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Millstone, E.; Lobstein, T.; ,
doi: 10.1111/j.1467-789X.2007.00353.xpmid: N/A
Obesity in Europe is reaching epidemic proportions, and Europe’s policymakers need more information on the approaches that stakeholders judge effective and consider acceptable. The Policy Options for Responding to the Growing Challenge of Obesity Research Project interviewed food producers, manufacturers and retailers, advertisers and caterers, life insurers, pharmaceutical companies, teachers, public health experts, town planners, advocacy organizations and consumer groups in nine countries: Cyprus, Finland, France, Greece, Hungary, Italy, Poland, Spain and the UK. Interviews were conducted using innovative Multi‐Criteria Mapping software which provides reproducible and transparent structured information on the stakeholders’ perceptions, judgements and reasons. The results indicate that a comprehensive portfolio of policy measures, integrated into a coherent programme, would be well‐supported by a broad coalitions of stakeholders. The costs of such a programme were not considered as important as the potential costs of not taking action. Policymakers can be confident that the great majority of stakeholders recognize the need for action and are prepared to accept their costs, but that the ‘upstream’ interventions such as marketing controls, planning and transport controls and fiscal measures, will need to be justified in terms of their wider health and social benefits.
Lobstein, T.; Millstone, E.; ,
doi: 10.1111/j.1467-789X.2007.00354.xpmid: 17371303
The Policy Options for Responding to the Growing Challenge of Obesity Research Project (PorGrow) study was conducted at a time when the prevalence levels of overweight and obesity among both adults and children had been rising for over a decade in most countries in Europe. The reasons are assumed to be related to changes in dietary patterns and in patterns of physical activity, and may be linked to economic as well as socio‐environmental influences on behaviour. Inequalities in the distribution of obesity across different socio‐economic groups are also apparent. The demographic and secular trends have led to increasing concern among policymakers over the costs of obesity‐related disease to the health services and to the economy generally. In response, a series of policy initiatives have been considered among the countries participating in the PorGrow study.
Stirling, A.; Lobstein, T.; Millstone, E.; ,
doi: 10.1111/j.1467-789X.2007.00355.xpmid: 17371304
The Policy Options for Responding to the Growing Challenge of Obesity Research Project (PorGrow) study provided a unique opportunity to develop a large‐scale application of a semi‐quantitative technique for exploring interviewees’ views on options to tackle obesity, using multi‐criteria mapping. This ‘heuristic’ approach utilizes the advantages of a structured interviews framework by predefining a set of options for appraisal, while leaving interviewees free to select their own criteria for making their judgements. Additional information can be gleaned from the interview transcripts and related materials to set the appraisals in their policy context, and allowing interviewees to express their views on the options presented and their own appraisals. The PorGrow study team agreed a predefined set of 20 options for appraisal, and interviewed sets of stakeholders representing more than 20 aspects of policy development in each of the nine participating countries. The details of the methodology adopted are set out in this paper.
doi: 10.1111/j.1467-789X.2007.00356.xpmid: 17371305
European policymakers need more information on policy responses to obesity that stakeholders judge effective and acceptable. The Policy Options for Responding to the Growing Challenge of Obesity Research Project gathered such intelligence by interviewing key stakeholder groups in nine countries. Interviews used an innovative multi‐criteria mapping (MCM) methodology that gathers quantitative and qualitative information on the stakeholders’ perceptions and judgements. Aggregating across all participants, a comprehensive portfolio of policy measures, integrated into a coherent programme, would be well‐supported by broad coalitions of stakeholders. Those portfolios should include measures (i) to provide improved educations in schools and to the general adult population; (ii) measures to improve access to and incentives for physical activity; (iii) measures to improve information about both foods and physical activity and (iv) changes to the supply of and demand for foodstuffs. There was little support for fiscal measures and technological ‘fixes’; they were judged ineffective and unacceptable. Significant differences were found across European regions, and across different stakeholder perspectives, but not across genders. There is a strong case for improved monitoring of body mass index levels, dietary habits and physical activity. An MCM study can effectively cover several countries, rather than being confined to just one, and generate both national and cross‐national policy analyses and proposals.
Savva, S. C.; Chadjioannou, M.; Tornaritis, M. J.
doi: 10.1111/j.1467-789X.2007.00357.xpmid: 17371306
A multifaceted public health policy approach is required for reversing the current obesity epidemic. The Policy Options for Responding to the Growing Challenge of Obesity Research Project aimed to explore the consistency and/or variability of the perspectives of key stakeholders towards a range of different options to respond to the growing challenge of obesity among nine participating European member states. The multi‐criteria mapping technique was used. Cyprus national data, when analysed in the public health and public policy context of Cyprus, collectively indicate that no single policy option appears to be unique in combating obesity, but rather need to be combined with other policy options. Specifically, measures are needed to improve levels of knowledge and understanding regarding food, diet, health and fitness beginning from early childhood with health professionals having an important role in this regard. These measures should be coupled with informational initiatives emphasizing the improvement of nutritional information labelling system, and the control of food and drink advertising. There was also a consensus regarding the need for modifying the supply of and demand for foodstuffs, but not via economic instruments. Practical feasibility, social acceptability, efficacy and social benefits but not the economic costs of the options were deemed the most important criteria for a successful implementation.
doi: 10.1111/j.1467-789X.2007.00358.xpmid: 17371307
The aim of the Finnish Policy Options for Responding to the Growing Challenge of Obesity Research Project study was to use a multi‐criteria mapping method to assess stakeholder opinions on policies that might have relevance when planning policies targeting obesity prevention. When evaluating policies, criteria relating to ‘Positive societal benefits’ and ‘Additional health benefits’ were often considered important, along with the more obvious ‘Efficacy in addressing obesity’. Other criteria (like economic factors) were of less importance. All policy options targeting at ‘Educational and Research Initiatives’ were highly ranked in the analysis by all stakeholders. Policies aimed at improving ‘Food‐Related Informational Initiatives’ were also ranked well on average, although more variation between stakeholders existed. Policies targeting increased physical activity and easier access/provision to healthy foods received also relatively good rankings but with wide variation and doubts in the appraisals. Policies encouraging new technological innovations and institutional reforms were mostly ranked poorly and were not seen as solutions to obesity problem. Irrespective of the stakeholder group, it seems that while traditional educational policies were most highly ranked, several other policies are also viable options in the policy portfolio of obesity prevention.
Holdsworth, M.; Kameli, Y.; Delpeuch, F.
doi: 10.1111/j.1467-789X.2007.00359.xpmid: 17371308
To explore the perspectives of key stakeholders towards a range of policy options to prevent obesity in France, a multi‐criteria mapping method was used to gather quantitative and qualitative data from 21 types of stakeholder groups. During structured interviews, stakeholders appraised a set of pre‐defined options by reference to criteria of their own choosing and provided relative weights to their criteria, and overall rankings of the policy options. Efficacy, feasibility and societal benefits were the groups of criteria given most importance by stakeholders. There was most consensus and preference for options related to health education, particularly in schools, compared with options that aimed at changing the environment to prevent obesity, i.e. options around physical activity; options that modified food supply and demand; and information‐related options. There was little support for technological solutions or institutional reforms. While there was broad interest in a range of different options, those related to behaviour change through education were the most valued by stakeholders. Raising awareness among policymakers about the convincing scientific evidence for the effectiveness of environmental level policy options will be a crucial first step.
Codrington, C.; Sarri, K.; Kafatos, A.
doi: 10.1111/j.1467-789X.2007.00360.xpmid: 17371309
The study aimed to map stakeholders’ evaluations of policy options to counter the rising prevalence of obesity in Greece, where the case for action on obesity is only now being made. The multi‐criteria mapping method was used to capture and compare stakeholders’ appraisals and to provide a policy analysis.
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