ORCID Profile
0000-0001-8484-9930
Current Organisation
Deakin University
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Publisher: Springer Science and Business Media LLC
Date: 14-05-2014
DOI: 10.1038/IJO.2014.78
Publisher: MDPI AG
Date: 13-04-2018
Publisher: Springer Science and Business Media LLC
Date: 18-01-2019
Publisher: Springer Science and Business Media LLC
Date: 04-09-2020
DOI: 10.1186/S13063-020-04692-6
Abstract: Community-based interventions have shown promise in addressing the childhood obesity epidemic. Such efforts rely on the knowledge of key community members and their engagement with the drivers of obesity in their community. This paper presents the protocol for the measurement and evaluation of knowledge and engagement among community leaders within a whole-of-community systems intervention across 10 large intervention communities in Australia. We will investigate the role of stakeholder knowledge and engagement in the implementation and effectiveness of the stepped wedge cluster randomised trial in ten communities in Victoria, Australia. Data will be collected using the Stakeholder-driven Community Diffusion Survey (SDCD) to measure levels of knowledge and engagement prior to commencement (2019), across the three separate levels of governance within the intervention at five time points. Primary outcomes will be baseline overall knowledge and engagement scores across the three levels of governance and change in overall knowledge and engagement over time. We hypothesise there will be heterogeneity between intervention sites on levels of knowledge and engagement and that these differences will be associated with variability in implementation success. Australian New Zealand Clinical Trials Registry ACTRN12618001986268 . Registered on 11 December 2018
Publisher: Oxford University Press (OUP)
Date: 20-02-2021
Abstract: To make effective progress towards a global reduction in obesity prevalence, there needs to be a focus on broader structural factors, beyond in idual-level drivers of diet and physical activity. This article describes the use of a systems framework to develop obesity prevention policies with adolescents. The aim of this research was to use the group model building (GMB) method to identify young people’s perceptions of the drivers of adolescent obesity in five European countries, as part of the EU-funded Co-Create project. We used GMB with four groups of 16–18-year-olds in schools in each of the five European countries (The Netherlands, Norway, Poland, Portugal and the UK) to create causal loop diagrams (CLDs) representing their perceptions of the drivers of adolescent obesity. The maps were then merged into one, using a new protocol. Two hundred and fifty-seven participants, aged 16–18 years, engaged in 20 separate system mapping groups, each of which generated 1 CLD. The findings were largely congruent between the countries. Three feedback loops in the merged diagram particularly stand out: commercial drivers of unhealthy diets mental health and unhealthy diets social media use, body image and motivation to exercise. GMB provides a novel way of eliciting from young people the system-based drivers of obesity that are relevant to them. Mental health issues, social media use and commercial practices were considered by the young people to be key drivers of adolescent obesity, subjects that have thus far had little or no coverage in research and policy.
Publisher: Wiley
Date: 16-06-2016
DOI: 10.1002/SRES.2409
Publisher: Springer Science and Business Media LLC
Date: 19-02-2020
DOI: 10.1038/S41746-020-0230-X
Abstract: Participatory systems thinking methods are often used in community-based participatory research to engage and respond to complexity. Participation in systems thinking activities creates opportunities for participants to gain useful insights about complexity. It is desirable to design activities that extend the benefits of this participation into communities, as these insights are predictive of success in community-based prevention. This study tests an online, computer-mediated participatory system modelling platform (STICKE) and associated methods for collating and analysing its outputs. STICKE was trialled among a group of community members to test a computer-mediated system modelling exercise. The causal diagrams resulting from the exercise were then merged, and network analysis and DEMATEL methods applied to inform the generation of a smaller summary model to communicate insights from the participant group as a whole. Participants successfully completed the online modelling activity, and created causal diagrams consistent with expectations. The DEMATEL analysis was identified as the participant-preferred method for converging in iduals causal diagrams into a coherent and useful summary. STICKE is an accessible tool that enabled participants to create causal diagrams online. Methods trialled in this study provide a protocol for combining and summarising in idual causal diagrams that was perceived to be useful by the participant group. STICKE supports communities to consider and respond to complex problems at a local level, which is cornerstone of sustainable effective prevention. Understanding how communities perceive their own health challenges will be important to better support and inform locally owned prevention efforts.
Publisher: SAGE Publications
Date: 13-10-2016
Abstract: Depression affects many Australian adolescents. Research points to the potential of lifestyle improvement for the population-level prevention of mental disorders. However, most studies examine single relationships without considering the combined contribution of lifestyle factors to variance in depression. This study examined associations between adolescent diet, physical activity and screen time behaviours and depressive symptomatology. A cross-sectional s le of year 8 and 10 students was recruited from 23 participating schools in 18 Victorian communities. Students were recruited using opt-out consent, resulting in 3295 participants from 4680 registered school enrolments (Participation Rate: 70.4%). Participants completed a supervised self-report questionnaire comprising Moods and Feelings Questionnaire–Short Form, an assessment of physical activity and sedentary behaviours during and outside school, and weekly food intake. Surveyed covariates included hours of sleep per night, age, socio-economic status and measured anthropometry. A hierarchical regression stratified by gender was conducted, with dichotomised Moods and Feelings Questionnaire–Short Form score as the outcome, and screen time, physical activity and dietary patterns as predictors. Nested regression analyses were then conducted to ascertain the variance in Moods and Feelings Questionnaire–Short Form score attributable to each significant predictor from the initial regression. Increased scores on an unhealthy dietary pattern (odds ratio = 1.18 95% confidence interval = [1.07, 1.32]) and physical activity guideline attainment (0.91 [0.85, 0.97]) were associated with depressive symptomatology in males, while screen time guideline attainment (0.95 [0.91, 0.98]) was associated with depression in females. No association was observed between healthy diet pattern and Moods and Feelings Questionnaire–Short Form. Overall, effect sizes were generally small, and the regression model accounted for 5.22% of Moods and Feelings Questionnaire–Short Form variance. Gender-specific associations were observed between physical activity and both sedentary and dietary behaviours and depressive symptomatology among adolescents, although reverse causality cannot be refuted at this stage. Lifestyle behaviours may represent a modifiable target for the prevention of depressive symptomatology in adolescents.
Publisher: Springer Science and Business Media LLC
Date: 12-2019
DOI: 10.1186/S12889-019-7936-1
Abstract: In Australia, around 67% of adults and 25% of children (5–17 years) are currently overweight or obese (Australian Bureau of Statistics, 4364.0.55.001 - National Health Survey: First Results, 2017–18, 2018). The C belltown – Changing our Future study will translate ‘a whole of system’ approach, previously trialed in rural communities in Victoria and the Australian Capital Territoty, to C belltown Local Government Area (LGA), a socioeconomically and ethnically erse urban community in south western Sydney, NSW. The study intervention will use a five-step approach 1 – set up a childhood obesity monitoring system by collecting baseline data from children in primary schools across C belltown LGA to give a local context to the community when developing the systems map 2 - key stakeholders develop systems maps which inform the development of the interventions 3 - key stakeholders and community groups identify priority areas for action and form working groups 4 - implementation of the interventions 5 - evaluation of the interventions. The study will adopt a longitudinal pre ost design with repeated measures at baseline, 2 years and 4 years. Both qualitative and quantitative methods will be used to collect and analyse the data. Addressing childhood overweight and obesity is complex and requires a multifaceted intervention. This approach has the capacity to impact a range of factors that influence childhood overweight and obesity utilising existing capacity of multiple partners with broad community reach. Findings will develop local responses which capture the complexity of obesity at a community level and further our understanding of the interrelationships and relative importance of local factors impacting childhood overweight and obesity. This study aims to provide evidence for systems methods and approaches suitable for adaption and scaling and may provide evidence of successful community intervention elements.
Publisher: Springer Science and Business Media LLC
Date: 20-01-2020
DOI: 10.1038/S41746-019-0205-Y
Abstract: Complex health problems require multi-strategy, multi-target interventions. We present a method that uses machine learning techniques to choose optimal interventions from a set of possible interventions within a case study aiming to increase General Practitioner (GP) discussions of physical activity (PA) with their patients. Interventions were developed based on a causal loop diagram with 26 GPs across 13 clinics in Geelong, Australia. GPs prioritised eight from more than 80 potential interventions to increase GP discussion of PA with patients. Following a 2-week baseline, a multi-arm bandit algorithm was used to assign optimal strategies to GP clinics with the target outcome being GP PA discussion rates. The algorithm was updated weekly and the process iterated until the more promising strategies emerged (a duration of seven weeks). The top three performing strategies were continued for 3 weeks to improve the power of the hypothesis test of effectiveness for each strategy compared to baseline. GPs recorded a total of 11,176 conversations about PA. GPs identified 15 factors affecting GP PA discussion rates with patients including GP skills and awareness, fragmentation of care and fear of adverse outcomes. The two most effective strategies were correctly identified within seven weeks of the algorithm-based assignment of strategies. These were clinic reception staff providing PA information to patients at check in and PA screening questionnaires completed in the waiting room. This study demonstrates an efficient way to test and identify optimal strategies from multiple possible solutions.
Publisher: BMJ
Date: 09-2016
Publisher: MDPI AG
Date: 28-01-2021
DOI: 10.3390/NU13020417
Abstract: Prior to the 2020 outbreak of COVID-19, 70% of Australians’ food purchases were from supermarkets. Rural communities experience challenges accessing healthy food, which drives health inequalities. This study explores the impact of COVID-19 on food supply and purchasing behaviour in a rural supermarket. Group model building workshops explored food supply experiences during COVID-19 in a rural Australian community with one supermarket. We asked three supermarket retailers “What are the current drivers of food supply into this supermarket environment?” and, separately, 33 customers: “What are the current drivers of purchases in this supermarket environment?” Causal loop diagrams were co-created with participants in real time with themes drawn afterwards from coded transcripts. Retailers’ experience of COVID-19 included ‘empty shelves’ attributed to media and government messaging, product unavailability, and community fear. Customers reported fear of contracting COVID-19, unavailability of food, and government restrictions resulting in cooking more meals at home, as influences on purchasing behaviour. Supermarket management and customers demonstrated adaptability and resilience to normalise demand and combat reduced supply.
Publisher: Elsevier BV
Date: 05-2022
DOI: 10.1016/J.AMEPRE.2021.10.006
Abstract: Applying systems science in public health trials is a recent innovation in childhood obesity prevention. This paper aims to use systems science conventions to propose a theory of change for community-based interventions aiming to build capacity and use exemplars from systems science for obesity prevention to describe how this approach works. Participants were community-based researchers. A dynamic hypothesis was created in workshops conducted in 2020 and 2021 by identifying variables critical to building community capacity for systems thinking. These were used to develop stock and flow diagrams representing in idual causal relationships, feedback loops, and the overall theory of change. The resultant model identified 9 stocks and 4 pairs of central balancing and reinforcing feedback loops. These represented building commitment through relationships, mutual learning, strengthening collaboration, and embedding capacity. The model is described using ex les from 3 trials involving 25 communities across Victoria, Australia. This nonlinear and practice-based model illustrates the process of community-based obesity prevention. The model integrates >20 years of community-based intervention implementation experience, providing an overarching theory of how such interventions work to create change and prevent obesity.
Publisher: Springer Science and Business Media LLC
Date: 10-09-2014
Publisher: Springer Science and Business Media LLC
Date: 26-06-2021
DOI: 10.1186/S12889-021-11288-5
Abstract: Obesity is a chronic disease that contributes to additional comorbidities including diabetes, kidney disease and several cancers. Change4C belltown implemented a ‘whole of system’ approach to address childhood overweight and obesity. We present methods to track implementation and stakeholder engagement in Change4C belltown. Change4C belltown aimed to build capacity among key leaders and the broader community to apply techniques from systems thinking to develop community-led actions that address childhood obesity. Change4C belltown comprised development of a stakeholder-informed Causal Loop Diagram (CLD) and locally-tailored action plan, formation of key stakeholder and community working groups to prioritise and implement actions, and continuous monitoring of intervention actions. Implementation data included an action register, stakeholder engagement database and key engagement activities and were collected quarterly by the project management team over 2 years of reporting. Engagement activities increased level of community engagement amongst key leaders, the school-sector and community members. Community-led action increased as engagement increased and this action is mapped directly to the primary point of influence on the CLD. As action spread ersified across the CLD, the geographical spread of action within the community increased. This paper provides a pragmatic ex le of the methods used to track implementation of complex interventions that are addressing childhood overweight and obesity.
Publisher: Elsevier BV
Date: 09-2019
Publisher: Wiley
Date: 22-11-2018
DOI: 10.1002/OSP4.306
No related grants have been discovered for Joshua Hayward.