接触外卖食品商店(“外卖”)与不良饮食和超重有关,这是发病率和死亡率过高的主要原因。截至2017年底,英格兰有35个地方当局(LA)采用了外卖管理区(或“禁区”),这是一项城市规划干预措施,旨在减少学校周围外卖的身体接触。在全国范围内,自然实验研究,我们使用中断的时间序列分析来估计这种干预措施对LA收到的外卖计划申请总数和拒绝百分比的变化的影响,在第一次决定和任何上诉后,在管理区域内,日历年的每个季度。这些近端工艺措施的变化将先于下游零售和健康影响。我们观察到,在干预后12个月,干预助理收到的申请数量总体下降(减少6.3,95%CI-0.1,-12.5),以及最初被拒绝的申请比例增加(增加18.8%,95%CI3.7,33.9)和最终(额外19.6%,95%CI4.7,34.6)决策,后者考虑到任何上诉结果。计划申请数量的这一效应大小维持在24个月,虽然没有统计学意义。我们还确定了三种不同的管理区法规子类型(完整,市中心豁免,和时间管理区)。在拒绝中观察到的变化对于完整的管理区(无论与市中心重叠,都适用法规)最为突出,在24个月内,被拒绝的申请百分比增加了46.1%。我们的发现表明,外卖管理区政策可能有可能遏制学校附近新外卖的扩散,并随后对人口健康产生影响。
Physical exposure to takeaway food outlets (\"takeaways\") is associated with poor diet and excess weight, which are leading causes of excess morbidity and mortality. At the end of 2017, 35 local authorities (LAs) in England had adopted takeaway management zones (or \"exclusion zones\"), which is an urban planning intervention designed to reduce physical exposure to takeaways around schools. In this nationwide, natural experimental study, we used interrupted time series analyses to estimate the impact of this intervention on changes in the total number of takeaway planning applications received by LAs and the percentage rejected, at both first decision and after any appeal, within management zones, per quarter of calendar year. Changes in these proximal process measures would precede downstream retail and health impacts. We observed an overall decrease in the number of applications received by intervention LAs at 12 months post-intervention (6.3 fewer, 95% CI -0.1, -12.5), and an increase in the percentage of applications that were rejected at first (additional 18.8%, 95% CI 3.7, 33.9) and final (additional 19.6%, 95% CI 4.7, 34.6) decision, the latter taking into account any appeal outcomes. This effect size for the number of planning applications was maintained at 24 months, although it was not statistically significant. We also identified three distinct sub-types of management zone regulations (full, town centre exempt, and time management zones). The changes observed in rejections were most prominent for full management zones (where the regulations are applied irrespective of overlap with town centres), where the percentage of applications rejected was increased by an additional 46.1% at 24 months. Our findings suggest that takeaway management zone policies may have the potential to curb the proliferation of new takeaways near schools and subsequently impact on population health.