title: A framework for evaluating the impact of obesity prevention strategies on socioeconomic inequalities in weight.
abstract: We developed a theoretical framework to organize obesity prevention interventions by their likely impact on the socioeconomic gradient of weight. The degree to which an intervention involves individual agency versus structural change influences socioeconomic inequalities in weight. Agentic interventions, such as standalone social marketing, increase socioeconomic inequalities. Structural interventions, such as food procurement policies and restrictions on unhealthy foods in schools, show equal or greater benefit for lower socioeconomic groups. Many obesity prevention interventions belong to the agento-structural types of interventions, and account for the environment in which health behaviors occur, but they require a level of individual agency for behavioral change, including workplace design to encourage exercise and fiscal regulation of unhealthy foods or beverages. Obesity prevention interventions differ in their effectiveness across socioeconomic groups. Limiting further increases in socioeconomic inequalities in obesity requires implementation of structural interventions. Further empirical evaluation, especially of agento-structural type interventions, remains crucial.
authors.affiliation: Kathryn Backholer, Anna Peeters, and Alison Beauchamp are with the Obesity and Population Health Unit, Baker IDI Heart and Diabetes Institute, Melbourne, Australia. Kylie Ball is with the Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, Australia. Gavin Turrell is with the School of Public Health and Social Work/Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia. Jane Martin is with the Obesity Policy Coalition, Melbourne, Australia. Julie Woods is with the School of Exercise and Nutrition Science, Deakin University.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Backholer
authors.forename: Alison
authors.initials: A
authors.lastname: Beauchamp
authors.forename: Kylie
authors.initials: K
authors.lastname: Ball
authors.forename: Gavin
authors.initials: G
authors.lastname: Turrell
authors.forename: Jane
authors.initials: J
authors.lastname: Martin
authors.forename: Julie
authors.initials: J
authors.lastname: Woods
authors.forename: Anna
authors.initials: A
authors.lastname: Peeters
mesh_terms: D001837:Body Weights and Measures; D004777:Environment; D015438:Health Behavior; D006291:Health Policy; D006293:Health Promotion / Q000458:organization & administration*; D054624:Health Status Disparities; D006801:Humans; D009765:Obesity / Q000517:prevention & control*; D012959:Socioeconomic Factors