Background
To address the epidemic of childhood obesity, attention is growing on the role of policies that affect energy balance. Health policies, in the form of laws, regulations, organizational practices, and funding priorities, have a substantial impact on the health and well-being of the population. In the United States, much of the authority for public health policy lies at the state level.

In response to the increasing public health priority for obesity prevention, many state laws have been introduced over the past few years—primarily focusing on obesity in youth. To date, there has been little systematic examination of state-level efforts in childhood obesity policy.

This study is funded through the Robert Wood Johnson Foundation.

Research Aims

• Provide a descriptive summary of state-level legislation relevant to the prevention and control of childhood obesity.

• Identify factors that influence the passage of obesity-related bills in state legislatures.

Methods

Content Analysis
The content analysis will include a descriptive summary of the patterns and trends of state-level childhood obesity legislation introduced in all 50 states between 2003 and 2005. In addition, key informant interviews and a detailed review of specific state-level bills will be conducted within pre-selected states to provide a more comprehensive account of the legislative process and important “model” legislation.

Multilevel Analysis
The second phase of the project will identify factors that influence the passage or enactment of obesity prevention legislation. A two-level hierarchical linear regression model (HLM) will be constructed to explore the relationship between bill-level and state-level independent variables and bill-level end-points (e.g., enactment of legislation). Bill-level variables include characteristics such as topic area (e.g., vending machine regulation, physical education requirements), political party of sponsor, fiscal impact, and evidence-based content. State-level characteristics include variables within the political (e.g., dominant political party, source of campaign contributions), economic (e.g., per capita public health expenditure), organizational (e.g., key industries in support or opposition), and sociocultural (e.g., obesity prevalence) domains.

Childhood Obesity Policy Qualitative Interview Script (pdf)