Interagency Working Group Research Articles

Alignment of Children's Food Advertising With Proposed Federal Guidelines.

It is well established that children are exposed to food marketing promoting calorically dense, low-nutrient products. Reducing exposure to obesogenic marketing presents an opportunity to improve children's health. The purpose of this study was to determine the extent to which televised food advertising practices targeting children (aged ≤12 years) were consistent with guidelines proposed by a coalition of federal authorities known as the Interagency Working Group on Foods Marketed to Children (IWG). A sample of children's TV programming aired on five national broadcast networks and two cable channels (N=103 shows) was recorded February to April 2013. The sample contained 354 food ads. Advertised products were identified and categorized using industry classification codes and nutrient data obtained from manufacturers. Product compliance with IWG saturated fat, trans fat, added sugar, and sodium guidelines was evaluated. Analyses conducted in 2013 revealed that nearly all food ads (94%) met guidelines for trans fats; 68% and 62% met guidelines for sodium and saturated fat, respectively; and 20% complied with added sugar guidelines. Overall, 1.4% of all child-targeted food ads met all aspects of IWG guidelines. Nearly all food advertisements exceeded guidelines for at least one recommended nutrient to limit. Individually, conformity was high for guidelines for trans fats, moderate for sodium and saturated fats, and poor for added sugar. These findings suggest that child-targeted food advertising remains strongly biased toward less healthy options. Policymakers wishing to regulate food marketing should understand the amount and types of advertisements that children view.

Young key populations and HIV: a special emphasis and consideration in the new WHO Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations.

No abstract available. (Published: 26 February 2015) Citation: Baggaley R et al. Journal of the International AIDS Society 2015, 18(Suppl 1) :19438 http://www.jiasociety.org/index.php/jias/article/view/19438 | http://dx.doi.org/10.7448/IAS.18.2.19438

Examination of Federal Data Management Plan Guidelines

Data management plans as expectations of the grant proposal process are still fairly novel, and the expected format and content of these plans is still evolving. The objective of this research is to gain a greater understanding of the expected content for data management plans submitted as part of grant proposals to federal funding agencies. This paper examines federal funding agencies’ data management plan guidelines in relation to the broad elements of data management identified by the Interagency Working Group on Digital Data: Description, Impact, Content & Format, Protection, Preservation, Access, and Transfer of Responsibility. Specifically, statements in agencies’ guidelines were categorized into the most applicable category (or categories). The representation of each category within each agency’s guidelines was addressed, and the statements falling in each category were analyzed. Some categories, including Access and Preservation, were represented in all or nearly all of the guidelines examined. Other categories — Impact and Transfer of Responsibility — were rarely addressed. The expectations for data management plans are evolving and will likely continue to evolve as more agencies require them.

Minimum initial service package (MISP) for sexual and reproductive health in disasters.

This paper is based on a presentation given at the Evidence Aid Symposium, on 20 September 2014, at Hyderabad, India. The paper provides background about how the sexual and reproductive health (SRH) got conceived as a humanitarian health response that adopts human right approach, based on core principles driven by needs of adolescent girls and women, and having respect for their values, ethics and morals. Good practices across nations documented by Inter-Agency Working Groups (IAWGs) on Reproductive Health in Humanitarian Crisis has supported the provision of essential SRH care services to adolescent girls and women in humanitarian crisis and in disasters. Secondary desk review is used to document the lessons learnt and good practices followed and documents for SRH. These essential SRH care services are to be provided as "Minimum Initial Service Package (MISP)" for implementation at the outset of disaster. The Sphere Humanitarian Charter and Minimum Standards in Disaster Response incorporated the MISP for SRH as a minimum standard of care in disaster response with a goal to reduce mortality, morbidity and disability among populations affected by crises, particularly women and girls. Disaster prone countries are expected to roll out MISP to improve humanitarian response and emergency preparedness systems. The East Europe and Central Asia (EECA) region including India have rolled out MISP starting from 2011 (EECA) and from 2013-2014 onwards in India across cities such as Chennai, Patna, Bhubaneshwar, Kolkata, Faridabad and Calcutta. Across India, through these national and state level trainings, nearly 600 people from NGOs, institutions, and government agencies were developed as national level trainers and resource persons for MISP who could advocate for RH in emergencies, apply core techniques provided in the MISP, apply coordination skills for the implementation of MISP and develop an action plan to integrate RH and Gender Based Violence (GBV) into Disaster Management Plans of respective agencies. The way forward includes focusing on MISP distance learning module, integration of MISP in Health action plans, and integration into national disaster preparedness and contingency planning of respective agencies and departments and building capacity at various levels.

How to Deal with Hornets: The Administrative Procedure Act and the Social Cost of Carbon

This Note explores the extent to which the 2013 revision to the social cost of carbon (SCC) — a figure used in the cost-benefit analysis of federal rules involving carbon dioxide emissions conforms to the Administrative Procedure Act’s (APA) notice and comment procedure. The Note analyzes two precedents the 2013 SCC revision process set: (1) an agency will not re-notice a proposed rule when it substitutes an old SCC with a revised SCC in the final rule and (2) the interagency working group that calculates the SCC will not submit revised SCCs for independent notice and comment. This Note argues that these precedents, although likely permitted under present judicial interpretations of the APA, contribute to an uncertain regulatory environment for industries subject to carbon emissions regulation. This Note recommends that the Office of Information and Regulatory Affairs, a member of the interagency working group as well as the hub of executive oversight of the rulemaking process, should communicate more clearly and transparently about the SCC revision process, using the Federal Reserve System’s forward guidance communications strategy as a model.

It’s all about the data: Responding to international chemical, biological, radiological, and nuclear incidents

After digesting lessons from US operations during the Fukushima Daiichi accident in Japan, the White House National Security Council staff created several interagency working groups to examine procedural issues associated with responding to international chemical, biological, radiological, and nuclear (CBRN) incidents. What emerged were best practices and lessons learned designed to transform data to decisions across the many levels of government during an international CBRN incident for those people making life-saving and life-sustaining choices. Actions at both the strategic and operational levels are needed to enable a country to more effectively transfer its domestic response capabilities and infrastructure to an international consequence management response. International complications include varying organizational relationships and legal authorities; resource limitations in overseas jurisdictions; nonstandard sources and formats of information; differing public health and protection standards; and language barriers. The technical data needed for emergency personnel to safely and effectively respond to CBRN incidents are especially difficult to obtain, require specialized analytical tools to process, and demand particular procedures for sharing in an international context. Without addressing these issues up front, any country responding to a CBRN event beyond its borders may struggle to effectively respond.

On Not Revisiting Official Discount Rates: Institutional Inertia and the Social Cost of Carbon

Within the federal government, official decisions are a product of both substantive judgments and institutional constraints. With respect to discounting, current practice is governed by OMB Circular A-4 and the 2010 and 2013 technical support documents of the Interagency Working Group on the Social Cost of Carbon. Reconsideration of existing judgments must be subjected to a demanding process of internal review (and potentially to external review as well). Institutional constraints, including the need to obtain consensus, can impose obstacles to efforts to rethink existing practices, especially in an area like discounting, which is at once technical and highly controversial. Both decisions costs and error costs must be considered.

The Role of Civil Society in Recalibrating Conservation Science Incentives

The Role of Civil Society in Recalibrating Conservation Science Incentives

Foreword

Chronic health conditions pose a significant burden on the health of Americans, and the number of people with chronic conditions is rapidly rising. In 2000, 125 million Americans had ≥1 chronic conditions. That number rose to an estimated 145 million in 2009, and will further rise to a projected 171 million persons in 2030.1 In addition, today some 26% of adults and 68% of Medicare beneficiaries have ≥2 chronic conditions, and two thirds of total healthcare spending is devoted to their care.1–3 To address this growing challenge, the US Department of Health and Human Services (HHS) created the Multiple Chronic Conditions (MCC) Interagency Workgroup, a department-wide effort to address the needs of people with MCC and the health systems that serve them. The Strategic Framework on Multiple Chronic Conditions,4 released by HHS in 2010 as a result of this effort, is designed to address the challenge of MCC across the spectrum of all population groups through 4 overarching goals: Fostering healthcare and public health system changes to improve the health of individuals with multiple chronic conditions. Maximizing the use of proven self-care management and other services by individuals with multiple chronic conditions. Providing better tools and information to healthcare, public health, and social services workers who deliver care to individuals with multiple chronic conditions. Facilitating research to fill knowledge gaps about, and interventions and systems to benefit, individuals with multiple chronic conditions. The papers in this supplement, resulting from 45 MCC research grant awards made by the Agency for Healthcare Research and Quality (AHRQ) that make up the AHRQ MCC Research Network, offer important findings and commentary addressing these goals. First, although newer, more coordinated models of care now exist, such as the patient-centered medical home and accountable care organizations (goal 1), patients with MCC may be less likely than patients without MCC to benefit from these innovations, and more likely to experience fragmented care. Second, although much is required of many MCC patients in managing their care (goal 2), complex treatment regimens can often prove burdensome for patients to follow. The researchers in the MCC Research Network studied how health systems and healthcare professionals can better partner with patients living with MCC to create patient-centered management plans. The articles in the supplement also propose and describe useful tools for the care of patients with MCC (goal 3), including a new scale to measure patients’ ability to follow treatment regimens they are asked to follow and new treatment guidelines for the joint management of several comorbid conditions. Finally, many of the articles contribute to mapping the landscape for future MCC research (goal 4), through a new conceptual model, description of methodological challenges in MCC research and possible remedies, and intriguing descriptive data that poses new questions for future researchers. HHS remains committed to leading the way on improving the care of patients with MCC. Important opportunities in this area include rapid analyses of secondary data to further develop clinical guidelines for patients with MCC, inclusion of patients with MCC in clinical trials, and development of effective behavioral interventions and useful quality measures for front-line providers caring for patients with MCC. The National Institutes of Health recently issued 4 important new funding opportunity announcements in these areas.5–8 However, HHS cannot meet the needs of MCC patients alone. We welcome the participation of public and private sector stakeholders who wish to take a coleadership role in expanding knowledge about the care of this population and rapidly translating research findings into practice. We hope you enjoy these pages and look forward to working with public and private partners to better guide, empower, and support patients with MCC and the healthcare professionals who serve them. We applaud the 45 AHRQ grantees comprising the AHRQ MCC Research Network for their ground breaking accomplishments to date. ACKNOWLEDGMENTS The authors would like to thank Therese Miller, DrPH, the Project Officer at AHRQ, and the guest editors Mary Tinetti, MD and Jayasree Basu, PhD for their intellectual contributions and for making this supplement possible. They would also like to thank the Medical Care staff, including the Deputy Editors, Amy Rosen, PhD, and Robert Weech-Maldonado, MBA, PhD, the Publisher, Druanne Martin, the Managing Editor, Karen Doyle, and the Abt Associates team, Lisa LeRoy, MBA, PhD, Melanie Wasserman, PhD, Meghan Woo, PhD, and Emma Oppenheim, for their technical contributions and logistical support.

California’s ZEV Action Plan

Accelerating the market for zero-emission vehicles (ZEVs) is a cornerstone of California’s long-term transportation strategy to reduce localized pollution and greenhouse gas emissions, save consumers money, and enable continued economic growth. In addition to promoting these vehicle technologies, the state supports the development and use of low carbon fuels, as well as planning more environmentally sustainable communities that reduce unnecessary vehicle travel and congestion. In March 2012 Governor Brown signed an Executive Order calling for 1.5 million ZEVs by 2025. To identify specific actions that the State can take to reach this goal, the Governor’s Office with the input from a Governor’s Office Interagency Working Group developed the 2013 ZEV Action Plan.

Nutritional Content of Food and Beverage Products in Television Advertisements Seen on Children's Programming

Given the high rates of childhood obesity, assessing the nutritional content of food and beverage products in television (TV) advertisements to which children are exposed is important. TV ratings data for children 2-5 and 6-11 years of age were used to examine the nutritional content of food and beverage products in advertisements seen by children on all programming and children's programming (≥35% child-audience share). Nutritional content was assessed based on the federal Interagency Working Group (IWG) recommended nutrients to limit (NTL), including saturated fat, trans fat, sugar, and sodium. A total of 46.2% of 2- to 5-year-olds' and 43.5% of 6- to 11-year-olds' total exposure to food and beverage TV advertising was for ads seen on children's programming. Among children 2-5 and 6-11 years, respectively, 84.1 and 84.4% of ads seen on all programming and 95.8 and 97.3% seen on children's programming were for products high in NTL, and 97.8 and 98.1% of Children's Food and Beverage Advertising Initiative (CFBAI) company-member ads seen on children's programming were for products high in NTL, compared to 80.5 and 89.9% of non-CFBAI product ads. Most food and beverage products in TV ads seen by children do not meet the IWG nutrition recommendations and less than one half of such ads are covered by self-regulation. Products advertised on children's versus general-audience programming and by CFBAI- versus non-CFBAI-member companies are particularly of low nutritional quality, suggesting that self-regulation has not successfully protected children from exposure to advertising for unhealthy foods and that continued monitoring is required.

Refocusing the Agenda on Cardiovascular Guidelines

When he dedicated the new National Institutes of Health (NIH) Bethesda campus in October 1940, President Franklin D. Roosevelt declared, “We cannot be a strong nation unless we are a healthy nation. And so we must recruit knowledge and science in the service of national strength.”1 For more than 65 years, the National Heart, Lung, and Blood Institute’s (NHLBI’s) core mission has been, and continues to be, the generation and dissemination of knowledge and science with the goal of securing a healthy nation.2 Thirty-two years after Roosevelt’s NIH dedication, on July 26, 1972, Elliot Richardson, the Secretary of the US Department of Health, Education, and Welfare, announced the establishment of a “National Hypertension Program.”3 The program planned a 4-step approach to include agreement on standards and conditions for treatment, education of health workers, public dissemination of information, and research on the impact of the program on healthcare delivery. Richardson appointed 2 committees: one, the Hypertension Information and Education Advisory Committee, was to focus on the knowledge of hypertension and the communication of that knowledge, whereas the other, the Interagency Working Group, was to focus on exchange of information and coordination with the professional community. In 1977, the NHLBI issued the first of a number of clinical practice guidelines4 that would emerge from the National High Blood Pressure Education Program, as well as from other similar efforts such as the National Cholesterol Education Program. The NHLBI guidelines have covered a variety of topics, including, but not limited to, cholesterol, blood pressure, asthma, and von Willebrand disease.5 Over the years, these groundbreaking health education initiatives have successfully promoted marked increases in the public’s awareness of cardiovascular disease risk factors and contributed to the major reductions in coronary heart disease mortality observed during this period.6,7 …

Climate Impacts on Economic Growth as Drivers of Uncertainty in the Social Cost of Carbon

One of the central ways that the costs of global warming are incorporated into U.S. law is in cost-benefit analysis of federal regulations. In 2010, to standardize analyses, an Interagency Working Group (IAWG) established a central estimate of the social cost of carbon (SCC) of $21/tCO2 drawn from three commonly-used models of climate change and the global economy. These models produced a relatively narrow distribution of SCC values, consistent with previous studies. We use one of the IAWG models, DICE, to explore which assumptions produce this apparent robustness. SCC values are constrained by a shared feature of model behavior: though climate damages become large as a fraction of economic output, they do not significantly alter economic trajectories. This persistent growth is inconsistent with the widely held belief that climate change may have strongly detrimental effects to human society. The discrepancy suggests that the models may not capture the full range of possible consequences of climate change. We examine one possibility untested by any previous study, that climate change may directly affect productivity, and find that even a modest impact of this type increases SCC estimates by many orders of magnitude. Our results imply that the SCC is far more uncertain than shown in previous modeling exercises and highly sensitive to assumptions. Understanding the societal impact of climate change requires understanding not only the magnitude of losses at any given time but also how those losses may affect future economic growth.

Value of information for climate observing systems

The Interagency Working Group Memo on the social cost of carbon is used to compute the value of information (VOI) of climate observing systems. A generic decision context is posited in which society switches from a business as usual (BAU) emissions path to a reduced emissions path upon achieving sufficient confidence that a trigger variable exceeds a stipulated critical value. Using assessments of natural variability and uncertainty of measuring instruments, it is possible to compute the time at which the required confidence would be reached under the current and under a new observing system, if indeed the critical value is reached. Economic damages (worldwide) from carbon emissions are computed with an integrated assessment model. The more accurate observing system acquires the required confidence earlier and switches sooner to the reduced emissions path, thereby avoiding more damages which would otherwise be incurred by BAU emissions. The difference in expected net present value of averted damages under the two observing systems is the VOI of the new observing system relative to the existing system. As illustration, the VOI for the proposed space-borne CLARREO system relative to current space-borne systems is computed. Depending on details of the decision context, the VOI ranges from 2 to 30 trillion US dollars.

Comparison of nutrient profiling schemes for restricting the marketing of food and drink to children

The food and beverage industry have made voluntary pledges to reduce children's exposure to the marketing of energy-dense foods and beverages, and in 2012 announced the replacement of company-specific nutrient profiling schemes with uniform sets of criteria from 2013 (in the USA) and 2014 (in the European Union [EU]). To compare the proposed USA and EU nutrient profiling schemes and three government-led schemes, paying particular attention to the differences in sugar criteria. Food and beverage products permitted to be advertised in the USA under pre-2013 criteria were examined using five nutrient profiling schemes: the forthcoming USA and EU schemes and three government-approved schemes: the US Interagency Working Group (IWG) proposals, the United Kingdom Office of Communications (OfCom) regulations and the Danish Forum co-regulatory Code. Under the new USA and EU nutrient profiling schemes, 88 (49%) and 73 (41%) of a total of 178 products would be permitted to be advertised, respectively. The US IWG permitted 25 (14%) products; the Ofcom regulations permitted 65 (37%) and the Danish Code permitted 13 (7%). Government-led schemes are significantly more restrictive than industry-led schemes, primarily due to their tougher sugar criteria. The Danish Forum (93%) and USA IWG scheme (86%) are the most restrictive of the five examined. Further harmonization of nutrient profiling schemes is needed to reduce children's exposure to the promotion of energy-dense foods.

Update of the Healthy Eating Index: HEI-2010

The Healthy Eating Index (HEI) is a measure of diet quality in terms of conformance with federal dietary guidance. Publication of the 2010 Dietary Guidelines for Americans prompted an interagency working group to update the HEI. The HEI-2010 retains several features of the 2005 version: (a) it has 12 components, many unchanged, including nine adequacy and three moderation components; (b) it uses a density approach to set standards, eg, per 1,000 calories or as a percentage of calories; and (c) it employs least-restrictive standards; ie, those that are easiest to achieve among recommendations that vary by energy level, sex, and/or age. Changes to the index include: (a) the Greens and Beans component replaces Dark Green and Orange Vegetables and Legumes; (b) Seafood and Plant Proteins has been added to capture specific choices from the protein group; (c) Fatty Acids, a ratio of polyunsaturated and monounsaturated to saturated fatty acids, replaces Oils and Saturated Fat to acknowledge the recommendation to replace saturated fat with monounsaturated and polyunsaturated fatty acids; and (d) a moderation component, Refined Grains, replaces the adequacy component, Total Grains, to assess overconsumption. The HEI-2010 captures the key recommendations of the 2010 Dietary Guidelines and, like earlier versions, will be used to assess the diet quality of the US population and subpopulations, evaluate interventions, research dietary patterns, and evaluate various aspects of the food environment.

Minimum Initial Service Package (MISP) for reproductive health during emergencies: Time for a new paradigm?

Reproductive health (RH) has historically received low priority in the hierarchy of humanitarian response. Awareness of RH needs in emergencies began in the mid-1990s and led to the formation of the Inter-Agency Working Group (IAWG) for RH. Subsequently, the Minimum Initial Service Package (MISP), a set of guidelines for RH service delivery in crisis settings, was created. The objectives of the MISP are to facilitate the coordination of RH services, prevent and manage the consequences of sexual violence, reduce HIV transmission, minimize maternal and neonatal morbidity and mortality, and plan for comprehensive RH services in the post-crisis phase. Available documentation on MISP implementation is minimal, and reveals mixed success. Challenges include low MISP awareness, inadequate RH training among humanitarian actors, logistical difficulties and poor coordination. Continued emphasis on advocacy and capacity building, a stronger focus on logistics and coordination and a greater commitment to monitoring and evaluation are essential for improving the MISP's effectiveness in the field.

Bioterrorism And Biological Threats Dominate Federal Health Security Research; Other Priorities Get Scant Attention

The federal government plays a critical role in achieving national health security by providing strategic guidance and funding research to help prevent, respond to, mitigate, and recover from disasters, epidemics, and acts of terrorism. In this article we describe the first-ever inventory of nonclassified national health security-related research funded by civilian agencies of the federal government. Our analysis revealed that the US government's portfolio of health security research is currently weighted toward bioterrorism and emerging biological threats, laboratory methods, and development of biological countermeasures. Eight of ten other priorities identified in the Department of Health and Human Services' National Health Security Strategy-such as developing and maintaining a national health security workforce or incorporating recovery into planning and response-receive scant attention. We offer recommendations to better align federal spending with health security research priorities, including the creation of an interagency working group charged with minimizing research redundancy and filling persistent gaps in knowledge.

Reply to Anthoff and Tol

What we found The FUND model, as used by the U.S. government's Interagency Working Group, produces a very low estimate of the social cost of carbon, in part because it projects a large net benefit of climate change in agriculture. We identified two defects in the FUND equation for crop yields as a function of temperature. First, the yield-maximizing temperature for each region is a Monte Carlo parameter that varies over implausibly wide ranges: the 95% confidence intervals stretch from well below the temperatures of the last ice age, up to temperatures that human beings cannot survive. Second, the crop yield equation includes fractions with denominators that would be equal to zero for a particular value of the Monte Carlo parameter. Both defects would be expected to produce an excessively wide range of results on successive iterations of the Monte Carlo analysis — some with extremely large net benefits, others with extremely large net damages. (As the key parameter approaches the divide-by-zero point from one side, the fraction tends toward positive infinity; on the other side, it tends toward negative infinity.) FUND has a built-in limit on the size of agricultural damages but no corresponding limit on the size of agricultural benefits, as explained in a footnote in our article. This asymmetric limitation screens out the excessive damages but leaves the excessive benefits intact, making the average outcome artificially positive. That is, the defects we identified both tend to exaggerate the benefits of climate change for agriculture.

Considerations on private human access to space from an institutional point of view

Private human access to space as discussed in this article addresses two market segments: suborbital flight and crew flights to Low Earth Orbit. The role of entrepreneurs, the technical complexity, the customers, the market conditions as well as the time to market in these two segments differ significantly. Space agencies take currently a very different approach towards private human access to space in both segments. Analysing the outcome of broader inter-agency deliberations on the future of human spaceflight and exploration, performed e.g. in the framework of the International Space Exploration Coordination Group, enables to derive some common general views on this topic. Various documents developed by inter-agency working groups recognise the general strategic importance for enabling private human access to space for ensuring a sustainable future of human spaceflight, although the specific definition of private human access and approaches vary.ESA has performed some reflections on this subject throughout the last 5 years. While it gained through these reflections a good understanding on the opportunities and implications resulting from the development of capabilities and markets for Private Human Access, limited concrete activities have been initiated in relation to this topic as of today.