Abstract
OBJECTIVES: This study aimed to assess expert stakeholder perceptions on the impact and feasibility of 21 national, state, and local nutrition policies for cancer prevention in the US. METHODS: We distributed a survey to members of professional groups in the field of nutrition, cancer prevention, and public policy through direct email contact, organizational email/e-newsletter, and listservs. The survey asked participants to rank the health impact and political feasibility of 21 nutrition policies across 5 domains: (a) taxes/subsidies, (b) labeling, (c) nutrition standards, (d) nutrition education, and (e) nutrition promotion in healthcare, based on a Likert scale (1 = least; 5 = most impactful or feasible). We compared the impact and feasibility scores for each policy and by levels of implementation (federal, state, or local). RESULTS: A total of 170 respondents provided complete responses, representing civil service employees (n = 92, 54.1%), employees of advocacy groups (n = 31, 18.2%), researchers (n = 19, 11.2%), healthcare professionals (n = 18, 10.6%), and others (n = 10, 5.9%). For perceived impact, policies with the highest impact scores were Medicare/Medicaid coverage of nutrition counseling for people with chronic conditions at the federal and state levels (mean ± SE: 4.25 ± 0.10); and policy with the lowest impact score was local tax on processed meat (2.90 ± 0.13). For perceived feasibility, policy with the highest feasibility score was federal subsidies on fruits, vegetables, and whole grains in Medicare/Medicaid (4.13 ± 0.09); and policy with the lowest feasibility score was federal tax on processed meat (1.86 ± 0.10). When the impact and feasibility were evaluated jointly, Medicare/Medicaid subsidies for fruits, vegetables, and whole grains and coverage of nutrition counseling received the highest scores, whereas taxes on processed meats or junk food received the lowest scores. CONCLUSIONS: Based on expert stakeholder perceptions, specific federal, state, and local government nutrition policies for cancer prevention have varying health impact and potential feasibility. Providing food subsidies and nutrition counseling in Medicare/Medicaid were considered the most jointly impactful and feasible, whereas taxing processed meat or junk food were least impactful and feasible. FUNDING SOURCES: This study was supported by NIH/NIMHD. SUPPORTING TABLES, IMAGES AND/OR GRAPHS: