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

描述(申请人提供)：尽管有许多公共卫生干预措施旨在教育年轻人健康饮食和体育活动的好处，但从1980年到2000年，美国年轻人的肥胖率增加了两倍。在见证了针对其他公共卫生问题(如烟草、自行车头盔、安全带)的公共政策通过取得成功之后，肥胖研究人员和政策制定者将政策作为一种干预工具进行宣传。在过去的十年里，针对青少年肥胖的州法案和决议的数量大幅增加；然而，人们对这些政策是否对饮食、活动或BMI产生影响知之甚少。NHANES最近的一份报告显示，1999至2006年间，全国青少年肥胖症的平均流行率没有显著上升。在几十年的持续增长之后，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影响。在这项研究中，我们将使用多水平建模来检查州内和跨州的高中生BMI和体重相关行为的趋势。然后，我们将研究高中的州级研究政策与体重指数和体重相关行为之间的联系。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(SHPP)。这项研究的目的是：目标1：检验2001-07年间青少年BMI时间趋势的州际差异，并找出导致这种异质性的人口统计学和行为变量。目的2：估计2001-07年间与人口统计学和行为变化相关的青少年BMI在州内变化的比例。目的3：确定2000-2006年国家一级营养和体育活动政策的变化是否与2007年的青年营养和体育活动行为有关。目的4：确定2000-2006年国家一级营养和体力活动相关政策的变化是否与2007年青少年BMI和肥胖率有关。考虑到肥胖流行病对美国年轻人当前和未来健康的巨大破坏性影响，令人惊讶的是，在评估大规模政策的影响方面所做的工作如此之少。据我们所知，这将是第一次将YRBS的数据与SHPP的数据合并，以评估州一级政策对青少年体重相关行为和肥胖的影响。 公共卫生相关性：我们将研究影响高中的州政策，以评估它们对青少年行为和BMI的影响。这将是迄今为止关于这一主题的最全面的研究，并将推进肥胖政策研究领域；这一领域有很大潜力影响我们年轻人的健康，但才刚刚开始。

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.