Improving the adoption and sustainability of evidence-based policies: A life course approach to reducing diet-related NCDs in adolescents
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Description
People, world-wide, are increasingly becoming overweight or obese (OO), even children. Being overweight or obese is a serious health concern and can lead to many diseases (called non-communicable diseases or NCDs) which reduce the quality of one's life or even untimely death. Many of these deaths occur in low- and middle-income countries. One important contributor to overweight and obesity is eating highly processed foods, often termed 'junk food'. Children who are OO are more vulnerable to developing NCD's and this continues into later in life. Therefore, the World Health Organisation, and other organisations concerned with health, believe that governments should prioritise policies that prevent young people become OO. In South Africa, the rate of OO amongst children is high compared to countries with similar economic circumstances. Indeed, South African children are at risk of developing high blood pressure or diabetes during childhood and numerous NCD's later in life. While the South African government has taken steps to improve children's health through a sugary beverage tax, and limiting the salt content of food, the problem persists. This shows that food policies are currently not working as they should. It seems that there is a gap in the implementation of those policies. It is therefore important to investigate the nature of this gap. This study will look at various aspects of South African food policies aimed at decreasing NCD's, to identify the problem, particularly as they effect children aged 10-14 years old and 15-19 years old in an urban and rural province and make recommendations to resolve these gaps. The study will be conducted over four years (2023-2027), using an existing implementation research tool called the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, which has four phases: Phase 1 - Exploration: We will review all South African policies aimed at improving diets and in particular those of children. Phase 2 - Preparation: We will engage with children, policy makers and enforcers as well as parents and other people with an interest to identify the strengths and weaknesses of existing policies, and whether they are being implemented as they should be. Phase 3 - Implementation: We will then develop intervention strategies to overcome identified weaknesses or harness existing strengths. We will cost these strategies and then with all the key stakeholders rank them in order of priority. Phase 4 - Sustainability: Finally, we will consider whether these strategies have the potential to be implemented in the long term. The main outcome of the study is a costed and prioritised list of interventions that will decrease OO of adolescents and decrease NCDs in South Africa.
Objectives
The research objectives are to: 1. Use evidence-based frameworks to map the landscape of national & regional policies with the potential to decrease ultra-processed food consumption and diet related non-communicable disease risk in South African adolescents 2. Identify and describe barriers and facilitators to effective adoption and sustainable implementation of relevant policies with key stakeholders 3. Cost and prioritise evidence-based strategies to facilitate effective adoption and sustainable implementation of relevant policies 4. Assess factors that will influence effective sustainability of implementing the prioritised evidence-based strategies at a national level
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