• Brenda Robles and Tony Kuo.
• Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, California, USA.
• BMJ Open. 2017 Jan 13; 7 (1): e012654.

BackgroundSince 2010, federal and local agencies have invested broadly in a variety of nutrition-focused policy, systems and environmental change (PSE) initiatives in Los Angeles County (LAC). To date, little is known about whether the public supports such efforts. We address this gap in the literature by examining predictors of support for a variety of PSEs.MethodsVoters residing in LAC (n=1007) were randomly selected to participate in a cross-sectional telephone survey commissioned by the LAC Department of Public Health. The survey asked questions about attitudes towards the obesity epidemic, nutrition knowledge and behaviours, public opinions about changing business practices/government policies related to nutrition, and sociodemographics. A factor analysis informed outcome variable selection (ie, type of PSEs). Multivariable regression analyses were performed to examine predictors of public support. Predictors in the regression models included (primary regressor) community economic hardship; (control variables) political affiliation, sex, age, race and income; and (independent variables) perceptions about obesity, perceived health and weight status, frequency reading nutrition labels, ease of finding healthy and unhealthy foods, and food consumption behaviours (ie, fruit and vegetables, non-diet soda, fast-food and sit-down restaurant meals).Results3 types of PSE outcome variables were identified: promotional/incentivising, limiting/restrictive and business practices. Community economic hardship was not found to be a significant predictor of public support for any of the 3 PSE types. However, Republican party affiliation, being female and perceiving obesity as a serious health problem were.ConclusionsThese findings have implications for public health practice and community planning in local health jurisdictions.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

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