Alexandra C. Lewin (2009, January). Whose responsibility? The role of the federal government in preventing childhood obesity: Perspectives of organizations, congressional staffers, and parents. Doctoral dissertation, Cornell University.

Abstract: This dissertation examined three stakeholder groups and their perspectives about the role of the federal government in preventing childhood obesity. The three stakeholder groups included organizations involved in childhood obesity, U.S. Congressional staffers working on health and agriculture policy, and low-income African-American parents of elementary school children in Washington, DC. Frequently at the core of the debate over the role of the federal government is the notion of personal responsibility � whether preventing childhood obesity is limited to individual decisions, whether there might be larger systemic issues that shape individual behavior, and when it may be the government�s responsibility to protect our children�s public health. The research completed to date has focused more on either the media�s use of the personal responsibility frame and public opinion studies that have gathered only a general understanding of individual support for/against pre-selected obesity frames and policies. The underlying perspectives shaping opinions, and the values and subjectivity embedded within these debates and policy options, have been sparsely documented. Rather than view nutrition as objective, where policy outcomes are the result of pure scientific debate, this research considers the policy process itself and within it the nuanced opinions, strategies employed, and values invoked by these three sectors. A discourse analysis to define and examine interpretive packages was completed to examine organizations� press release language in response to one or more of the four obesity-related Institute of Medicine reports. A Q study, using statements largely from the aforementioned press releases, and follow-up interviews, were completed with individual Congressional staffers. A Q study was also completed with each parent, and follow-up focus groups were completed with groups of parents. Two interpretive packages, with two sub-emphases, emerged from the organization study. The Multiple Responsibility package contained both Political Responsibility and Everyone�s Responsibility sub-emphases. The Self-Reliance package contained both Self-Regulation and Consumer Sovereignty sub-emphases. The Congressional staffer Q study revealed three perspectives: Government Action Advocates, Select Government Action Advocates, and Personal Responsibility Advocates. The Parent Q study also revealed three perspectives: Parents + Specific Government, Parents + General Government, and Government + Other.

Alexandra Lewin received her undergraduate degree from Cornell University in 2004 and a Masters in Public Administration from the Cornell Institute for Public Affairs in 2005. Her thesis focused on the impact of different sugar trade policies on least-developed countries. As part of her MPA, she attended Cornell-in-Washington and worked as an Agriculture Fellow in the U.S. Senate. She is currently a Nutrition Policy Fellow at the Center for Science in the Public Interest.

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