ments obtained through discovery, and federal efforts at tort reform are all likely to shape the litigation environment over the next few years.

Prevention and Treatment Programs

In addition to the effects of product marketing, different environments, economic factors, and laws on health-related behaviors, there is also the strong and direct role played by individual efforts and planned interventions to improve health behaviors. The impact of specific interventions on public health success stories is described earlier in this paper. It is not the intent here to review the literature on the quality of the scientific evidence for changing dietary behaviors, but rather to highlight lessons from other public health areas that may have some utility for multiple health problems, and may be generalizable to preventing childhood obesity.

School-Based Interventions

As previously discussed, school-based programs appear to have robust and generalizable benefits to a number of public health programs, including oral health, motor vehicle safety, and tobacco control. With respect to tobacco use prevention programs, evidence has found them to be effective, especially those that have been conducted in coordination with comprehensive community and mass-media prevention programs (DHHS, 1994; Jago and Baranowski, 2004). It is likely that school-based nutrition and physical activity programs could be even more effective in preventing childhood obesity than school tobacco programs are in reducing tobacco use (Dietz and Gortmaker, 2001). This opinion is due to the fact that nutrition and physical activity behaviors are a normal part of every school day and public health approaches could be fairly easily adopted and implemented. Vending machine policies, school breakfast and lunch programs, and required physical activity programs are all significant components to childhood obesity prevention programs in which schools can play a constructive role.

Media Campaigns

Mass-media efforts that build on sophisticated marketing approaches can also be effective in improving dietary behavior and increasing physical activity levels among young people. In tobacco control, themes of tobacco industry manipulation, the health effects of involuntary smoking on nonsmokers, and graphic depictions of the harm of smoking among real people have proven to be effective (Hersey et al., 2004; Sowden and Arblaster, 2004). It is not clear whether these themes will be relevant for preventing



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement