{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T06:24:17Z","timestamp":1787639057224,"version":"build-2736575974"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Youth weight management is a complex public health challenge requiring coordinated action across settings, with schools serving as primary implementation environments. This study examined how Chinese national policies allocate school responsibilities and configure external collaborative support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty-six national policy documents issued in China between 2016 and 2025 were systematically analyzed. Unlike one-dimensional frequency analyses, the proposed framework linked policy targets, instruments, and implementing actors through three cross-dimensional co-occurrence matrices. NVivo-assisted coding, descriptive association indicators, and a sensitivity analysis were used to characterize policy-design patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Environmental targets, capacity-building instruments, and schools were the most frequent categories. In the policy corpus, schools were overrepresented in pairings with command instruments and physical fitness targets, whereas external actors appeared in differentiated but weakly integrated pairings dominated by exhortation and capacity-building tools. Incentive and system-change instruments were comparatively uncommon. These textual patterns indicate that national policy design concentrates specified obligations in schools while providing relatively fewer structural and incentive mechanisms to connect schools with external actors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The three-dimensional framework identifies a school-centered policy design in which mandated tasks are more prominent than explicit mechanisms for systemic empowerment and cross-sector coordination. Policymakers can use the framework to compare assigned tasks with enabling instruments, clarify responsibility boundaries, establish school\u2013health referral and coordination protocols, and match school mandates with earmarked resources. Because the analysis is limited to policy texts, the findings describe policy design rather than verified implementation or effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1941280","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T05:36:23Z","timestamp":1787636183000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Structural imbalance in youth weight management policies in China: a three-dimensional analysis of school responsibility and collaborative support"],"prefix":"10.3389","volume":"14","author":[{"given":"Yun","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Physical Education, Capital Normal University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Physical Education, Capital Normal University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1435","DOI":"10.3390\/nu18091435","article-title":"Industrial food systems as environmental drivers of women's health and childhood obesity: a cross-national ecological study","volume":"18","author":"Castiblanco-Amaya","year":"2026","journal-title":"Nutrients"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1186\/s13063-026-09635-1","article-title":"Generation healthy kids: a protocol for the mixed methods process evaluation of a school- and community-based intervention targeting healthy weight and wellbeing among 6\u201311-year-olds in Denmark","volume":"27","author":"Kr\u00f8lner","year":"2026","journal-title":"Trials"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1186\/s12875-025-03054-y","article-title":"Co-creation of the logic model for a health-promoting school program in vulnerable areas in a Brazilian capital: ProMOVE Escolas + Saud\u00e1veis","volume":"26","author":"Barbosa Filho","year":"2025","journal-title":"BMC Prim Care"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1080\/01942638.2022.2073799","article-title":"Perspectives of international experts on collaborative tiered school-based physiotherapy service delivery","volume":"42","author":"Cinar","year":"2022","journal-title":"Phys Occup Ther Pediatr"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/s12889-018-6274-z","article-title":"Whole systems approaches to obesity and other complex public health challenges: a systematic review","volume":"19","author":"Bagnall","year":"2019","journal-title":"BMC Public Health"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2602","DOI":"10.1016\/S0140-6736(17)31267-9","article-title":"The need for a complex systems model of evidence for public health","volume":"390","author":"Rutter","year":"2017","journal-title":"Lancet"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1177\/10598405241288538","article-title":"Nurse-involved policy, systems, and environmental school-based interventions for supporting healthy nutrition and obesity prevention among children and adolescents: a systematic review","volume":"41","author":"Francis","year":"2025","journal-title":"J Sch Nurs"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e1115","DOI":"10.1016\/S2468-2667(24)00245-7","article-title":"Public health interventions against childhood obesity in China","volume":"9","author":"Yuan","year":"2024","journal-title":"Lancet Public Health"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1093\/tbm\/ibab037","article-title":"Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review","volume":"11","author":"Barnes","year":"2021","journal-title":"Transl Behav Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"103333","DOI":"10.1016\/j.healthplace.2024.103333","article-title":"How to get children moving? 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