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

描述（由申请人提供）：长期目标是降低儿童肥胖症的患病率，儿童肥胖症已被世界卫生组织宣布为21世纪世纪的主要公共卫生挑战之一。拟议研究的直接目的是评估肥胖相关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，洛杉矶县是一个社会人口统计学多样化的地区，人口1000万。来自加州大学洛杉矶分校和加州大学伯克利分校的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建立合作伙伴关系。（PHFE WIC）[全国最大的地方机构妇女、婴儿和儿童补充营养援助计划（WIC）]，以及加州食品政策倡导者（CFPA），利用系统科学方法开发新的评估研究方法，为此目的。 拟议的研究将挑战和改变目前的范式评价研究方法，（1）使用结果数据（学龄前儿童的肥胖状况）;（2）开发一种方法，用于回顾性地量化社区努力解决肥胖或肥胖相关行为的影响（饮食和身体活动），以及（3）开创性地将因果推理方法和系统科学方法结合起来进行分析。自2003年以来，提供结局数据的行政数据库一直由PHFE WIC维护;它包含每年从约200，000名2至5岁WIC参与者收集的身高和体重数据。这些数据最近被评估的有效性，并显示出与加州大学洛杉矶分校的一个研究小组采取的测量高度相关。量化肥胖相关社区干预措施和政策对儿童早期肥胖影响的方法将使用LACPPH收集的现有数据以及LACPPH和CFPA帮助下确定的关键知情人访谈信息（两个组织对洛杉矶县解决儿童肥胖问题的社区努力非常了解），以制定一个指数;该指数的编制将借鉴在烟草控制领域开展类似工作的研究小组的经验。因果推理方法的应用，这可能是流行病学中增长最快的方法学进步，结合系统科学方法来分析数据，将改变目前的评价研究方法的范式，允许评估可能随时间变化的干预措施的无计划混合物的影响。

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.