BLOG | Public engagement as a game changer for obesity prevention?

NewsBLOG | Public engagement as a game changer for obesity prevention?

Public engagement as a game changer for obesity prevention?


Author: Dr. Stefanie Vandevijvere
Senior Research Fellow in Global Health and Food policy


Opinion polls often indicate substantial public support for food systems interventions to reduce obesity (1-3), such as restricting junk food marketing to kids, but tools and processes are needed to convert this quiet public support into a ‘felt demand and recognition’ for action. 

Obesity rates continue to increase across the globe (4) and national progress on the implementation of internationally recommended policies to reverse the epidemic remains patchy (5). Various legal, economic, corporate, political and other factors play a role in the successful implementation and sustainability of nutrition policies for better health and we need to learn much more about key successes and failures from natural experiments internationally. Some of the insights from such case studies have recently been published and provide key learnings for civil society and policymakers to improve future successes in the promotion and protection of healthy diets and physical activity (6, 7). For example it is important to carefully consider the best ways to frame the messages about a particular policy to gain strong and visible support from a diverse range of stakeholders, including the public (8). 

To date, the corporate sector has been much more effective than policymakers in influencing public attitudes and behaviour. Corporates have been the social engineers of our desires and have been the major reactionary forces against public policies which threaten their bottom line. In addition, the pressure for action on big societal health problems, such as obesity, has been predominantly driven by health experts and professionals. Although the groundswell of public awareness and support for such action has been increasing, the public has not played a big role in shaping public health and more specifically obesity prevention to date. Serious efforts need to be undertaken to increase, strengthen and vocalize public support for broad systems change to prevent obesity. Some of these efforts could include: 

  • Engaging young people to become champions for healthier food and physical activity in their local communities.  Social media can play an important role to get young people engaged for civic action (9). Young people can be encouraged to think about and share perceived barriers and facilitators to healthy eating or physical activity in their communities, through the collection of pictures, comments or stories (10). This could increase their awareness and motivation to become champions for local systems change.

 

  • Bringing a diverse range of local community change agents, namely people in the power to make changes to create healthier communities (e.g. schools, retailers, sport clubs, local Government officials), together to collectively identify, prioritize and take actions at community level to improve local food and activity systems. One example of this is the good food planning tool developed and used among disadvantaged communities in Australia (11). Resident-led change initiatives have great potential for creating local systems change.

 

  • Involving the public to crowd source data on their neighbourhood environments, e.g. on the healthiness of foods advertised and sold in local community settings, and feeding the data back to their local change agents in the form of summary scores, ratings and stories, such as attempted by the Foodback project in New Zealand (12). Foodback aims to empower New Zealand people to encourage and support local change agents to make positive, healthy changes to foods advertised and sold in their communities. Engaging communities through direct observations and environmental audits has been done at small scales before (13, 14).

 

  • Collecting and widely distributing positive stories of different communities and places creating healthy changes might inspire other communities and places to implement similar changes. In addition, seeking feedback from community members on what they particularly like or don’t like about their community food and activity environments will help to create a common narrative for local systems change. The narrative will likely focus on creating healthier communities rather than obesity prevention as such. 

Citizen engagement might strengthen existing and create new social movements for healthier living environments and accelerate progress on obesity prevention. There is a great need for this since the implementation of a comprehensive package of strong policies at the national level to reduce obesity typically takes time and is particularly difficult when the political climate for it is not optimal. Ultimately, public pressure, in addition to the current pressure of health professionals, might accelerate the implementation of strong national policies to reduce obesity. 

It is important to listen better to what ordinary people think and want.  How can we engage the public for broad systems change to reduce obesity? Post any ideas through twitter, using #WOBlog and #publicforhealth or in the discussion thread in the World Obesity Linkedin Group.


References

  1. Pollard CM, Daly A, Moore M, Binns CW. Public say food regulatory policies to improve health in Western Australia are important: population survey results. Aust N Z J Public Health. 2013 Oct;37(5):475-82.
  2. Morley B, Martin J, Niven P, Wakefield M. Public opinion on food-related obesity prevention policy initiatives. Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals. 2012 Aug;23(2):86-91.
  3. Gendall P, Hoek J, Taylor R, Mann J, Krebs J, Parry-Strong A. Should support for obesity interventions or perceptions of their perceived effectiveness shape policy? Aust N Z J Public Health. 2015 Apr;39(2):172-6.
  4. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014 May 28.
  5. Roberto CA, Swinburn B, Hawkes C, Huang TT, Costa SA, Ashe M, et al. Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking. Lancet. 2015 Jun 13;385(9985):2400-9.
  6. Vallgarda S, Holm L, Jensen JD. The Danish tax on saturated fat: why it did not survive. Eur J Clin Nutr. 2014 Oct 29.
  7. Studdert DM, Flanders J, Mello MM. Searching for Public Health Law's Sweet Spot: The Regulation of Sugar-Sweetened Beverages. PLoS Med. 2015 Jul;12(7):e1001848.
  8. Pomeranz JL, Brownell KD. Can government regulate portion sizes? N Engl J Med. 2014 Nov 20;371(21):1956-8.
  9. Lenzi M, Vieno A, Altoe G, Scacchi L, Perkins DD, Zukauskiene R, et al. Can Facebook informational use foster adolescent civic engagement? American journal of community psychology. 2015 Jun;55(3-4):444-54.
  10. Watts AW, Lovato CY, Barr SI, Hanning RM, Masse LC. An obesity-promoting environment? A description of how school and community environments influence the food choices of overweight adolescents. Appetite. 2015 Jul 23.
  11. Brimblecombe J, van den Boogaard C, Wood B, Liberato SC, Brown J, Barnes A, et al. Development of the good food planning tool: A food system approach to food security in indigenous Australian remote communities. Health Place. 2015 Jul;34:54-62.
  12. Foodback: Your feedback for healthier food places. Available from: www.foodback.org.nz.
  13. Seguin RA, Morgan EH, Connor LM, Garner JA, King AC, Sheats JL, et al. Rural Food and Physical Activity Assessment Using an Electronic Tablet-Based Application, New York, 2013-2014. Preventing chronic disease. 2015;12:E102.
  14. Kemner AL, Stachecki JR, Bildner ME, Brennan LK. Increasing community capacity for participatory evaluation of healthy eating and active living strategies through direct observations and environmental audits. Journal of public health management and practice : JPHMP. 2015 May-Jun;21 Suppl 3:S90-5.