Journal Issue: Childhood Obesity Volume 16 Number 1 Spring 2006
Challenges of Translating Research into Change
Conducting research on built environments and childhood obesity and implementing changes based on the findings will be challenging. Researchers will probably not find a single “smoking gun.” It is more likely that many built environment variables will show a strong cumulative effect on diet, physical activity, and weight status in children than that any single variable will have a dominant influence. Further, different environmental variables are likely to be operating for children of different ages and genders as well as for those of different racial, ethnic, and cultural groups and socioeconomic backgrounds. Thus changing the built environment in all the ways needed to combat obesity may be a complex task. Research is further complicated by the paucity of reliable and valid measures of food and physical activity environmental factors. And changing the built environment alone is unlikely to induce large changes in eating habits and physical activity. Educational programs, promotional activities, incentives, and policies will all be necessary to support the physical changes.
Making so many changes in the built environment would affect not only many government departments at all levels, but also the food industry, the real estate industry, many transportation- related industries, recreation-related industries, and entertainment industries. Some of these industries will actively oppose policies that threaten their current operating practices.81 Stimulating health-oriented policy change in government agencies not normally focused on health will require creative and sustained effort. Public support for changing the built environment to combat childhood obesity has seldom been studied but may be decisive in adopting and implementing both promising and evidence-based policies.82
Enhancements to encourage more active commuting in communities and potential subsidies for healthful foods may well be costly. Those costs must be better understood and balanced against the costs of continuing current policies that may be driving the youth obesity epidemic. Careful economic analyses must inform policy decisions.83
Making major changes in government policy and industry practice will require a substantial investment in advocacy that will in turn require people, organization, and funding. Although many organizations have interests consistent with the built environment's changes already noted, their capacity is not sufficient to achieve even the initial policy changes supported by existing data. Continuous evaluation will be required to learn whether the changes that are made lead to the expected outcomes and contribute to reducing the obesity epidemic.
Finally, there is an urgent need for the next generation of studies on how the built environment affects youth physical activity, eating, and obesity. Because simply identifying built environment risk factors is not sufficient to create change, advancing the science of policy change is also a high priority. A new research emphasis must be to improve the understanding of policy change processes of greatest relevance to youth physical activity, eating, and obesity.