgeable about community efforts to address child obesity in LA County), to develop an index; development of this index will borrow from the experiences of research groups that have conducted similar work in the field of tobacco control. The application of causal inference methods, which perhaps represent the fastest growing methodological advances in epidemiology, in combination with systems science approaches to analyze the data will shift current paradigms in evaluation research methodology, allowing for the assessment of the effects of unplanned mixtures of possibly time-varying interventions.