Health Policy and Planning Advance Access originally published online on October 19, 2007
Health Policy and Planning 2007 22(6):363-374; doi:10.1093/heapol/czm030
Translating research into action: a case study on trans fatty acid research and nutrition policy in Costa Rica
1Behavioral Research Program, National Cancer Institute, Bethesda, MD, USA.
2Program in Public Health Nutrition, Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
3Costa Rican Institute for Research and Education on Nutrition and Health (Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud), Ministry of Health, Costa Rica.
4Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, USA.
*Corresponding author. Health Promotion Research Branch, Behavioral Research Program, National Cancer Institute, 6130 Executive Blvd MSC 7335, Bethesda, MD 20892–7335, USA. Tel: +1 301 657 2101. Fax: +1 301 480 2087. E-mail: colonramosu{at}mail.nih.gov.
Mounting epidemiologic evidence worldwide has fostered policy regulation of industrially made trans fatty acids (TFA) in several developed countries. Despite country-specific evidence about the effects of TFA on cardiovascular disease in Costa Rica, policy regulation has yet to occur. This qualitative study uses a conceptual framework to identify factors that may impede or promote the process of translation of scientific evidence about TFA into policy in the specific context of Costa Rica.
We used single case-study methodology to integrate two sources of data: review of relevant internal documents and in-depth, semi-structured interviews with 21 respondents purposively sampled from three sectors: the cooking oil and food industries, research and academia, and government entities. Content analysis, guided by a conceptual framework of research utilization, revealed 68 emergent themes divided across four categories of analysis.
In brief, study participants perceived the political context suitable for discussing policies related to healthy fats. Nevertheless, TFA regulation was not part of the Costa Rican political agenda. Barriers perceived by respondents that impede knowledge translation included: (1) lack of awareness of in-country scientific studies on health effects of TFA; (2) lack of consensus or information about policy options (nutrition labelling, dietary guidelines, legislative mandates); (3) perceived distrust and disparate attitudes between sectors, believed by study participants to result in (4) limited collaboration across sectors.
Commissioned task forces and other mechanisms to foster research engagement and facilitate sustained interaction and systematic collaboration among government, food industry and researcher sectors appear crucial in the consideration and adoption of nutrition policy in Costa Rica and other emerging economies.
Key Words: Health policy, nutrition, Costa Rica, developing countries, trans fatty acids
Accepted for publication 9 July 2007.
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