Overview

The 2-day PEN virtual workshop on “Approaches to the evaluation of nutrition policies: state of the art, challenges and new directions” took place on March 25-26, 2021.

It was hosted by the Institute of Health Economics and Health Care Management at the Helmholtz Zentrum München in collaboration with the Department of Statistical Sciences “Paolo Fortunati” at the University of Bologna as part of the EU Joint Programming Initiative “A Healthy Diet For A Healthy Life” – Policy Evaluation Network (PEN).

Experts covered important topics on both, simulation modeling approaches (March 25) and ex-post econometric methods (March 26) that are used for the evaluation of dietary policies.

PROGRAMM AND PRESENTED TOPICS

Day 1 Thu. 25 March:  EX-ANTE SIMULATION MODELLING

Moderated by Michael Laxy and Karl Emmert-Fees (Helmholtz Zentrum München (HMGU)

Simulation modeling for the economic evaluation of population-based dietary policies - Karl Emmert-Fees (Helmholtz Zentrum München))

This talk presented findings from a systematic scoping review on simulation modeling methods used for the evaluation of dietary policies. Emphasis was on evaluated nutritional targets, policy types, modeled pathways and corresponding limitations. Based on the reviewed literature several recommendations and challenges were derived.

Karl Emmert-Fees is a doctoral researcher with Prof. Michael Laxy at the Research Unit Public Health and Prevention at Technical University Munich and the Institute for Health Economics and Healthcare Management at the Helmholtz Zentrum München. He is currently part of the PhD program “Medical Research in Epidemiology and Public Health” of the Munich Medical Research School at LMU Munich. The topic of his thesis is the application of simulation modeling for the economic evaluation of population-based dietary policy in Europe. He received his Master of Science in Public Health from LMU Munich.

See the slides presented  by Karl Emmert-Fees

Cost Effective Strategies to Prevent Child and Adult Obesity and Improve Population Health - Steven Gortmaker (Harvard University)

This talk reviewed recent findings from the CHOICES research group. Results include: projecting future obesity rates and health disparities in the United States; evaluating the impact of recent dietary policy changes; cost-effectiveness modeling of sugary beverage taxes in the United States, and impact on population health and health disparities. 

Steve Gortmaker is Professor of the Practice of Health Sociology at the Harvard Chan School of Public Health. He directs the Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES). CHOICES is working to identify cost-effective prevention policies and programs that will help more children achieve and maintain a healthy weight and improve health equity. These studies use cost-effectiveness analysis to compare the costs and outcomes of different policies and programs, and microsimulation models to create virtual populations based on large databases (e.g. US Census, National Health and Nutrition Examination Surveys, Behavioral Risk Factor Surveillance System). He and the CHOICES team have been conducting cost-effectiveness analyses with 22 state and city health departments in the US. Published studies include a four-paper obesity modeling series in the Lancet, and CHOICES papers in Health Affairs, Preventive Medicine, Pediatrics, Obesity, and the New England Journal of Medicine. He and colleagues have designed interventions that are low cost, easily disseminated, and sustainable, and evaluated them via randomized trials and quasi-experimental designs.

See the slides presented by Steve Gortmaker

Quantifying the potential effectiveness, cost-effectiveness, and equity of food policies around the world: examples from salt reformulation and sugar labelling policies - Chris Kypridemos (University of Liverpool)

This talk drew on the recent experiences of the NCD Prevention and Food Policy Research Group at the University of Liverpool in modelling the wider impact of food policies with some emphasis on propagating uncertainty, model validation, and transparency. 

Chris Kypridemos is a Senior Lecturer in Public Health Informatics & Data Science with expertise in dynamic stochastic microsimulation. Originally from a clinical background, he gained his Master in Public Health from Dundee University with distinction in 2013 and his PhD in Public Health modelling from the University of Liverpool in 2016. He uses data to generate actionable evidence for decision-makers through epidemiological and policy modelling. Chris has developed the IMPACTNCD microsimulation framework that has been used in England and the US to quantify the effectiveness, cost-effectiveness, & equity of a wide range of interventions and public health policies.

See the slides presented by Chris Kypridemos

Challenges in modelling food consumption and obesity for policy analysis - Franco Sassi (Imperial College London)

The talk illustrated and provided a discussion of key challenges involved in modelling the complex relationships between food consumption, obesity and health in the context of simulation models designed to assess policy impacts. Challenges include accounting for both direct health impacts of food intakes and impacts mediated by adiposity; translating measures and characterisations of food intakes into health impacts; accounting for social multiplier effects, especially at the household level; accounting for food environment dimensions, including food prices.

Professor Franco Sassi graduated with a degree in economics and a doctorate in health economics from the University of London in 2000. He is currently Chair in International Health Policy and Economics and Director of the Centre for Health Economics & Policy Innovation at Imperial College Business School, and a Senior Health Economist at the OECD (on leave). Previously he was Senior Lecturer in Health Policy at the London School of Economics and Political Science (LSE), and held adjunct and visiting positions at a number of universities in the US, including the University of California at Berkeley, Harvard University, the University of California at San Francisco, and Duke University — as well as at the at the Université de Montréal in Canada and at the Università Cattolica del Sacro Cuore in Rome. Professor Sassi's research focuses on economic analysis of health services, the economics of chronic disease prevention and measuring inequalities in access to healthcare. He is Principal Investigator and Project Coordinator on the European Commission funded Horizon 2020 project Science & Technology in childhood Obesity Policy (STOP). He is the lead author of Obesity and the Economics of Prevention: Fit not Fat (OECD and Edward Elgar, 2010), editor and author of Tackling Harmful Use: Economics and public health policy (OECD, 2015) and Promoting Health, preventing disease: The economic case (OUP, 2015); and author of a large number of publications on the economics of chronic disease prevention. He was awarded a 2000–2001 Commonwealth Fund Harkness Fellowship in Health Care Policy.

See the slides presented by Franco Sassi

Day 2 Fri. 26 March: EX-POST ECONOMETRIC METHODS

Moderated by Mario Mazzochi and Sara Capacci (University of Bologna (UNIBO)

Welcome and introduction to state of the art in quasi-experimental methods with application to food and physical activity - Sara Capacci (UNIBO) and Mario Mazzochi (UNIBO)

How well targeted are soda taxes? - Pierre Dubois (Toulouse School of Economics)

Using micro longitudinal data, this talk showed how to exploit the panel dimension to estimate individual specific preferences in demand models. This can be useful for the evaluation of the targeting of soda taxes because we can relate preferences and counterfactual predictions to individual characteristics. An application to the UK showed that soda taxes are relatively effective at targeting the sugar intake of the young, are less successful at targeting the intake of those with high total dietary sugar, and are unlikely to be strongly regressive especially if consumers benefit from averted internalities.

Pierre Dubois is professor of Economics at TSE, fellow of the CEPR and of the Institute for Fiscal Studies in London. Pr. Dubois has been visiting professor at the Department of Economics of Harvard University (2015, 2019-220), Managing Editor of the International Journal of Industrial Organization from 2013 to 2018, Scientific Director of the Toulouse School of Economics during 2015-2019 and is currently associate editor of the European Economic Review and Co-Editor of the Journal of the European Economic Association (2021).

See the slides presented by Pierre Dubois

The talk focused on distributional changes in diet quality over the last 30 years in the United States, paying particular attention to the role of product reformulation in changing diet quality. This is relevant for thinking producers' responses to soda taxes and other regulations. Estimates of the long run potential of soda taxes and other regulations to raise revenues and improve health depend critically on assumptions about producer behavior

Timothy Beatty is a Professor in the Department of Agricultural and Resource Economics at the University of California, Davis.  He studies the economics of food, nutrition, and health.  He is currently the Director of the Gifford Center for Population Studies and a Director of the Agricultural and Applied Economics Association.  He was previously the Editor of the American Journal of Agricultural Economics.

See the slides presented by Timothy Beatty

This workshop section focused on: 1) evaluating the impact of SSB taxes using observational data, 2) defining counterfactual scenarios to estimate treatment effects for different outcomes, 3) methods/challenges in quasi-experimental evaluations, and 4) choosing the right outcomes for quasi-experimental methods.

David Frisvold is an Associate Professor in the Department of Economics and a Senior Research Fellow and the Director of Social and Education Policy Research in the Public Policy Center at the University of Iowa. He is a NBER Research Associate and IZA Research Fellow.  He has extensive experience using different types of data to evaluate the impact of taxes on sugary beverages throughout the United States on prices, product availability, purchases, and consumption.

See the slides presented by David Frisvold

https://www.helmholtz-muenchen.de/igm/service/pen-workshop/index.html

• Webinar: Measuring policy actions for healthy and sustainable food and physical activity environments - A SIG Policies and Environment webinar, webinar led by PEN and the International Society of Behavioral Nutrition and Physical Activity (ISBNPA), 22 September 2020. Find more information and the recording of this webinar here.

• Virtual joint workshop: Disrupting childhood obesity trends across Europe; a joint symposium of CO-CREATE, STOP and PEN 
      - CO-CREATE: CO-CREATE: Cocreating policies with youth in Europe (Professor Knut-Inge Klepp)
      - STOP: Strengthening evidence and engaging different actors (Professor Franco Sassi)
      - PEN: Monitoring and accountability of public policies across Europe (Professor Wolfgang Ahrens)
  at the European and International Congress on Obesity (ECO-ICO 2020), 2 Septemer 2020.

• Virtual joint symposium „Addressing health policy and research at the STOP/ CO-CREATE/ PEN Symposium”, 30^th June 2020. A virtual joint symposium of the STOP, CO-CREATE and PEN was organized with key members of the three consortia as an opportunity for the projects to collaborate and share updates on progress to date. Quotes from the coordinators of the STOP, CO-CREATE and PEN project, as well as the link to the recorded symposium on 30th June 2020 can be found at the website of the STOP project here.

• Identifying the 'best buys' in public policy for promotion of physical activity and healthy nutrition; Can we do it? If yes, How? Why? and What we can learn from each other. Pre-Conference Workshop at the 19th Meeting of the International Society of Behavioral Nutrition and Physical Activity (SBNPA) - Advancing Behaviour Change Science, Auckland, New Zealand, 17-20 June 2020.

• What can we learn from food and physical activity policy evaluation to maximise impact on health and sustainability: The intersection between research and practice. Symposium at the 19th Meeting of the International Society of Behavioral Nutrition and Physical Activity (ISBNPA) - Advancing Behaviour Change Science. Auckland, New Zealand, 17-20 June 2020.

• A study on implementation of food-related policies in Poland using the Healthy Food Environment Policy Index. Speaker: Piotr Romaniuk. Talk at PEN session at the 16th World Congress on Public Health /EUPHA 2020 - Public health for the future of humanity: analysis, advocacy and action, virtual meeting, Rome, Italy, October 2020.

• Benchmarking the implementation of recommended food environment policies in Norway using the Healthy Food Environment Policy Index (Food-EPI). Speaker: Liv Elin Torheim. Talk at PEN session at the 16th World Congress on Public Health /EUPHA 2020 - Public health for the future of humanity: analysis, advocacy and action, virtual meeting, Rome, Italy, October 2020.

• Has the Netherlands created a healthy food environment for its citizens? Application of the Food Environment Policy Index (Food-EPI). Speaker: Sanne Djojosoeparto. Talk at PEN Session at the 16th World Congress on Public Health /EUPHA 2020 - Public health for the future of humanity: analysis, advocacy and action, virtual meeting, Rome, Italy, October 2020.

• Evaluating food-related policies in Germany using the Food Environment Policy Index. Speaker: Karin Geffert. Talk at PEN session at the 16th World Congress on Public Health /EUPHA 2020 - Public health for the future of humanity: analysis, advocacy and action, virtual meeting, Rome, Italy, October 2020.

• Has the European Union created a healthy food environment for its citizens? Application of the Food Environment Policy Index (EPI). Speaker: Maartje Poelman. Talkt at PEN session at the 16th World Congress on Public Health /EUPHA 2020 - Public health for the future of humanity: analysis, advocacy and action, virtual meeting, Rome, Italy, October 2020.

• Political framework for nutrition in Germany: A political field analysis with an experts survey. Speaker: Peter von Philipsborn. Talk at the 36th Annual Meeting of the German Association for the Study of Obesity, Leipzig, Germany, June 2020.

• Public acceptability of a sugar-sweetened beverages tax and its associated factors in the Netherlands. Speaker: Michelle Eykelenboom. Talk at the 16th World Congress on Public Health /EUPHA 2020 - Public health for the future of humanity: analysis, advocacy and action, virtual meeting, Rome, Italy, October 2020. 

• Key indicators for harmonized European population health surveillance: an iterative approach. Speaker: Stefanie Do. Talk at the 16th World Congress on Public Health /EUPHA 2020 - Public health for the future of humanity: analysis, advocacy and action, virtual meeting, Rome, Italy, October 2020.

• Health surveillance indicators: what is available in European data sets for policy evaluation?. Speaker: Isobel Stanley. Talk at the 16th World Congress on Public Health /EUPHA 2020 - Public health for the future of humanity: analysis, advocacy and action, virtual meeting, Rome, Italy, October 2020.

• Systematic review examining the evidence for impact of school policies on physical activity. Speaker: Catherine Woods. Talk at the 16th World Congress on Public Health /EUPHA 2020 - Public health for the future of humanity: analysis, advocacy and action, virtual meeting, Rome, Italy, October 2020.

• Evaluation of policy measures to promote a healthy diet and physical activity – The PEN Project. Speaker: Wolfgang Ahrens. Talk at the 16th World Congress on Public Health /EUPHA 2020 - Public health for the future of humanity: analysis, advocacy and action, virtual meeting, Rome, Italy, October 2020.

• Has the European Union created a healthy food environment for its citizens? Application of the Food Environment Policy Index (EPI). Speaker: Sanne Djojosoeparto. Talk at the European and International Congress on Obesity, Dublin, Ireland, September 2020.

• A Physical Activity Policy Audit of four PEN countries: What can we learn for sustainability and health promotion? Measuring policy actions for healthy and sustainable food and physical activity environments. Speaker: Sven messing. At the SIG Policies and Environment webinar,PEN/ISBNPA, 22 September 2020.

• Building a systems map of determinants of dietary intake in low-income groups as a basis for health equity policies. Speaker: Alexia Sawyer. Talk at the Joint STOP/ CO-CREATE/ PEN symposium, virtual Conference, June 2020.

• Policy impact evaluation: Simulation modeling and quasi-experimental methods. Spaeker: Michael Laxy. Talk at the Joint STOP/ CO-CREATE/ PEN symposium, virtual Conference, June 2020.

• Monitoring and benchmarking government policies and actions to improve the healthiness of food environments in Europe: Progress on Food Environment Policy Index (Food-EPI) in Europe. Speaker: Janas Harrington. Talk at the Joint STOP/ CO-CREATE/ PEN symposium, virtual Conference, June 2020.

• Talk based on published article” Public acceptability of a sugar-sweetened beverage tax in the Netherlands”. Speaker: Michelle Eykelenboom. Invited talk at the National Sugar Challenge 2020, Online, Netherlands, June 2020.

• Politische Rahmenbedingungen für Ernährung in Deutschland: Eine Politikfeldanalyse mit Expertenbefragung. Speaker: Peter von Philipsborn. Talk at the 36th Annual Meeting of the German Association for the Study of Obesity, Leipzig, Germany, June 2020.

• The Food–Environment Policy Index (EPI): monitoring and benchmarking government policies and actions to improve the healthiness of food environments in Ireland. Speaker: Janas Harrington. Talk at the 24th Annual Health Promotion Conference, virtual Conference, Ireland, June 2020.

• Building a literature-based systems map of determinants of dietary intake in low-income groups as a basis for health equity policies. Speaker: Alexia Sawyer. Talk at the ISBNPA Xchange, virtual meeting, June 2020.

• The Work of the WHO CC for Physical Activity and Public Health at FAU. Speaker: Peter Gelius. Invited talk at the Kick-off meeting of the EU-sponsored LOGOPAS project. Cluj-Napoca, Romania, 4-5 February 2020.

• The Food – Environment Policy Index (Food-EPI): monitoring and benchmarking government policies and actions to improve the healthiness of food environments in Ireland: Process Outline. Speaker: Janas Harrington. Talk at the SPHeRE Conference, Dublin, February 2020.

• Policy implementation evaluation: a stakeholder-centred approach. Author: Daniel Scheller. 16th World Congress on Public Health /EUPHA 2020 - Public health for the future of humanity: analysis, advocacy and action, virtual meeting, Rome, Italy, October 2020.

• A qualitative study of stakeholder views on the effects of a sugar-sweetened beverages tax on the budgets, dietary intake, and health of lower and higher socioeconomic groups in the Netherlands. Author: Carlijn Kamphuis. 16th World Congress on Public Health /EUPHA 2020 - Public health for the future of humanity: analysis, advocacy and action, virtual meeting, Rome, Italy, October 2020.

• Developing a literature-based systems map of determinants of dietary intake in low-income groups. Author: Alexia Sawyer. 16th World Congress on Public Health /EUPHA 2020 - Public health for the future of humanity: analysis, advocacy and action, virtual meeting, Rome, Italy, October 2020.

• Talk Sub-national structures matter when evaluating physical activity promotion: Lessons from Germany. Author: Sarah Forberger. 16th World Congress on Public Health /EUPHA 2020 - Public health for the future of humanity: analysis, advocacy and action, virtual meeting, Rome, Italy, October 2020.

• Policy Evaluation: a comprehensive European approach by the JPI HDHL Network PEN. Author: Antje Hebestreit. European and International Congress on Obesity (ECO-ICO 2020), Dublin, Ireland, 17-20 May 2020.

• Evaluation and prioritization on food environment policies in Norway using th Healthy Food Environment Policy Index (Food-EPI). Author: Liv Elin Torheim. 12th Nordic Nutrition Conference, Helsinki, Finland, 8-12 June 2020.

• Policy impact indicators. Expert workshop at the Robert Koch Institute. Berlin, Germany, 26-27 September 2019.

• Taxation policies regarding sugar-sweetened beverages (SSB) and other junk foods. Learning from experience. Workshop at the 4th V4 Public Health Conference. Debrecen, Hungary, 25 April 2019.

• Health-enhancing physical activity (HEPA) policy audit tool (PAT) Training. HEPA-PAT training workshop at the Kick-off Meeting of the PEN project. Bremen, Germany, 5 February 2019.

• Overview of Food Environment Policy Index (Food EPI) Processes. Food-EPI training workshop at the Kick-off Meeting of the PEN project. Bremen, Germany, 4 February 2019.

• European Food Environment Policy Index (Food EPI) Roadmap development. Food-EPI training workshop at the Kick-off Meeting of the PEN project. Bremen, Germany, 4 February 2019.

• Workshop for stakeholders consultation. Stuttgart, Germany, 4 February 2019.

• Best food policy practices.  Road to Framework Convention on Food Systems: tackling global syndemic with food policy. Speaker: Piotr Romaniuk. Invited talk at the pre-conference workshop of the 12th EPH Conference 2019. Marseille, France, 20-23 November 2019.

• An emerging trend to tax sugar sweetened beverages and other junk foods: overregulation or an effective way to modify dietary behaviours? Speaker: Piotr Romaniuk. 12th EPH Conference 2019. Marseille, France, 20-23 November 2019.

• Identifying best practices in junk food taxation and other food policies. Selected examples and their assessment. Speaker: Piotr Romaniuk. 12th EPH Conference 2019. Marseille, France, 20-23 November 2019.

• Public policies addressing health-related behaviours in Europe. Speaker: Wolfgang Ahrens. Expert workshop to identify indicators important for monitoring and surveillance in young and adult populations. Berlin, Germany, 26-27 September 2019.

• The Physical activity and sedentary behaviour side of PEN. Speaker: Catherine Woods. Invited talk at the 15th Annual meeting and 10th conference of HEPA Europe. Odense, Denmark, 28-30 August 2019.

• Political and social acceptability of a sugar-sweetened beverages tax: a mixed-method systematic review and meta-analysis. Speaker: Michelle Eykelenboom. 18th Meeting of the International Society of Behavioral Nutrition and Physical Activity (ISBNPA). Prague, Czech Republic, 7 June 2019.

• The Work of the WHO CC for Physical Activity and Public Health at FAU. Speakers: Peter Gelius, Karim Abu-Omar. Invited talk at the meeting of the Workgroup “Physical activity in everyday life” of the German Ministry of Health. Berlin, Germany, 7 May 2019.

• Public policies addressing health-related behaviours in Europe
  Policy mapping and EPI development. Speaker: Janas Harrington. Invited talk at the JPI HDHL 5th International Conference, Brussels, Belgium, 20 February 2019.

• European Project Policy Evaluation Network (PEN): geriatric point of view. Roma Krzymińska-Siemaszko et al. 15th International Congress of the European Geriatric Medicine Society (EuGMS). Krakow, Poland, 25-27 September 2019.
  

• Effectiveness of Existing Policies for Lifestyle Interventions – Policy Evaluation Network – WP4 Implementation. Daniel Scheller et al. 8th Conference of the European Initiative for Exercise in Medicine (EIEIM). Amsterdam, Netherlands, 20-21 September 2019.

• Sustainable Urban Mobility Plans (SUMPs) - Fostering Sustainable and Active Transport in Copenhagen. Noah Peters & Lucia Reisch. ‘Festival for the Global Goals’ organised by Frederiksberg Municipality and hosted by Copenhagen Business School (CBS), Copenhagen, Denmark, 13-14 September 2019.

• Siec ewaluacji polityk – projekt europejski; zadania Uniwersytetu Medycznego w Poznaniu (European Project Policy Evaluation Network: from the perspective of Poznan University of Medical Sciences). Katarzyna Wieczorowska-Tobis et al. National conference for dieticians. Poznan, Poland, 2 March 2019.

• Health Policies, Theories and Implementation Research. Pre-PEN Workshop at the 7th European Exercise is Medicine Conference, Warsaw, Poland, 21-23 September 2018.

• Policy Evaluation Network (PEN). Speaker: Catherine Woods. Invited talk at the ISPAH conference. London, United Kingdom, 15-17 Oktober 2018.

• Policy Evaluation Network (PEN). Speaker: Catherine Woods. Invited talk at the working group of the European network for the promotion of health-enhancning physical activity (HEPA). Video conference, 11 June 2018.

• Effectiveness of existing policies for lifestyle interventions - Policy Evaluation Network (PEN). Speaker: Lucia Reisch. Internal event at the Copenhagen Business School. Copenhagen, Denmark, 23 March 2018.

• Effectiveness of existing policies for lifestyle interventions - Policy Evaluation Network (PEN). Speaker: Antje Hebestreit & Sarah Forberger. Internal event ("Jour-Fixe") at BIPS, Bremen, Germany, 5 February 2018.