Oral Presentation Australian & New Zealand Obesity Society 2016 Annual Scientific Meeting

To nanny or nudge to prevent obesity? An analysis of the ‘intrusiveness’ of stakeholder recommendations to the Australian Government. (#60)

Emily Haynes 1 , Dianne Reidlinger 1 , Roger Hughes 2
  1. Bond University, Palm Beach, QLD, Australia
  2. Public Health, Massey University, Auckland, New Zealand

The ethical concern of a ‘nanny state’ averts governments from implementing cohesive policies for obesity prevention. This study explored the similarities and differences in policy options, proposed by different stakeholder groups, through constructs of intrusiveness and autonomy. We conducted a content analysis of submissions to the Australian Government’s Inquiry into Obesity (2009), sub-grouped by setting, target behaviour and stakeholder, and categorised by intrusiveness to choice. Each recommendation was labelled as autonomy-positive, neutral or negative according to an existing ethical framework (1). Submissions (n=158) were made by academia (23%), industry (18%), public health specialists (16%), NGOs (15%), consumers (13%), public providers (11%) and policymakers (5%). The findings suggest the degree of influence to autonomy, is significantly associated with the frequency of recommendation (<0.001). Enhancing autonomy for dietary change was the most frequent recommendation in all groups. Options which reduced autonomy were least frequently recommended in every setting; but more likely in schools (28%, n=26). Cross-group comparison suggests a significant difference in the frequency of autonomy-negative, neutral, and positive recommendations made between the stakeholder groups (p<0.05). Consumers recommend reducing individual autonomy to the greatest extent, whilst industry and policy makers suggest this least frequently. To improve dietary choice, industry were the only group not to recommend diminishing autonomy. To increase physical activity, consumers were the only group to recommend reducing autonomy more frequently than enhancing autonomy. This analysis supports the relevance of these constructs to obesity prevention policy options. The acceptable level of intrusiveness may vary according to setting, target behaviour and stakeholder. The findings emphasise the diversity of perspectives involved in obesity, and significance of industry in influencing policy decisions. Given the consensus across stakeholder groups favouring policies which enhance autonomy, considering the influence of policy on autonomy could provide a tool for governments to re-frame action for obesity prevention.

 

  1. (1) Griffiths & West (2015) http://dx.doi.org/10.1016/j.puhe.2015.08.007