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University of Washington NOPREN Pilot Project

University of Washington NOPREN Pilot Project. Donna B. Johnson, RD, PhD. This presentation was supported by Cooperative Agreement Number 5U4BDP001011-02 from the Centers for Disease Control and Prevention.

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University of Washington NOPREN Pilot Project

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  1. University of Washington NOPREN Pilot Project Donna B. Johnson, RD, PhD

  2. This presentation was supported by Cooperative Agreement Number 5U4BDP001011-02 from the Centers for Disease Control and Prevention. The findings and conclusions in this presentation are those of the author and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

  3. WA State NOPREN

  4. Purpose of Pilot Study • Advance understanding of the public health function of policy development in order to improve public health practice • Describe the process • Identify facilitators, barriers, lessons learned • Disseminate results

  5. County Public Health Departments Work to Improve Restaurant Food

  6. Design & Methods Multiple-case, replication design Data: documents and key informant interviews • Interviews: public health officials, board of health members, restaurant owners and Restaurant Association representatives • Interview questions: explore themes related to policy process and change as described by the Advocacy Coalition Framework

  7. Advocacy Coalition Framework1 Policy Subsystem Relatively Stable Parameters System-wide with enduring/constraining effect Coalition APolicy beliefsResourcesStrategy Coalition BPolicy beliefsResourcesStrategy Constraints & Resources Decisions by Governmental Authorities External Events - Change in socioeconomic conditions, public opinion, leaders- Policy decisions/impacts from other subsystems Policy Outputs & Impacts 1) Adapted from: Breton E, Richard L, Gagnon F, Jacques M, Bergeron P. Health promotion research and practice require sound policy analysis models: The case of Quebec’s Tobacco Act. Social Science & Medicine 2008; 67:1679-1689.

  8. Interview Guide - ACF Constructs

  9. Interview Sample (n) One interview with Representative of Washington Restaurant Association

  10. Coding Example: Beliefs

  11. Preliminary Findings • External Events • Policy Beliefs • Leadership Resources • Policy Learning

  12. Policy Subsystem Actors Healthy Eating Active Living staff

  13. Examples of External Events • CSPI & NYC mandate: helped set agenda • Legal Action in NYC • King: carefully worded requirement • Thurston: Avoided any regulation • Pierce: restaurants & their association very interested in partnering • National legislation: Pierce stopped considering further initiatives

  14. Examples of Beliefs • Deep core beliefs • Freedom for businesses • Importance of nutrition & health • Policy Beliefs on Appropriate Instruments & Role of Health Department • Education • Regulation • Both

  15. Examples of Constraints & Resources: Leadership • New Health Department Director in King Co had strong focus on policy as a public health tool & the board of health initiated and championed the menu labeling policy despite industry pushback. • In Pierce Co, budget cuts led to personnel changes at the health department including the loss of several champions for menu labeling. Menu labeling policy development was put on hold during the transition.

  16. Policy Oriented Learning • King County had most extensive policy oriented learning. • Initial regulations: labeling applied if had 10 franchises, information display requirements seen as burdensome by restaurants • Restaurant Association went to state legislature in an attempt to get preemptive and less restrictive regulations. • County and restaurant association worked collaboratively to modify regulation. • Final regulations: 15 outlets & changes to display rules

  17. Next Steps • Complete preliminary analysis • Present to restaurant research team • “Member checking” • Work with NOPREN members • Use of model & compare findings

  18. Questions?

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