Abstract
Childhood obesity has tripled to a prevalence rate of 17% since 1980. Numerous stakeholders influence the policy process impacting childhood obesity. Professional associations, advocacy groups, clinicians, researchers, and insurers inform the policy process. As a result, nurses must understand interdisciplinary policies impacting childhood obesity prevention and management. Knowledge of available policy resources is vital to advocating for the prevention and management of childhood obesity. The purpose of this brief article is to identify some useful sources of information for the development, support, and implementation of policies impacting childhood obesity. Consumer and professional advocacy centers for childhood obesity, research and funding opportunities for policy research, and insurance policy information specific to childhood obesity are discussed. Focused childhood obesity policy resources are compiled for future policy reference.
Introduction
Nurses are frontline clinicians in the care of children who are obese. Comprising the largest segment of the healthcare delivery system, nurses are trusted professionals who are leaders in clinical and policy settings and have the ability to impact the current and evolving healthcare environment.3,4 Nurses must understand interdisciplinary policies impacting childhood obesity prevention and management. Knowledge of available policy resources is vital to advocating for the prevention and management of childhood obesity.
The purpose of this brief article is to identify some useful sources of information for the development, support, and implementation of policies impacting childhood obesity. These resources address consumer and professional advocacy centers for childhood obesity, research and funding opportunities for policy research, and insurance policy information specific to childhood obesity. Selected childhood obesity policy resources are compiled in Table 1.
Advocacy Center Sites
Advocacy is an important policy process for educating consumers and professionals and informing the policy process. Most policy resource sites have developed advocacy tools for consumers and professionals to inform legislators about prioritized issues impacting childhood obesity.
Obesity Action Coalition
The Obesity Action Coalition (OAC) is a nonprofit education and advocacy organization involved with all issues related to obesity. In support of effective childhood obesity policies, the OAC encourages members and others to contact their legislators in support of the Fitness Integrated with Teaching (FIT) Kids Act of 2009 (HR1057/S576). 5 This important legislation would ensure policies requiring physical activity for children throughout the school day as a method of preventing and treating childhood obesity.
Center for Science in the Public Interest
The Center for Science in the Public Interest (CSPI) is a consumer advocacy group that conducts research and advocacy programs related to health and nutrition information for the public as well as the policy-makers. The CSPI promotes evidence-based policy options promoting nutrition and activity in the prevention of obesity. Decreasing calorie-dense foods and improving physical activity in schools are two of the many policy recommendations advocated by the CSPI. 6
Let's Move!
First Lady Michelle Obama's political and policy platform significantly increased the political feasibility of moving childhood obesity onto the national agenda. 7 With the signature of a Presidential Memorandum, the first-ever Task Force on Childhood Obesity was established. 8 A review of federal programs and policies relating to child nutrition and physical activity led to the development of a national action plan to set benchmarks toward the First Lady's national goal. Policy goals focus on ensuring a healthy start for children, empowering parents and caregivers, ensuring healthy food in schools, improving access to healthy, affordable foods, and increasing physical activity in schools and communities.
Robert Wood Johnson Foundation Center to Prevent Childhood Obesity
Building on the goals of the Let's Move! Campaign, the Robert Wood Johnson Foundation (RWJF) Center recognizes the importance of changing public policies in order to reverse the childhood obesity epidemic. Focusing on prevention strategies, the RWJF Center informs and influences policy stakeholders, advocates, and community organizations through the identification and promotion of the most promising obesity-prevention strategies. Policy strategies focus on healthy foods and beverages, increased physical activity, and building consensus on the need to reverse the childhood obesity epidemic by 2015. 9
Research and Funding Sources
Just as policy advocacy sites inform consumers, professionals, and legislators, research informs, builds, and expands the body of evidence relating to childhood obesity. Many professional associations offer research funding opportunities as well as advocacy tools.
National Association of Bariatric Nurses
The National Association of Bariatric Nurses (NABN) exists to advance the health and quality of life of individuals and families living with obesity and to promote best practices of holistic nursing care for patients and their families. 10 Promoting excellence in nursing about the care of patients who are morbidly obese and their families, the NABN promotes and funds original research that builds the body of nursing science and informs the policy process regarding obesity across the life span. 11
Active Living Research
Active Living Research, a national program of the RWJF, supports research to identify environmental factors and policies that influence physical activity. 12 Research funding focuses on removing disparities among minority and low-income communities. Research findings inform the policy process by addressing environmental factors impacting childhood obesity.
The Obesity Society
Research, education, and political advocacy are tools utilized by The Obesity Society to build a body of evidence for understanding, prevention, and treatment of obesity. 13 Research awards and grants promote and reward obesity research with major contributions to basic science, prevention, and treatment of obesity. Research findings inform the policy process and stakeholders involved in childhood obesity.
American Society for Metabolic and Bariatric Surgery
Founded in 1983, the American Society for Metabolic and Bariatric Surgery (ASMBS) serves to improve public health by mitigating the human and economic burden of obesity and related diseases. 14 The ASMBS provides educational and support programs for bariatric surgeons and integrated health professionals involved in the care of the bariatric client. Advocacy for policies ensuring patient access to prevention, treatment, and follow-up of obesity is a strong focus of the ASMBS. 14
National Institute of Child Health and Human Development
The National Institute of Child Health & Human Development (NICHD) conducts and supports research on all stages of human development, from preconception to adulthood, to better understand the health of children, adults, families, and communities. Research priorities include research on obesity and hyperlipidemia with a focus on the etiology, consequences, and prevention of childhood obesity and secondary complications. 15
Insurance Policy
Advocacy and research inform the policy process, but it is also important, however, to understand how insurance reimbursement impacts health policy and the management of childhood obesity. The Affordable Care Act and numerous studies call for an emphasis on prevention and management of chronic health problems like childhood obesity.16–21 Interdisciplinary team members, including bariatric nurse coordinators, school nurses, and advanced practice nurses caring for children must understand the insurance policy recommendations that relate to childhood obesity in order to ensure effective prevention, management, and follow-up for children suffering from or at risk for obesity. 22
Centers for Medicare and Medicaid Services
The Centers for Medicare and Medicaid Services (CMS) is the federal agency with oversight of the Medicare and Medicaid programs. The Children's Health Insurance Program (CHIP) is the branch of Medicaid that provides health coverage for nearly 40 million children. 23 Medicaid policy mandates benchmarking for preventive and obesity-related services covered by Medicaid. This important coverage attempts to mitigate the childhood obesity-related disparities experienced by low-income and minority children.1,23 As CMS establishes insurance policies, many private insurers throughout the United States will follow.
Blue Cross Blue Shield
Blue Cross Blue Shield (BCBS) Association is one of the largest insurance carriers in the United States. This organization has a long history of community-based educational programs for their constituents. As a strong stakeholder in childhood obesity, BCBS advocates for policy solutions that will prevent and mitigate the prevalence and risks associated with childhood obesity through a platform of increased physical activity, healthy nutrition, and wellness programs. 24
Conclusion
Effective utilization of policy resources is critical to nursing leadership in the prevention, management, and follow-up of childhood obesity. Stakeholders in childhood obesity policy bring differing agendas to the policy process. As one of the most trusted of all health professionals, nurses must understand and provide leadership in the utilization of all policy resources in the fight against childhood obesity; the future of nursing and the future of children may depend on it!
Footnotes
Author Disclosure Statement
No competing financial interests exist.