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Mindell JS, Parag Y, Bartington SE, Stoll L, Barlow J, Janda KB. The Middle-Out Perspective: an approach to formalise 'normal practice' in public health advocacy. Perspect Public Health 2024; 144:232-241. [PMID: 36583536 PMCID: PMC11308348 DOI: 10.1177/17579139221138451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIMS The middle-out perspective (MOP) provides a lens to examine how actors positioned between government (top) and individuals (bottom) act to promote broader societal changes from the middle-out (rather than the top-down or bottom-up). The MOP has been used in recent years in the fields of energy, climate change, and development studies. We argue that public health practitioners involved with advocacy activities and creating alliances to amplify health promotion actions will be familiar with the general MOP concept if not the formal name. The article aims to demonstrate this argument. METHODS This article introduces the MOP conceptual framework and customises it for a public health audience by positioning it among existing concepts and theories for actions within public health. Using two UK case studies (increasing signalised crossing times for pedestrians and the campaign for smoke-free legislation), we illustrate who middle actors are and what they can do to result in better public health outcomes. RESULTS These case studies show that involving a wider range of middle actors, including those not traditionally involved in improving the public's health, can broaden the range and reach of organisations and individuals involving in advocating for public health measures. They also demonstrate that middle actors are not neutral. They can be recruited to improve public health outcomes, but they may also be exploited by commercial interests to block healthy policies or even promote a health-diminishing agenda. CONCLUSION Using the MOP as a formal approach can help public health organisations and practitioners consider potential 'allies' from outside traditional health-related bodies or professions. Formal mapping can expand the range of who are considered potential middle actors for a particular public health issue. By applying the MOP, public health organisations and staff can enlist the additional leverage that is brought to bear by involving additional middle actors in improving the public's health.
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Affiliation(s)
- JS Mindell
- Professor of Public Health, Institute of Epidemiology & Health Care, UCL, 1-19 Torrington Place, London WC1E 6BT, UK
| | - Y Parag
- Professor of Energy Policy, Vice Dean, School of Sustainability, Reichman University, Herzliya, Israel
| | - SE Bartington
- Clinical Research Fellow, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - L Stoll
- Public Health Specialty Registrar, Institute of Epidemiology & Health Care, UCL, London, UK
| | - J Barlow
- Professor of Technology & Innovation Management (Healthcare), Imperial College Business School, London, UK
| | - KB Janda
- Principal Research Fellow, Energy Institute, UCL, London, UK
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Le Bouthillier M, Veilleux S, Loignon J, Turcotte M, Trudel L, Provencher V. Knowledge mobilization between the food industry and public health nutrition scientists: findings from a case study. BMC Nutr 2024; 10:81. [PMID: 38845063 PMCID: PMC11155086 DOI: 10.1186/s40795-024-00889-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 05/28/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Improving the nutritional quality of the food supply increases access to nutritious foods, which improves dietary habits and population health. Yet, knowledge mobilization initiatives between public health nutrition researchers and food industries are often not adequately considered and understood. This study explored what elements related to this specific context need to be recognized so that researchers can better mobilize nutrition science knowledge with the food industry to promote the nutritional improvement of food products. METHOD A case study qualitative approach was selected to answer the research question, using semi-structured interviews as the data collection technique. Québec baking industry actors were shown a mock-up of an online mobilization platform sharing the results of the Food Quality Observatory that describes the nutritional quality of breads offered in Québec, Canada. They were asked to think aloud as they explored the web platform and were interviewed. Two coders analyzed the data using an inductive approach and thematic content analysis, starting with individual open coding, and then put forward their analyses and drafted the final themes. RESULTS The final data consisted of 10 semi-structured interviews conducted between October 2019 and August 2020. Four main themes were identified: the industry's context, the knowledge mobilization initiative, the product-related matters stemming from the information shared and the motivation within the industry. Within each theme, sub-themes were highlighted and related to the industries' motivation to improve their products' nutritional quality. This study also specified key considerations for changes to the sodium and fiber content in bread. CONCLUSION Other steps beyond using simple language and a website format could be taken to better mobilize scientific knowledge with food industries, such as providing more consumer information, using an integrated knowledge mobilization approach that includes a consideration of ethics, working with communication professionals, collaborating with food science experts, and providing resources to act on shared information. Legislation such as the front-of-pack regulations could accelerate the pace of collaboration between researchers and industry. Overall, establishing a prior relationship with industries could help gain a better understanding of the themes highlighted in this study. Future research could build on this case study to provide more insights and solidify these findings. CLASSIFICATION CODES Public Health, Public Private, Policy Making, Research Institutions, Use of Knowledge.
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Affiliation(s)
- Marie Le Bouthillier
- Centre NUTRISS-Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada
- École de Nutrition, Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada
| | - Sophie Veilleux
- Centre NUTRISS-Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada
- Faculté des sciences de l'administration, Université Laval, Quebec, QC, G1V 0A6, Canada
- Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada
| | - Jeanne Loignon
- Centre NUTRISS-Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada
- Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada
| | - Mylène Turcotte
- Centre NUTRISS-Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada
| | - Laurélie Trudel
- Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada
| | - Véronique Provencher
- Centre NUTRISS-Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada.
- École de Nutrition, Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada.
- Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, 2440, Hochelaga Boulevard, Pavillon des services, office 2729-L Qc, Quebec, QC, G1V 0A6, Canada.
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Delaine A, Ferguson M, Bacon R, Cullerton K. An analysis of the features of successful written submissions to government inquiries. Aust N Z J Public Health 2024; 48:100133. [PMID: 38442570 DOI: 10.1016/j.anzjph.2024.100133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 01/17/2024] [Accepted: 01/21/2024] [Indexed: 03/07/2024] Open
Abstract
OBJECTIVE Government inquiries present a policy window for advocates to influence policy. Evidence on how to write influential submissions, however, is sparse. We aimed to identify features of successful written submissions to the Parliament of Australia's Inquiry into Food Pricing and Food Security in Remote Indigenous Communities (Inquiry). METHOD A scoping review was conducted to identify influential features of written submissions to government inquiries. A content analysis of a sub-sample of government Inquiry submissions and their recommendations was then coded for influential features. The frequency of submission recommendations incorporated into the final Inquiry report was recorded, as was their link to influential features. RESULTS Thirty features were identified. Results from 21 submissions indicate that when writing a submission to a government inquiry, advocates should: (1) ensure their submission is clear and concise; (2) convey the authority of both the writer and supporting evidence; and (3) where possible, align submission recommendations with the government agenda. CONCLUSIONS We encourage future research to test the framework of influential features on other inquiry topics and in other countries to increase the reliability of results. IMPLICATIONS FOR PUBLIC HEALTH This study consolidates and presents a list of features that advocates can consider incorporating when writing a submission to a government inquiry.
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Affiliation(s)
- Adam Delaine
- Menzies School of Health Research, Charles Darwin University, Australia.
| | - Megan Ferguson
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Rachel Bacon
- Discipline of Nutrition and Dietetics, Faculty of Health, The University of Canberra, ACT, Australia
| | - Katherine Cullerton
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
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Cullerton K, Adams J, Forouhi NG, Francis O, White M. Avoiding conflicts of interest and reputational risks associated with population research on food and nutrition: the Food Research risK (FoRK) guidance and toolkit for researchers. BMJ 2024; 384:e077908. [PMID: 38286473 PMCID: PMC10823375 DOI: 10.1136/bmj-2023-077908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/07/2023] [Indexed: 01/31/2024]
Affiliation(s)
| | - Jean Adams
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge CB2 0QQ, UK
| | - Nita G Forouhi
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge CB2 0QQ, UK
| | - Oliver Francis
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge CB2 0QQ, UK
| | - Martin White
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge CB2 0QQ, UK
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Hamel V, Hennessy M, Mialon M, Moubarac JC. Interactions Between Nutrition Professionals and Industry: A Scoping Review. Int J Health Policy Manag 2023; 12:7626. [PMID: 38618820 PMCID: PMC10590255 DOI: 10.34172/ijhpm.2023.7626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 07/31/2023] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND In recent years, interactions between nutrition professionals (NPs) and the food industry, such as sponsorship arrangements, have raised concerns, particularly as these may negatively impact the trustworthiness and credibility of the nutrition profession. This study aimed to map the literature and identify knowledge gaps regarding interactions between NPs and industry. We sought to examine the nature of such interactions and NPs perspectives about these, as well as the risks and solutions. METHODS We conducted a scoping review according to a pre-registered protocol, searching eight electronic databases and grey literature sources in March 2021 to identify documents for inclusion. Two independent reviewers screened citations for inclusion and conducted data extraction. Quantitative and qualitative syntheses were conducted. RESULTS We identified 115 documents for analysis, published between 1980 to 2021, with a majority from the United States (n=59, 51%). Only 32% (n=37) were empirical studies. The food industry was the most frequent industry type discussed (n=91, 79%). We identified 32 types of interactions between NPs and industry, such as continuing education provided by industry and sponsorship of professional bodies and health and nutrition organizations. The financial survival of nutrition organizations and continuing education access for NPs were the most frequently cited advantages of industry-NPs interactions. On the other hand, undermining public trust, NPs credibility and public health nutrition recommendations were pointed out as risks of these interactions. Following a code of ethics, policies, or guidelines was the most frequently proposed solution for managing these interactions. CONCLUSION Despite the increasing attention given to this issue, few empirical papers have been published to date. There is a need for more research to better and systematically document industry interactions with NPs and the impacts associated with these, as well as more research on effective management strategies. Registry Name and Number: Interactions between nutrition professionals and industry actors: A scoping review protocol. doi:10.17605/OSF.IO/Q6PUA.
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Affiliation(s)
- Virginie Hamel
- Department of Nutrition, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Centre de recherche en Santé publique, Montreal, QC, Canada
| | - Marita Hennessy
- College of Medicine and Health, University College Cork, Cork, Ireland
| | - Mélissa Mialon
- Trinity Business School, Trinity College Dublin, Dublin, Ireland
| | - Jean-Claude Moubarac
- Department of Nutrition, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Centre de recherche en Santé publique, Montreal, QC, Canada
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Vogel C, Dijkstra C, Huitink M, Dhuria P, Poelman MP, Mackenbach JD, Crozier S, Seidell J, Baird J, Ball K. Real-life experiments in supermarkets to encourage healthy dietary-related behaviours: opportunities, challenges and lessons learned. Int J Behav Nutr Phys Act 2023; 20:73. [PMID: 37340326 DOI: 10.1186/s12966-023-01448-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 04/04/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Supermarkets are the primary source of food for many people yet their full potential as a setting to encourage healthy dietary-related behaviours remains underutilised. Sharing the experiences from research groups who have worked with supermarket chains to evaluate strategies that promote healthy eating could improve the efficiency of building such relationships and enhance the design quality of future research studies. METHODS A collective case study approach was used to synthesise experiences of engaging and sustaining research collaborations with national supermarket chains to test the effectiveness of health-focused in-store interventions. The collective narrative covers studies conducted in three high-income countries: Australia, the Netherlands and the United Kingdom. RESULTS We have distilled our experiences and lessons learned into six recommendations for conducting high quality public health research with commercial supermarket chains. These include: (i) using personal contacts, knowledge of supermarket activities and engaging executive management to establish a partnership and allowing time to build trust; (ii) using scientifically robust study designs with appropriate sample size calculations; (iii) formalising data exchange arrangements and allocating adequate resource for data extraction and re-categorisation; (iv) assessing effects at individual/households level where possible; (v) designing a mixed-methods process evaluation to measure intervention fidelity, dose and unintended consequences; and (vi) ensuring scientific independence through formal contract agreements. CONCLUSIONS Our collective experiences of working in non-financial partnerships with national supermarket chains could be useful for other research groups looking to develop and implement supermarket studies in an efficient manner. Further evidence from real-life supermarket interventions is necessary to identify sustainable strategies that can improve population diet and maintain necessary commercial outcomes.
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Affiliation(s)
- Christina Vogel
- Centre for Food Policy, City, University of London, Northampton Square, London, EC1V 0HB, UK.
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital Tremona Road, Southampton, SO16 6YD, UK.
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK.
| | - Coosje Dijkstra
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, Amsterdam, 1081 HV, the Netherlands.
| | - Marlijn Huitink
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, Amsterdam, 1081 HV, the Netherlands
| | - Preeti Dhuria
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital Tremona Road, Southampton, SO16 6YD, UK
| | - Maartje P Poelman
- Chair group Consumption and Healthy Lifestyles, Wageningen University & Research, P.O. Box 8130, Wageningen, 6700 EW, The Netherlands
| | - Joreintje D Mackenbach
- Department of Epidemiology and Data Science, Amsterdam UMC, location VUmc, Amsterdam Public Health research institute, De Boelelaan 1089a, 1081HV, Amsterdam, the Netherlands
| | - Sarah Crozier
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital Tremona Road, Southampton, SO16 6YD, UK
| | - Jacob Seidell
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, Amsterdam, 1081 HV, the Netherlands
| | - Janis Baird
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital Tremona Road, Southampton, SO16 6YD, UK
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
| | - Kylie Ball
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
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McKevitt S, White M, Petticrew M, Summerbell C, Vasiljevic M, Boyland E, Cummins S, Laverty AA, Junghans C, Millett C, De Vocht F, Hrobonova E, Vamos EP. Typology of how 'harmful commodity industries' interact with local governments in England: a critical interpretive synthesis. BMJ Glob Health 2023; 8:e010216. [PMID: 36690378 PMCID: PMC9872461 DOI: 10.1136/bmjgh-2022-010216] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 12/20/2022] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Industries that produce and market potentially harmful commodities or services (eg, tobacco, alcohol, gambling, less healthy foods and beverages) are a major influence on the drivers of behavioural risk factors for non-communicable diseases. The nature and impact of interactions between public bodies and 'harmful commodity industries' (HCIs) has been widely recognised and discussed at national and international levels, but to date little is known about such interactions at local or regional government levels. This study aimed to identify and characterise actual and potential interactions and proposes a typology of interactions between HCIs and English local authorities (LAs). METHODS Five electronic databases covering international literature (PubMed, EBSCO, OVID, Scopus and Web of Science) were searched up to June 2021. We also performed online searches for publicly available, web-based grey literature and documented examples of interactions in an English LA context. We conducted a critical interpretive synthesis of the published and grey literature to integrate and conceptualise the data in the context of English LAs. RESULTS We included 47 published papers to provide the frame for the typology, which was refined and contextualised for English LAs through the available grey literature. Three categories were developed, describing the medium through which interactions occur: (1) direct involvement with LAs, (2) involvement through intermediaries and (3) involvement through the local knowledge space. Within these, we grouped interactions into 10 themes defining their nature and identified illustrative examples. CONCLUSION Our typology identifies complex inter-relationships and characterises interactions between HCIs and LAs, with illustrative examples from English LAs. Drawn from well-established theories and frameworks in combination with contextual information on English LAs, this typology explores the LA perspective and could help local decision-makers to maximise population health while minimising negative impacts of HCIs. PROSPERO REGISTRATION NUMBER CRD42021257311.
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Affiliation(s)
- Sarah McKevitt
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Mark Petticrew
- PHP, London School of Hygiene and Tropical Medicine, London, UK
| | - Carolyn Summerbell
- Fuse - Centre for Translational Research in Public Health, Newcastle University, Newcastle upon Tyne, UK
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Milica Vasiljevic
- Fuse - Centre for Translational Research in Public Health, Newcastle University, Newcastle upon Tyne, UK
- Department of Psychology, Durham University, Durham, UK
| | - Emma Boyland
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Steven Cummins
- Population Health Innovation Lab, Department of Public Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Cornelia Junghans
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Frank De Vocht
- Population Health Sciences, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West, Bristol, UK
| | | | - Eszter P Vamos
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
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Ng SW, Colchero MA, White M. How should we evaluate sweetened beverage tax policies? A review of worldwide experience. BMC Public Health 2021; 21:1941. [PMID: 34702248 PMCID: PMC8546197 DOI: 10.1186/s12889-021-11984-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 10/12/2021] [Indexed: 02/02/2023] Open
Abstract
Over 45 jurisdictions globally have implemented sweetened beverage taxes. Researchers and policymakers need to assess whether and how these taxes change beverage demand and supply, their intended and unanticipated health, economic and equity impacts. Lessons from such evaluations can maximise the policies' success and impact on non-communicable disease prevention globally. We discuss key theoretical, design and methodological considerations to help policymakers, funders and researchers commission and conduct rigorous evaluations of these policies and related disease prevention efforts. We encourage involving the perspectives of various stakeholders on what evaluations are needed given the specific context, what data and methods are appropriate, readily available or can be collected within time and budget constraints. A logic model /conceptual system map of anticipated implications across sectors and scales should help identify optimal study design, analytical techniques and measures. These models should be updated when synthesising findings across diverse methods and integrating findings across subpopulations using similar methods.
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Affiliation(s)
- Shu Wen Ng
- Carolina Population Center, University of North Carolina at Chapel Hill, CB #8120, 137 East Franklin Street, Chapel Hill, NC, 27516, USA.
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, CB#7461, UNC-Chapel Hill, Chapel Hill, NC, 27599-7461, USA.
| | - M Arantxa Colchero
- Center for Health Systems Research, Instituto Nacional de Salud Pública, Universidad No 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, CP, 62100, Cuernavaca, Morelos, Mexico
| | - Martin White
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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Policy Inertia on Regulating Food Marketing to Children: A Case Study of Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189607. [PMID: 34574531 PMCID: PMC8472389 DOI: 10.3390/ijerph18189607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/06/2021] [Accepted: 09/09/2021] [Indexed: 11/16/2022]
Abstract
Unhealthy food marketing shapes children’s preference towards obesogenic foods. In Malaysia, policies regulating this food marketing were rated as poor compared to global standards, justifying the need to explore barriers and facilitators during policy development and implementation processes. The case study incorporated qualitative methods, including historical mapping, semi-structured interviews with key informants and a search of cited documents. Nine participants were interviewed, representing the Federal government (n = 5), food industry (n = 2) and civil society (n = 2). Even though the mandatory approach to government-led regulation of food marketing to children was the benchmark, more barriers than facilitators in the policy process led to industry self-regulations in Malaysia. Cited barriers were the lack of political will, industry resistance, complexity of legislation, technical challenges, and lack of resources, particularly professional skills. The adoption of industry self-regulation created further barriers to subsequent policy advancement. These included implementer indifference (industry), lack of monitoring, poor stakeholder relations, and policy characteristics linked to weak criteria and voluntary uptake. These underlying barriers, together with a lack of sustained public health advocacy, exacerbated policy inertia. Key recommendations include strengthening pro-public health stakeholder partnerships, applying sustained efforts in policy advocacy to overcome policy inertia, and conducting monitoring for policy compliance and accountability. These form the key lessons for advocating policy reforms.
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Chavez‐Ugalde Y, Jago R, Toumpakari Z, Egan M, Cummins S, White M, Hulls P, De Vocht F. Conceptualizing the commercial determinants of dietary behaviors associated with obesity: A systematic review using principles from critical interpretative synthesis. Obes Sci Pract 2021; 7:473-486. [PMID: 34401205 PMCID: PMC8346378 DOI: 10.1002/osp4.507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 03/04/2021] [Accepted: 03/12/2021] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Unhealthy diet is an important preventable risk factor for overweight and obesity. Identifying the key drivers of an unhealthy diet is an important public health aim. "Big Food" has been identified as an influential factor shaping dietary behavior and obesity, and their practices have broadly been labeled as the "commercial determinants of obesity," but there is a lack of definitions and conceptualizations for these terms. This review aimed to synthesize literature on the commercial determinants of dietary behavior associated with obesity. It presents the development of an integrative definition and a conceptual framework involving potential influences on dietary behavior, and it examines the prevalence of certain narratives within papers that focus on children and adolescents. METHODS Four electronic databases (Ovid MEDLINE, PubMed, Web of Science, and Scopus) were searched up to December 2020. Eighty-one articles met the inclusion criteria: they were published in a peer-reviewed academic journal, described a practice from the food/beverage industry in relation to dietary behavior or obesity. Data were integrated using critical interpretative synthesis. RESULTS The commercial determinants of dietary behavior are conceptualized in terms of three corporate spheres of action-political and legal; production, processing and design; and marketing and preference shaping-which enable powerful food industry to successfully pursue their business, market, and political objectives. The most frequently reported sphere of action targeting children and adolescents was marketing and preference shaping. CONCLUSIONS In the included literature, the commercial determinants of dietary behavior associated with obesity have been conceptualized as being part of a complex system where corporate practices are enabled by power structures. The proposed framework can facilitate a structured identification and systematic study of the impact of specific aspects of food industry's strategies and increase opportunities for primary prevention by anticipating industry responses and by discouraging corporate practices that harm health.
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Affiliation(s)
- Yanaina Chavez‐Ugalde
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Russell Jago
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Centre for Exercise, Nutrition & Health Sciences, School for Policy StudiesUniversity of BristolBristolUK
- National Institute for Health Research Collaboration for Leadership, Applied Health Research and Care West (NIHR CLAHRC West)BristolUK
| | - Zoi Toumpakari
- Centre for Exercise, Nutrition & Health Sciences, School for Policy StudiesUniversity of BristolBristolUK
| | - Matt Egan
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Department of Public Health, Environments and SocietyLondon School of Hygiene and Tropical MedicineLondonUK
| | - Steven Cummins
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Department of Public Health, Environments and SocietyLondon School of Hygiene and Tropical MedicineLondonUK
| | - Martin White
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Centre for Diet and Activity Research (CEDAR) MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - Paige Hulls
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
| | - Frank De Vocht
- National Institute for Health ResearchSchool for Public Health ResearchNewcastle upon TyneUK
- Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK
- National Institute for Health Research Collaboration for Leadership, Applied Health Research and Care West (NIHR CLAHRC West)BristolUK
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Mialon M, Ho M, Carriedo A, Ruskin G, Crosbie E. Beyond nutrition and physical activity: food industry shaping of the very principles of scientific integrity. Global Health 2021; 17:37. [PMID: 33879204 PMCID: PMC8056799 DOI: 10.1186/s12992-021-00689-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is evidence that food industry actors try to shape science on nutrition and physical activity. But they are also involved in influencing the principles of scientific integrity. Our research objective was to study the extent of that involvement, with a case study of ILSI as a key actor in that space. We conducted a qualitative document analysis, triangulating data from an existing scoping review, publicly available information, internal industry documents, and existing freedom of information requests. RESULTS Food companies have joined forces through ILSI to shape the development of scientific integrity principles. These activities started in 2007, in direct response to the growing criticism of the food industry's funding of research. ILSI first built a niche literature on COI in food science and nutrition at the individual and study levels. Because the literature was scarce on that topic, these publications were used and cited in ILSI's and others' further work on COI, scientific integrity, and PPP, beyond the fields of nutrition and food science. In the past few years, ILSI started to shape the very principles of scientific integrity then and to propose that government agencies, professional associations, non-for-profits, and others, adopt these principles. In the process, ILSI built a reputation in the scientific integrity space. ILSI's work on scientific integrity ignores the risks of accepting corporate funding and fails to provide guidelines to protect from these risks. CONCLUSIONS The activities developed by ILSI on scientific integrity principles are part of a broader set of political practices of industry actors to influence public health policy, research, and practice. It is important to learn about and counter these practices as they risk shaping scientific standards to suit the industry's interests rather than public health ones.
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Affiliation(s)
- Mélissa Mialon
- Trinity Business School, Trinity College Dublin, Dublin, Ireland.
| | - Matthew Ho
- School of Community Health Sciences, University of Nevada, Reno, USA
| | | | | | - Eric Crosbie
- School of Community Health Sciences, University of Nevada, Reno, USA
- Ozmen Institute for Global Studies, University of Nevada, Reno, USA
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Ng S, Kelly B, Yeatman H, Swinburn B, Karupaiah T. Tracking Progress from Policy Development to Implementation: A Case Study on Adoption of Mandatory Regulation for Nutrition Labelling in Malaysia. Nutrients 2021; 13:457. [PMID: 33573100 PMCID: PMC7910920 DOI: 10.3390/nu13020457] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/20/2021] [Accepted: 01/26/2021] [Indexed: 11/16/2022] Open
Abstract
Mandatory nutrition labelling, introduced in Malaysia in 2003, received a "medium implementation" rating from public health experts when previously benchmarked against international best practices by our group. The rating prompted this qualitative case study to explore barriers and facilitators during the policy process. Methods incorporated semi-structured interviews supplemented with cited documents and historical mapping of local and international directions up to 2017. Case participants held senior positions in the Federal government (n = 6), food industry (n = 3) and civil society representations (n = 3). Historical mapping revealed that international directions stimulated policy processes in Malaysia but policy inertia caused implementation gaps. Barriers hindering policy processes included lack of resources, governance complexity, lack of monitoring, technical challenges, policy characteristics linked to costing, lack of sustained efforts in policy advocacy, implementer characteristics and/or industry resistance, including corporate political activities (e.g., lobbying, policy substitution). Facilitators to the policy processes were resource maximization, leadership, stakeholder partnerships or support, policy windows and industry engagement or support. Progressing policy implementation required stronger leadership, resources, inter-ministerial coordination, advocacy partnerships and an accountability monitoring system. This study provides insights for national and global policy entrepreneurs when formulating strategies towards fostering healthy food environments.
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Affiliation(s)
- SeeHoe Ng
- Early Start, School of Health and Society, University of Wollongong, Wollongong 2522, Australia; (S.H.N.); (B.K.); (H.Y.)
| | - Bridget Kelly
- Early Start, School of Health and Society, University of Wollongong, Wollongong 2522, Australia; (S.H.N.); (B.K.); (H.Y.)
| | - Heather Yeatman
- Early Start, School of Health and Society, University of Wollongong, Wollongong 2522, Australia; (S.H.N.); (B.K.); (H.Y.)
| | - Boyd Swinburn
- School of Population Health, University of Auckland, Auckland 1072, New Zealand;
| | - Tilakavati Karupaiah
- Dietetics Program, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya 47500, Malaysia
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Mialon M, Vandevijvere S, Carriedo-Lutzenkirchen A, Bero L, Gomes F, Petticrew M, McKee M, Stuckler D, Sacks G. Mechanisms for addressing and managing the influence of corporations on public health policy, research and practice: a scoping review. BMJ Open 2020; 10:e034082. [PMID: 32690498 PMCID: PMC7371213 DOI: 10.1136/bmjopen-2019-034082] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE We identified mechanisms for addressing and/or managing the influence of corporations on public health policy, research and practice, as well as examples of where these mechanisms have been adopted from across the globe. DESIGN We conducted a scoping review. We conducted searches in five databases on 4 June 2019. Twenty-eight relevant institutions and networks were contacted to identify additional mechanisms and examples. In addition, we identified mechanisms and examples from our collective experience working on the influence of corporations on public health policy, research and practice. SETTING We identified mechanisms at the national, regional and global levels. RESULTS Thirty-one documents were included in our review. Eight were peer-reviewed scientific articles. Nine discussed mechanisms to address and/or manage the influence of different types of industries; while other documents targeted specific industries. In total, we identified 49 mechanisms for addressing and/or managing the influence of corporations on public health policy, research and practice, and 43 of these were adopted at the national, regional or global level. We identified four main types of mechanisms: transparency; management of interactions with industry and of conflicts of interest; identification, monitoring and education about the practices of corporations and associated risks to public health; prohibition of interactions with industry. Mechanisms for governments (n=17) and academia (n=13) were most frequently identified, with fewer for the media and civil society. CONCLUSIONS We identified several mechanisms that could help address and/or manage the negative influence of corporations on public health policy, research and practice. If adopted and evaluated more widely, many of the mechanisms described in this manuscript could contribute to efforts to prevent and control non-communicable diseases. TRIAL REGISTRATION DETAILS The protocol was registered with the Open Science Framework on 27 May 2019 (https://osf.io/xc2vp).
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Affiliation(s)
- Melissa Mialon
- School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
- School of Nutrition and Dietetics, University of Antioquia, Medellin, Colombia
| | | | | | - Lisa Bero
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Fabio Gomes
- Pan American Health Organization, Washington, District of Columbia, USA
| | - Mark Petticrew
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, London, UK
| | - Martin McKee
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, London, UK
| | - David Stuckler
- Dondena Research Centre and Department of Policy Analysis and Public Management, Bocconi University, Milano, Lombardia, Italy
| | - Gary Sacks
- Global Obesity Centre, Deakin University, Burwood, Victoria, Australia
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White M, Aguirre E, Finegood DT, Holmes C, Sacks G, Smith R. What role should the commercial food system play in promoting health through better diet? BMJ 2020; 368:m545. [PMID: 32184211 PMCID: PMC7190369 DOI: 10.1136/bmj.m545] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Martin White and coauthors consider that the commercial food system has the potential to show leadership and support for dietary public health, but systemic change is needed first and this is likely to require governmental action
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Affiliation(s)
- Martin White
- Centre for Diet and Activity Research, MRC Epidemiology Unit, Institute of Metabolic Sciences, University of Cambridge, UK
| | - Emilie Aguirre
- University of Chicago Law School, Chicago, IL, USA
- Harvard Business School, Boston, MA, USA
| | - Diane T Finegood
- Morris J Wosk Centre for Dialogue, Simon Fraser University, Vancouver, BC, Canada
| | | | - Gary Sacks
- Global Obesity Centre, Deakin University, Burwood, VIC 3125, Australia
| | - Richard Smith
- College of Medicine and Health, University of Exeter, Exeter, UK
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Food Industry Donations to Academic Programs: A Cross-Sectional Examination of the Extent of Publicly Available Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051624. [PMID: 32138233 PMCID: PMC7084227 DOI: 10.3390/ijerph17051624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/18/2020] [Accepted: 02/27/2020] [Indexed: 12/02/2022]
Abstract
No studies have documented the prevalence of the food industry’s funding of academic programs, which is problematic because such funding can create conflicts of interest in research and clinical practice. We aimed to quantify the publicly available information on the food industry’s donations to academic programs by documenting the amount of donations given over time, categorizing the types of academic programs that receive food industry donations, cataloguing the source of the donation information, and identifying any stated reasons for donations. Researchers cataloged online data from publicly available sources (e.g., official press releases, news articles, tax documents) on the food industry’s donations to academic programs from 2000 to 2016. Companies included 26 food and beverage corporations from the 2016 Fortune 500 list in the United States. Researchers recorded the: (1) monetary value of the donations; (2) years the donations were distributed; (3) the name and type of recipient; (4) source of donation information; and (5) reasons for donations. Adjusting for inflation, we identified $366 million in food industry donations (N = 3274) to academic programs. Universities received 45.2% (n = 1480) of donations but accounted for 67.9% of total dollars given in the sample. Community colleges, schools (i.e., preschool, elementary, middle, and high schools), and academic nonprofits, institutes, foundations, and research hospitals collectively received 54.8% of the donations, but made up less than one-third of the monetary value of donations. Half of the donations (49.0%) did not include a stated reason for the donation. In our sample, donations grew from $3 million in 2000 to $24 million in 2016. Food companies in our sample donated millions of dollars to universities and other academic programs but disclosed little information on the purpose of the donations. Achieving transparency in donation practices may only be possible if federal policies begin to require disclosures or if companies voluntarily disclose information.
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Mialon M, Fabbri A, Fooks G. Reply to the article: "What principles should guide interactions between population health researchers and the food industry? Systematic scoping review of peer-reviewed and grey literature". Obes Rev 2019; 20:1504-1506. [PMID: 31237105 DOI: 10.1111/obr.12905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 05/14/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Melissa Mialon
- Center for Epidemiological Studies in Health and Nutrition (NUPENS), Department of Nutrition, Faculty of Public Health, University of São Paulo, São Paulo, Brazil
| | - Alice Fabbri
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Gary Fooks
- School for Languages and Social Sciences, Aston University, Birmingham, UK
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17
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Conflict of interest in nutrition research: an editorial perspective. Eur J Clin Nutr 2019; 73:1213-1215. [PMID: 31485036 DOI: 10.1038/s41430-019-0488-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 07/19/2019] [Indexed: 01/25/2023]
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18
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Kraak VI. Critique of a scoping review of principles to guide interactions between population health researchers and the food industry. Obes Rev 2019; 20:1335-1337. [PMID: 31293040 DOI: 10.1111/obr.12890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 05/14/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia
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Cullerton K, Adams J, Francis O, Forouhi N, White M. In reply to letter to the editor from V. Kraak and M. Mialon et al. Obes Rev 2019; 20:1338-1339. [PMID: 31197922 DOI: 10.1111/obr.12886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 05/15/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Katherine Cullerton
- MRC Epidemiology Unit & Centre for Diet and Activity Research, Institute of Metabolic Sciences, University of Cambridge, Cambridge, UK.,School of Public Health, University of Queensland, Herston, Australia
| | - Jean Adams
- MRC Epidemiology Unit & Centre for Diet and Activity Research, Institute of Metabolic Sciences, University of Cambridge, Cambridge, UK
| | - Oliver Francis
- MRC Epidemiology Unit & Centre for Diet and Activity Research, Institute of Metabolic Sciences, University of Cambridge, Cambridge, UK
| | - Nita Forouhi
- MRC Epidemiology Unit & Centre for Diet and Activity Research, Institute of Metabolic Sciences, University of Cambridge, Cambridge, UK
| | - Martin White
- MRC Epidemiology Unit & Centre for Diet and Activity Research, Institute of Metabolic Sciences, University of Cambridge, Cambridge, UK
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Building consensus on interactions between population health researchers and the food industry: Two-stage, online, international Delphi study and stakeholder survey. PLoS One 2019; 14:e0221250. [PMID: 31437189 PMCID: PMC6705832 DOI: 10.1371/journal.pone.0221250] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 08/04/2019] [Indexed: 11/19/2022] Open
Abstract
Key to scientific integrity is ensuring that research findings are considered credible by scientific peers, practitioners, policymakers and the public. Industry sponsorship of nutritional research can result in bias and raises significant professional, public and media concern. Yet, there is no international consensus on how to prevent or manage conflicts of interest for researchers considering engaging with the food industry. This study aimed to determine internationally agreed principles to guide interactions between population health researchers and the food industry to prevent or manage conflicts of interest. We used a two-stage, online Delphi study for researchers (n = 100 in 28 countries), and an online survey for stakeholders (n = 84 in 26 countries). Levels of agreement were sought with 56 principles derived from a systematic review. Respondent comments were analysed using qualitative content analysis. High levels of agreement on principles were achieved for both groups (researchers 68%; stakeholders 65%). Highest levels of agreement were with principles concerning research methods and governance. More contentious were principles that required values-based decision-making, such as determining which elements of the commercial sector are acceptable to interact with. These results provide the basis for developing internationally-agreed guidelines for population health researchers governing interactions with the food industry.
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Cullerton K, Adams J, Forouhi N, Francis O, White M. What principles should guide interactions between population health researchers and the food industry? Systematic scoping review of peer-reviewed and grey literature. Obes Rev 2019; 20:1073-1084. [PMID: 30968553 PMCID: PMC6767600 DOI: 10.1111/obr.12851] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 03/02/2019] [Accepted: 03/03/2019] [Indexed: 12/18/2022]
Abstract
There is no explicit consensus amongst population health researchers regarding what constitutes acceptable or effective interactions with the food industry. This has led to confusion and disagreements over conflicts of interest, which can undermine the integrity of science. To clarify this issue, we aimed to systematically identify the key principles developed by population health researchers to prevent or minimize conflicts of interest when interacting with the food industry. Databases of peer-reviewed literature were searched. In addition, an advanced Google search, a request to experts seeking related documents, and hand searching of references were undertaken. Thematic analysis of the extracted data was undertaken. We examined 54 eligible documents describing guidelines for population health researchers when interacting with the food industry. Fifty-six principles were identified and synthesized in five themes. There were high levels of agreement in themes relating to research governance, transparency, and publication but less agreement and guidance on how principles should be applied in relation to funding and risk assessment. There is agreement on some of the general principles for preventing and minimizing conflicts of interests for population health researchers when interacting with the food industry. However, for issues such as assessing the appropriateness of an industry partner, greater clarity and consensus are required.
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Affiliation(s)
- Katherine Cullerton
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.,School of Public Health, University of Queensland, Herston, Australia
| | - Jean Adams
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Nita Forouhi
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Oliver Francis
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Martin White
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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Current opportunities to catalyze research in nutrition and cancer prevention - an interdisciplinary perspective. BMC Med 2019; 17:148. [PMID: 31357989 PMCID: PMC6664739 DOI: 10.1186/s12916-019-1383-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 07/02/2019] [Indexed: 02/02/2023] Open
Abstract
Cancer Research UK and Ludwig Cancer Research convened an inaugural international Cancer Prevention and Nutrition Conference in London on December 3-4, 2018. Much of the discussion focused on the need for systematic, interdisciplinary approaches to better understand the relationships of nutrition, exercise, obesity and metabolic dysfunction with cancer development. Scientists at the meeting underscored the importance of studying the temporal natural history of exposures that may cumulatively impact cancer risk later in life.A robust dialogue identified obesity as a major risk for cancer, and the food environment, especially high energy and low nutrient processed foods, as strong and prevalent risk factors for obesity. Further engagement highlighted challenges in the post-diagnostic setting, where similar opportunities to understand the complex interplay of nutrition, physical activity, and weight will inform better health outcomes.Going forward, holistic research approaches, encompassing insights from multiple disciplines and perspectives, will catalyze progress urgently needed to prevent cancer and improve public health.
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