Improving the adoption and sustainable implementation of evidence-based policies: A life course approach to reduce diet-related NCDs in adolescents

Background

The burden of overweight and obesity is a growing, preventable public health pandemic, causing premature deaths, with most occurring in low- and middle-income countries. Diet is a critical risk factor for NCDs among men, women and children thus the term diet-related NCDs (DR-NCDs). One important contributor to DR-NCDs is high intake of ultra-processed foods (UPFs). Food marketing has consistently been found to influence food preferences, purchasing and consumption behaviour, particularly in adolescents. These preferences and behaviour not only lead to obesity in adolescence but continue into adulthood, causing NCD’s later in life. Investments in adolescent health and wellbeing including healthier diet, represents one of the best-buys identified by the WHO to prevent DR-NCDs.

In South Africa, studies estimate adolescent overweight and obesity to be between 22% and 29%. This is much higher than in comparable middle-income countries. Despite South Africa (SA) having a number of policies such as a sugary beverage tax, and others in preparation, such as front of package labelling, the challenge continues. This experience underscores failures in the implementation of food policies through the policy cycle, i.e. policy-implementation gaps.

Aims

The aim of this study is to facilitate effective adoption and sustainable implementation of public policy with the potential to decrease UPF consumption and DR-NCD risk in SA adolescents (10-19 years) and through their life-course.

Project plan

An exploratory, sequential study will be conducted over four-years (2023-2027), using a combination of quantitative and qualitative research methods. The study will be underpinned by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, highlighting four phases that will guide the research process to meet the research objectives.

• Phase 1 – Exploration: Map the food policy landscape in South Africa.

• Phase 2 – Preparation: Engaging a steering committee and stakeholders including adolescents we will identify and describe barriers and facilitators to effective policy adoption and sustainable implementation.

• Phase 3 – Implementation: We will cost and with stakeholders and prioritise evidence-based strategies to facilitate effective adoption. Using mixed methods involving participatory research, in-depth interviews, surveys and existing cost data.

• Phase 4 – Sustainability: Assess factors that will influence effective sustainability of the policies.

Funding organisations

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