Youth on a Healthy Weight (JOGG); integrated approach towards obesity.

Jacob C. Seidell

VU University

June 3rd 2015, Belfast

Obesity trends in oecd countries

Strategies --to help children eat more fruits

and vegetables, --decrease sweetened beverage

consumption, --reduce consumption of high

energy-dense foods,--help children to be more active

and less sedentary

Fruit & Vegetable intake European children

Pieter Breughel de Oude, Luilekkerland, Cocagne, 1567, Alte Pinakothek München

Huang TT et al, CDC, 2009

WHO

• Encourage industry ‘health-for-all principles’• Facilitatie universal access to drugs and health

services• Accelerate R and D• Acquire knowledge and expertise from the

commercial sector

How to change food environment ?

• Food composition• Marketing• Prices• Availability

Strategies

• Regulation and litigation• Publiek-private engagement• Grass-roots civil movement

PPP (PPE): in public health• Donations, funding, sponsoring• salesagreement• Licence or franchise• Fusion or take-over• PPS: Alliance model:

– Complex projects– Equal relations; governance (triple helix etc)– Joint plan and partnerselection.

• PPP: Concession model- Well-ordered clear project- Public party develops policy and looks for partners for execution/implementation- Public party is directing is and is mandator

Pro’s and Con’s of PPEPro’s Con’s

Access to financial resources fading of responsibilities and accountability

Access to knowledge and expertise Complexity formation and management

Creative and innovative solutions Differences in partners (objectives, cultures etc)

Marketing- en communication skills Uncertain results

Legitimacy Reputation damage

Integrated approach to problem Limits of publication

Compromising academic freedom

(gebaseerd op Van Huijstee, Francken, & Leroy 2007)

Logic model for interventions

1 Intervention dose is either 1 or 0 (intervention, control) or $$ (economic input – all schools)2 Capacity is leadership, skills/knowledge, structures, resources3 Relevant environments are schools, homes, neighbourhoods, churches4 Weight, BMI, BMI-z, waist, waist:height, %fat, prevalence of o/w+obesity

InterventionDose1

Δ Community capacity2

Δ Environments3

Δ Knowledge, attitudes, beliefs, perceptions etc

Δ Behaviours Δ Anthropometry4

INPUTS

POPULATION MEDIATORS

INDIVIDUAL MEDIATORS OUTCOMES

MODERATORS

Ethnicity, socio-cultural factors, gender, age, SES

Δ QoL

Δ QALYs gained

Δ Policy

= Measured = Modelled

JOGG Model – based on the EPODE model (Van Koperen, 2013)

COMMUNICATIE

20

Urban agriculture, schoolgardens, farm-education influence food choice &

preferences

Changes in food systems and community efforts

Summary:

• Health related behavior largely determined by physical, social-cultural and economic factors.• Changing the food environment is a crucial

step in effective obesity prevention• PPE is an important but risky tool. Careful

planning and management is needed.