Preferred Child Obesity Message Frames and Their Perceived Strength among State Policymakers

Health message framing, including gain or loss frames, can influence perceptions of child health messaging. It is unknown how characteristics such as political party and education may impact policymakers' message frame preference and perceived strength of child obesity messages. The purpose of this study was to examine preferred child obesity message frame, perceived strength of child obesity messages, and group differences among state policymakers. A cross-sectional online survey was administered in-person to state representatives and senators via electronic tablet between February and May, 2019, at a midwest State Capitol building. Participants were asked their message frame preference and perceived strength of child obesity messages related to long-term health, school, geographic region, military readiness, cost-savings, and the workforce. They were also asked who was responsible for preventing child obesity and strategies to prevent it. Data were analyzed descriptively and via chi-square tests for group differences. One hundred fifteen state policymakers completed the survey. Participants overall favored gain-framed messages, which were perceived as stronger than loss-framed. Parents were viewed as most responsible overall for preventing child obesity, with Republicans (vs. Democrats; χ² = 8.54; p = 0.008) and those with less education (vs. more; χ² = 5.97; p = 0.029) perceiving them as more responsible (χ² = 8.54; p = 0.008). Democrats viewed the food industry as more responsible (χ² = 11.4; p = 0.001) than Republicans. Increasing physical activity, nutrition education, and fresh fruits and vegetables in schools were the most preferred prevention strategies. Child health advocates should consider using gain-framed messages related to child obesity when communicating with policymakers, and targeting their preferred strategies may enhance policy development.