ORCID Profile
0000-0003-1671-3091
Current Organisation
Deakin University
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: BMJ
Date: 04-07-2022
DOI: 10.1136/BMJNPH-2022-000445
Abstract: Few studies have explored behavioural and financial impacts of retail initiatives after 2 years to address the unhealthy food environments common in local government sporting settings. To evaluate the impact of a 2-year local government capacity building intervention in sporting facility food outlets on (1) the healthiness of refrigerated drink choices available and visible to customers, (2) healthiness of refrigerated drinks sold and (3) refrigerated drink revenue. 52 sporting facilities within 8 local governments from Victoria, Australia, participated in an intervention between March 2018 and February 2020 by limiting ‘red’ (least healthy) drinks to ≤20% of refrigerator display and increasing ‘green’ (healthiest) drinks to ≥50% of display. Mixed models assessed changes in mean percentage of ‘red’, ‘amber’ and ‘green’ drinks displayed over time, compared with baseline. Facilities provided electronic weekly itemised sales data (December 2015 to February 2020). Weekly volume of ‘red’ or ‘green’ drinks sold as a proportion of total drinks sold, and total refrigerated drinks revenue were compared preimplementation and postimplementation using mixed models (seasonal facilities), and mixed-effect interrupted time series models (non-seasonal facilities). Display of ‘red’ drinks decreased by mean −17.1 percentage points (pp) (95% CI −23.9 to −10.3) and ‘green’ drinks increased 16.1 pp (95% CI 9.30, 22.9) between baseline and 18-month audits. At nine seasonal facilities, compared with the summer preimplementation, the mean volume of ‘red’ drinks sold decreased by −19.0 pp (95% CI −28.6, to –9.51) and refrigerated drink revenue decreased by−AU$81.8 (95% CI −AU$123 to –AU$40.8) per week. At 15 non-seasonal facilities, by February 2020, the volume of ‘red’ drinks sold decreased on average by −11.0 pp (95% CI −21.6 to –0.41) with no change in drink revenue. Reducing the display of unhealthy drinks can be an effective public health policy to improve the healthiness of customer purchases, provided there is consideration of potential impacts on revenue.
Publisher: Wiley
Date: 08-08-2019
DOI: 10.1111/OBR.12912
Abstract: Large changes to food retail settings are required to improve population diet. However, limited research has comprehensively considered the business implications of healthy food retail strategies for food retailers. We performed a systematic scoping review to identify types of business outcomes that have been reported in healthy food retail strategy evaluations. Peer-reviewed and grey literature were searched. We identified qualitative or quantitative real-world food or beverage retail strategies designed to improve the healthiness of the consumer nutrition environment (eg, changes to the "marketing mix" of product, price, promotion, and/or placement). Eligible studies reported store- or chain-level outcomes for measures of commercial viability, retailer perspectives, customer perspectives, and/or community outcomes. 11 682 titles and abstracts were screened with 107 studies included for review from 15 countries. Overall item sales, revenue, store patronage, and customer level of satisfaction with strategy were the most frequently examined outcomes. There was a large heterogeneity in outcome measures reported and in favourability for retailers of outcomes across studies. We recommend more consistent reporting of business outcomes and increased development and use of validated and reliable measurement tools. This may help generate more robust research evidence to aid retailers and policymakers to select feasible and sustainable healthy food retail strategies to benefit population health within and across countries.
Publisher: Oxford University Press (OUP)
Date: 13-03-2016
Abstract: The emergence of new media-including branded websites, social media and mobile applications-has created additional touch points for unhealthy food and beverage companies to target children and adolescents. The aim of this study was to perform an audit of new media for three top selling food and beverage brands in Australia. The top selling brand in three of the most advertised food and beverage categories was identified. Facebook, websites and mobile phone applications from these three brands were assessed using a combination of descriptive analyses and structured data collection during June and July 2013. Information on target audience, main focus of the activity, marketing strategies employed and connectivity were collected. Promotional activities were assessed against industry self-regulatory codes. McDonald's, Coca-Cola and Cadbury Dairy Milk were audited, with 21 promotional activities identified. These promotional activities appeared to use a number of marketing strategies, with frequent use of indirect product association, engagement techniques and branding. We identified strategic targeting of both children and adolescents. We found that while all promotional activities technically met self-regulatory codes (usually due to media-specific age restrictions) a number appeared to employ unhealthy food or beverage marketing directed to children. Brands are using engaging content via new media aimed at children and adolescents to promote unhealthy food and beverages. Given the limitations of self-regulatory codes in the context of new media, strategies need to be developed to reduce exposure of children and adolescents to marketing of unhealthy food and beverage products via these avenues.
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.JAND.2017.06.367
Abstract: Limited evidence has been gathered on the real-world impact of sugar-sweetened beverage price changes on purchasing behavior over time or in community-retail settings. Our aim was to determine changes in beverage purchases, business outcomes, and customer and retailer satisfaction associated with a retailer-led sugar-sweetened beverage price increase in a convenience store. We hypothesized that purchases of less-healthy beverages would decrease compared to predicted sales. A convergent parallel mixed methods design complemented sales data (122 weeks pre-intervention, 17 weeks during intervention) with stakeholder interviews and customer surveys. Electronic beverage sales data were collected from a convenience store in Melbourne, Australia (August through November 2015). Convenience store staff completed semi-structured interviews (n=4) and adult customers exiting the store completed surveys (n=352). Beverages were classified using a state government framework. Prices of "red" beverages (eg, nondiet soft drinks, energy drinks) increased by 20%. Prices of "amber" (eg, diet soft drinks, small pure fruit juices) and "green" beverages (eg, water) were unchanged. Changes in beverage volume, item sales, and revenue during the intervention were compared with predicted sales. Sales data were analyzed using time series segmented regression while controlling for pre-intervention trends, autocorrelation in sales data, and seasonal fluctuations. Beverage volume sales of red (-27.6% 95% CI -32.2 to -23.0) and amber (-26.7% 95% CI -39.3 to -16.0) decreased, and volume of green beverages increased (+26.9% 95% CI +14.1 to +39.7) in the 17th intervention week compared with predicted sales. Store manager and staff considered the intervention business-neutral, despite a small reduction in beverage revenue. Fifteen percent of customers noticed the price difference and 61% supported the intervention. A 20% sugar-sweetened beverage price increase was associated with a reduction in their purchases and an increase in purchases of healthier alternatives. Community retail settings present a bottom-up approach to improving consumer beverage choices.
Publisher: Cambridge University Press (CUP)
Date: 04-06-2021
DOI: 10.1017/S1368980021002421
Abstract: To assess the feasibility of implementation and customer perspectives of a sugar-sweetened beverage (SSB) reduction initiative across YMCA Victoria aquatic and recreation centres. Two data sources were used to assess implementation and customer acceptability. Photo audits were used to assess the type of drinks available for purchase 6 months prior to initiative implementation and 6 months after, in thirty centres. Change in the range of SSB targeted for removal, non-targeted SSB, as well as drinks classified as ‘red’ (limit), ‘amber’ (choose carefully) and ‘green’ (best choice), was reported. Customer surveys were conducted in three centres to assess acceptability and awareness of the initiative. Inductive and deductive thematic analysis was used to analyse customers’ perspectives of the initiative. 30 aquatic and recreation centres in Victoria, Australia. 806 customers. At post-implementation, 87 % of centres had removed targeted SSB. ‘Red’ drinks reduced by an average of 4·4 drink varieties compared to pre-implementation (11·9 varieties) and ‘green’ drinks increased by 1·4 varieties (3·2 varieties pre-implementation). Customers were largely unaware of the SSB-reduction initiative (90 %) but supported YMCA Victoria in continuing the initiative (89 %), with many believing it would support children in making healthier choices. Implementation of an initiative that limited SSB availability across a large number of aquatic and recreation centres was feasible and considered acceptable by customers. Customers frequently mentioned the importance of protecting children from consuming SSB.
Publisher: Wiley
Date: 27-07-2015
DOI: 10.1111/OBR.12297
Abstract: Whole-of-community (WOC) interventions have led to modest reductions in population weight gain. Whether they exhibit differential effectiveness by socioeconomic position (SEP) remains unknown. We aimed to summarize evidence of differential effectiveness of WOC interventions by SEP. Electronic databases and grey literature were searched to identify studies that evaluated the effectiveness of a WOC intervention on behavioural change measures, energy balance behaviours and/or anthropometric outcomes according to any measure of SEP. Interventions were assessed for the following characteristics: structural changes to the environment, number of settings the intervention acted in, presence of community engagement and whether equity was considered in its design. Ten studies were included. Nine reported a greater or equal effect among low SEP groups compared with high SEP groups. These studies commonly featured interventions that incorporated structural changes to the environment, acted across more than three settings and/or employed community engagement. Conclusions did not change when excluding low-quality studies (n = 4). WOC interventions represent an effective and equitable approach for the reduction of population weight. Structural components, a larger number of settings and community engagement were common in equitable WOC interventions and should be considered in the design of future WOC interventions.
Publisher: Cambridge University Press (CUP)
Date: 11-09-2020
DOI: 10.1017/S1368980020002414
Abstract: To investigate (i) changes in stakeholder commitment and (ii) perceptions of the purpose, challenges and benefits of healthy food and beverage provision in community sports settings during the stepwise implementation of a healthy beverage policy. Convergent, parallel, mixed-methods design complemented (i) repeat semi-structured interviews with council stakeholders ( n 17 interviews, n 6 interviewees), with (ii) repeat quantitative stakeholder surveys measuring Commitment to Organisational Change (iii) weekly sales data examining health behaviour and revenue effects (15 months pre-intervention 14 months post-intervention) (iv) customer exit surveys ( n 458) and (v) periodic photographic audits of beverage availability. Interviews were analysed inductively. Stakeholder surveys, sales data, customer surveys and audits were analysed descriptively. Four local government-owned sports and recreation centres in Melbourne, Australia, completed a 3-month trial to increase the availability of healthy beverages and decrease the availability of unhealthy beverages in food outlets. Interviews were conducted with council managers and those involved in implementation (September 2016–October 2017). Customers were surveyed (September–October 2017). Interviews and surveys indicated that stakeholders’ commitment to policies varied such that, over time, optimism that changing beverage availability could increase the healthiness of customers’ purchases became more widespread among interviewees. Stakeholder focus generally progressed from anticipatory concern to solutions-focused discussions. Sales, audit and customer survey data supported interview findings. We found a general increase in optimism regarding policy outcomes over time during the implementation of a healthy beverage policy. Stepwise trials should be further explored as an engagement tool within community retail settings.
Publisher: Cambridge University Press (CUP)
Date: 13-04-2020
DOI: 10.1017/S1368980019004610
Abstract: In 2015, beverages were removed from display at a self-service café within a major health service, resulting in fewer purchases of unhealthy beverages. This initiative was continued following initial evaluation of the results. The current study aimed to determine customer acceptability of the initiative, and whether healthier purchases had continued, at 18 months following implementation. Drinks were categorised as ‘green’ (best choices), ‘amber’ (choose carefully) and ‘red’ (limit), based on the state government nutrient profiling system, for intervention and analysis purposes. In 2015, unhealthy ‘red’ drinks were removed from display. In 2017, weekly beverage sales were counted, through stock-taking, for 6 weeks, and customer surveys were conducted over 2 days. A café located within a major Victorian health service. Café customers (hospital staff, patients and visitors). Eighteen months after the implementation of the initiative, the proportion of ‘red’ beverages sold was 7 % of total drink sales (compared with 33 % before the removal of unhealthy beverages from display in 2015 ( P 0·001), and 10 % immediately following the removal of unhealthy beverages from display). Customer surveys revealed high levels of acceptability for the initiative and low levels of awareness of the initiative. The removal of unhealthy beverages from display can result in customers making healthier purchases, and this appears to continue over the long-term. Such interventions have the potential to contribute to the sustained shift in population purchases and consumption needed to make meaningful improvements to population health.
Publisher: Wiley
Date: 24-01-2017
DOI: 10.1111/OBR.12498
Abstract: Obesity is associated with excessive daytime sleepiness, but its causality remains unclear. We aimed to assess the extent to which intentional weight loss affects daytime sleepiness. Electronic databases were searched through 24 October 2016. Studies involving overweight or obese adults, a weight loss intervention and repeated valid measures of daytime sleepiness were included in the review. Two independent reviewers extracted data on study characteristics, main outcome (change in daytime sleepiness score standardized by standard deviation of baseline sleepiness scores), potential mediators (e.g. amount of weight loss and change in apnoea-hypopnoea index) and other co-factors (e.g. baseline demographics). Forty-two studies were included in the review. Fifteen before-and-after studies on surgical weight loss interventions showed large improvements in daytime sleepiness, with a standardized effect size of -0.97 (95% confidence interval [CI] -1.21 to -0.72). Twenty-seven studies on non-surgical weight loss interventions showed small-to-moderate improvement in daytime sleepiness, with a standardized effect size of -0.40 (95%CI -0.52 to -0.27), with no difference between controlled and before-and-after studies. We found a nonlinear association between amount of weight loss and change in daytime sleepiness. This review suggests that weight loss interventions improve daytime sleepiness, with a clear dose-response relationship. This supports the previously hypothesized causal effect of obesity on daytime sleepiness. It is important to assess and manage daytime sleepiness in obese patients.
Publisher: Cambridge University Press (CUP)
Date: 08-09-2020
DOI: 10.1017/S1368980020002323
Abstract: Local governments have integral roles in contributing to public health. One recent focus has been on how local governments can impact community nutrition by engaging food service outlets to improve their food offer. The Healthier Catering Commitment (HCC) is an initiative where London local governments support takeaways and restaurants to meet centrally defined nutrition criteria on their food options. Using the case of HCC, the current study aims to provide (1) practical learnings of how local governments could facilitate and overcome barriers associated with implementing healthy food service initiatives in general, and (2) specific recommendations for enhancements for HCC. Key informant, semi-structured interviews were conducted with local government staff involved in HCC, exploring barriers and facilitators to HCC implementation in food businesses. A thematic analysis approach was used, with results presented according to a logic pathway of ideal implementation in order to provide practical, focused insights. Local governments implementing HCC. Twenty-two in iduals supporting HCC implementation. Facilitators to implementation included flexible approaches, shared resourcing and strategically engaging businesses with practical demonstrations. Barriers were limited resources, businesses fearing negative customer responses and low uptake in disadvantaged areas. Key suggestions to enhance implementation and impact included offering additional incentives, increasing HCC awareness and encouraging recruited businesses to make healthy changes beyond initiative requirements. In order to facilitate the implementation of healthy food initiatives in food outlets, local governments would benefit from involving their environmental health team, employing community-tailored approaches and focusing on supporting businesses in disadvantaged areas.
Publisher: Wiley
Date: 08-02-2023
DOI: 10.1111/OBR.13556
Abstract: Healthy food outlet accreditation schemes represent an avenue for incentivizing food retailers to promote healthy eating patterns by improving the healthiness of food environments. This systematic review aimed to (i) assess the impact of food outlet‐level accreditation schemes on outlet practices and customer purchases and (ii) identify barriers and enablers to scheme implementation. Peer‐reviewed and grey literature were systematically searched. Eligible studies related to outlet‐level food and beverage accreditation schemes across any food retail setting. Findings were narratively synthesized by retailer type according to (i) scheme characteristics (governance, targeted products, support, and monitoring) (ii) scheme outcomes (rate of uptake, proportion of certified retailers, impact on purchasing, customer perspectives, and retailer perspectives) and (iii) barriers and enablers to implementation. From 21,943 records screened, 48 were included, covering 26 schemes. Most (18) targeted restaurants or convenience stores. Average uptake was 65% of all outlets approached to participate. Implementation of accreditation schemes was associated with healthier customer purchases in convenience stores, schools, and hospitals, but evidence from restaurants was mixed. Enablers of scheme implementation included support for implementation and maintenance, flexible scheme criteria, and motivated retail staff. Healthy food outlet accreditation schemes represent a promising mechanism for engaging retailers to improve the healthiness of food retail environments.
Publisher: BMJ
Date: 03-2020
DOI: 10.1136/BMJOPEN-2019-029492
Abstract: To assess the impact of a sugar-sweetened beverage (SSB) reduction initiative on customer purchasing patterns, including volume sales of healthy and unhealthy packaged drinks and sales value of all packaged drinks, in a major Australian aquatic and recreation provider, YMCA Victoria. Prospective 16 aquatic and recreation centres in Victoria, Australia. The SSB-reduction initiative aimed to remove all SSBs (excluding sports drinks) and increase healthier drink availability over a 1-year period. Itemised monthly drink sales data were collected for 16 centres, over 4 years (2 years preimplementation, 1 year implementation and 1 year postimplementation). Drinks were classified as ‘green’ (best choice), ‘amber’ (choose carefully) or ‘red’ (limit). Interrupted time series analysis was conducted for each centre to determine the impact on volume sales of ‘red’ and ‘green’ drinks, and overall sales value. A novel meta-analysis approach was conducted to estimate the mean changes across centres. Following implementation, volume sales of ‘red’ drinks reduced by 46.2% across centres (95% CI: −53.2% to −39.2%), ‘green’ drink volume did not change (0.0%, 95% CI: −13.3% to 13.2%) and total drink sales value decreased by 24.3% (95% CI: −32.0% to −16.6%). The reduction of SSBs in health-promoting settings such as recreation centres is a feasible, effective public health policy that is likely to be transferable to other high-income countries with similarly unhealthy beverage offerings. However, complementary strategies should be considered to encourage customers to switch to healthier alternatives, particularly when translating policies to organisations with less flexible income streams.
Publisher: Massachusetts Medical Society
Date: 24-04-2014
DOI: 10.1056/NEJMC1402397
Publisher: Elsevier BV
Date: 07-2017
Publisher: Wiley
Date: 30-08-2019
Abstract: In 2012, a large Australian metropolitan health service introduced a healthy food policy, where there was a requirement for food and drinks for sale within retail stores to conform to standards based on macronutrients and energy content. The aim of the present study was to evaluate the experience of those implementing a healthy food retail policy in order to inform the translation of such policies into other organisations. A qualitative approach was used, with semistructured interviews exploring informants' involvement in, experiences of, factors affecting and perceived outcomes of policy implementation. Interviews were conducted with seven in iduals participating in the introduction of the healthy food retail policy. Results were analysed using a thematic analysis approach. Four themes and 21 sub-themes were identified, with analysis interpreted using the socio-ecological model. Participants identified that successful policy implementation hinged on the provision of resources and support by the health service to the retail staff. Trusting relationships between retail and health service staff were built through effective and frequent communication. The fear of tensions between the policy and business income had significantly lessened after implementation. A key factor contributing to this change was the use of low-risk trials to remove less healthy products or introduce new healthier foods. Implementing a healthy food retail policy within a health service benefits from dedicated resourcing, investment in relationship building with key stakeholders and introducing changes gradually with a long-term approach.
Publisher: Wiley
Date: 07-05-2021
DOI: 10.1111/OBR.13264
Abstract: Fear of unfavorable business outcomes, including negative financial impacts, deters implementation of school food service initiatives to support healthy student eating behaviors. There have been no systematic reviews to guide feasible long‐term healthy school food initiatives. This review aimed to synthesize evidence on the effect of school food service initiatives on business outcomes, including commercial viability, stakeholder perceptions, customer perceptions, and initiative maintenance and scale‐up. Business, education, and health peer‐reviewed databases, and grey literature were systematically searched. Eligible studies reported on the business impact of initiatives encouraging sales of healthier foods within school cafeterias, canteens, vending machines, or online canteens. Synthesis incorporated a count of studies addressing business outcomes, health behavior outcomes, and the favorability of those outcomes. Of 5173 studies screened, 16 studies were included for analysis. Commercial viability was the most frequent theme ( n = 12/16 studies), followed by stakeholder perceptions ( n = 9/16), customer perceptions ( n = 6/16), and initiative maintenance and scale‐up ( n = 2/16). Favorable business outcomes were identified in cafeterias/canteens ( n = 8/10) and online canteens ( n = 1/1). All vending machine initiatives ( n = 7/7) reported unfavorable, mixed, or neutral outcomes. Future research should determine which types of healthy food retail initiatives deliver the most favorable business outcomes long‐term for schools while optimizing student nutrition outcomes.
Publisher: Elsevier BV
Date: 04-2017
Abstract: Examine the nutritional quality of food and beverages consumed across a s le of community aquatic and recreation centres in metropolitan Melbourne, Australia. Interviewer-administered surveys of randomly selected patrons attending four aquatic and recreation centres were conducted to ascertain food and beverage items consumed over two data collection periods (May-June 2014, January-February 2015). We selected centres in and around metropolitan Melbourne with a sit-down cafeteria and children's swimming classes. We classified items by government nutrient profiling guidelines 'green' (best choice), 'amber' (choose carefully) or 'red' (limit). A total of 2,326 surveys were conducted (response rate 63%). Thirty-five per cent of surveyed patrons consumed food or beverages while at the centre 54% of patrons purchased from the café and 61% brought items to the centre. More than half the food consumed from the café was 'red', increasing to 92% for children. One in five children visiting the centre consumed a 'red' item bought from the centre café. The nutritional quality of food and beverages consumed at recreation centres was generally poor, with the on-site cafés providing the majority of discretionary items consumed. Implications for public health: Community aquatic and recreation centres provide an opportunity to promote healthy eating by increasing the provision of healthy options and limiting discretionary food and drink items.
Publisher: Elsevier BV
Date: 08-2019
Abstract: Price promotions are used to influence purchases and represent an important target for obesity prevention policy. However, no long-term contemporary data on the extent and frequency of supermarket price promotions exists. We aimed to evaluate the frequency, magnitude and weekly variation of beverage price promotions available online at two major Australian supermarket chains over 50 weeks. Beverages were categorised into four policy-relevant categories (sugar-sweetened beverages, artificially-sweetened beverages, flavoured milk and 100% juice, milk and water). The proportional contribution of each category to the total number of price proportions, the proportion of price promotions within the available product category, the mean discount, and weekly variation in price promotions were calculated. For Coles and Woolworths respectively, 26% and 30% of all beverages were price promoted in any given week. Sugar-sweetened beverages made up the greatest proportion of all price promotions (Coles: 46%, Woolworths: 49%). Within each product category, the proportion of sugar-sweetened and artificially-sweetened beverages that were price promoted was similar, higher than the other categories and reasonably constant over time. Diet drinks and sugar-sweetened soft drinks were most heavily discounted (by 29-40%). Beverage price promotions are used extensively in Australian supermarkets, undermining efforts to promote healthy population diets. Implications for public health: Policies restricting price promotions on sugar-sweetened beverages are likely to be an important part of strategies to reduce obesity and improve population nutrition.
Publisher: Elsevier BV
Date: 06-2020
No related grants have been discovered for Tara Boelsen-Robinson.