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0000-0002-1244-3947
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ELEVE SCIENCE Pesquisa e Desenvolvimento
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Deakin University
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Publisher: Elsevier BV
Date: 07-2022
Publisher: MDPI AG
Date: 27-01-2021
DOI: 10.20944/PREPRINTS202101.0553.V1
Abstract: Objective: To highlight opportunities for future nutrition intervention research within early childhood and education care (ECEC) settings, with a focus on generating evidence that has applicability to real-world policy and practice. Methods: An overview of opportunities to progress the field was developed by authors using a collaborative writing approach and informed by recent research in the field. The group developed a list of recommendations aligned with the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework. Pairs of authors drafted in idual sections of the manuscript, which was then reviewed by a separate pair. The first and senior author consolidated all sections of the manuscript and sought critical input on draft iterations of the manuscript. Results: Interventions that employ digital platforms (Reach) in ECEC settings, as well as research in the family day care setting (Effectiveness) were identified as areas of opportunities. Research understanding the determinants of and effective strategies for dissemination (Adoption), implementation of nutrition programs, in addition to de-implementation (Implementation) of inappropriate nutrition practices, is warranted. For maintenance, there is a need to better understand sustainability and sustainment of interventions, in addition to undertaking policy-relevant research. Conclusions: The ECEC setting is prime for innovative and practical nutrition intervention research.
Publisher: Wiley
Date: 13-08-2019
DOI: 10.1111/OBR.12925
Abstract: Interventions for obesity prevention in early childhood (first 5 years of life) are likely to have a significant preventive health impact. This mapping review identified recommended policy options for the Australian Federal Government (AFG) by comparing countries with similar population, income, and language to Australia. Policies were mapped in six countries using two matrices. The first matrix examined policy context, describing obesity prevention governance. The second matrix examined policy content, compared with global recommendations. Policies were grouped into downstream (healthcare), midstream (lifestyle and settings), and upstream (determinants of health, including food and built environments). Results identified variance in obesity governance across the six countries including policy coherence, leadership, institutional drivers, and overlapping responsibility across different levels of government. While countries tended to have more downstream or midstream policies, upstream policies were more likely when countries had invested in system-wide approaches to obesity such as developing a national obesity strategy, having separate food/nutrition and physical activity plans, and a dedicated preventive health agency. This study recommends a range of initiatives for the AFG to strengthen policies for the prevention of obesity in early childhood, including prioritising the development of a national food/nutrition strategy.
Publisher: Oxford University Press (OUP)
Date: 28-04-2015
Publisher: MDPI AG
Date: 29-02-2020
Abstract: Caregivers’ perceptions of children’s pickiness are relatively scarce in relation to the five core food groups and their importance in providing a nutritionally balanced diet. Furthermore, there is no validated questionnaire that examines child-reported food preferences in an age-appropriate manner, and the use of terms such as a “picky eater” can be attributed to environmental and genetic factors. Despite potential links between children’s food preferences and endophenotype bitter taste, associations between bitter taste sensitivity and picky eating is relatively unexplored. The proposed cross-sectional study aims to develop and validate a parent-reported core-food Picky Eating Questionnaire (PEQ) and child-reported Food Preference Questionnaire (C-FPQ) and simultaneously investigate environmental and phenotype determinants of picky eating. The study will be conducted in three stages: Phase 1, piloting PEQ and C-FPQ questionnaires (15–20 primary caregivers and their children aged 7–12 years) Phase 2 and 3, validating the revised questionnaires and evaluating the 6-n-propylthiouracil (PROP) bitter taste sensitivity to examine perception to bitter taste (369 primary caregivers and their children). Study findings will generate new validated tools (PEQ, C-FPQ) for use in evidence-based practice and research and explore picky eating as a behavioural issue via the potential genetic-phenotype basis of bitter taste sensitivity.
Publisher: Springer Science and Business Media LLC
Date: 04-02-2021
DOI: 10.1186/S12889-021-10270-5
Abstract: Behavioural interventions for the early prevention of childhood obesity mostly focus on English-speaking populations in high-income countries. Cultural adaptation is an emerging strategy for implementing evidence-based interventions among different populations and regions. This paper describes the initial process of culturally adapting Healthy Beginnings, an evidence-based early childhood obesity prevention program, for Arabic and Chinese speaking migrant mothers and infants in Sydney, Australia. The cultural adaptation process followed the Stages of Cultural Adaptation theoretical model and is reported using the Framework for Reporting Adaptations and Modifications-Enhanced. We first established the adaptation rationale, then considered program underpinnings and the core components for effectiveness. To inform adaptations, we reviewed the scientific literature and engaged stakeholders. Consultations included focus groups with 24 Arabic and 22 Chinese speaking migrant mothers and interviews with 20 health professionals. With input from project partners, bi-cultural staff and community organisations, findings informed cultural adaptations to the content and delivery features of the Healthy Beginnings program. Program structure and delivery mode were retained to preserve fidelity (i.e. staged nurse calls with key program messages addressing modifiable obesity-related behaviours: infant feeding, active play, sedentary behaviours and sleep). Qualitative analysis of focus group and interview data resulted in descriptive themes concerning cultural practices and beliefs related to infant obesity-related behaviours and perceptions of child weight among Arabic and Chinese speaking mothers. Based on the literature and local study findings, cultural adaptations were made to recruitment approaches, staffing (bi-cultural nurses and project staff) and program content (modified call scripts and culturally adapted written health promotion materials). This cultural adaptation of Healthy Beginnings followed an established process model and resulted in a program with enhanced relevance and accessibility among Arabic and Chinese speaking migrant mothers. This work will inform the future cultural adaptation stages: testing, refining, and trialling the culturally adapted Healthy Beginnings program to assess acceptability, feasibility and effectiveness.
Publisher: Wiley
Date: 09-2021
Publisher: Frontiers Media SA
Date: 10-01-2023
DOI: 10.3389/FENDO.2022.1071489
Abstract: Disappointingly few efficacious health interventions are successfully scaled up and implemented in real world settings. This represents an evidence-to-practice gap, with loss of opportunity to improve practice. Aiming to improve nutrition in the first 1000 days of life, we have combined four efficacious dietary interventions into a single adapted digital resource (Nutrition Now) for implementation in a Norwegian community setting. Nutrition Now targets pregnant women and parents of 0–2-year-olds with messages focusing on healthy dietary behaviours. Early childhood education and care (ECEC) staff are provided with pedagogical tools addressing healthy food exposure and child food acceptance. Objectives: a) evaluate the effectiveness of provision of the Nutrition Now resource on child diet and diet-related outcomes, with special attention to the influence of socio-economic position, b) gather information on the effectiveness of the implementation process to inform forthcoming scale-up and c) perform trial- and model-based economic evaluations. This is a hybrid type 1 implementation study, focusing on evaluation of effectiveness. A quasi-experimental design with pre- and post-tests, where one municipality gets access to the resource (n~800), while a matched non-equivalent control municipality (n~800) does not, will be used. Effectiveness will be assessed by examining e.g., diet outcomes, developmental outcomes, and feeding practices. The resource will be implemented in ECEC settings and made available to pregnant women and parents through the Norwegian system of maternal and child health (MCH) care. The implementation process includes iterative adjustments and implementation strategies from the implementation framework Expert Recommendations for Implementing Change (ERIC) informed by dialogues with stakeholders. Implementation outcomes (e.g., acceptability and adoption) will be assessed through questionnaires and interviews with parents, ECEC and MCH staff, with particular attention to ethnic erse groups. Both within-trial and modelling-based economic evaluation will be performed. Nutrition Now will bridge the existing evidence-to-practice gap through rigorous scientific effectiveness evaluation of municipal scale up and inform subsequent county scale up. The study is the first to implement efficacious nutrition interventions in early life with potential for health improvement using technology to maximise the reach and impact of both parental and MCH dietary guidance and ECEC practice. www.isrctn.com/ , identified ISRCTN10694967.
Publisher: Springer Science and Business Media LLC
Date: 09-12-2023
Publisher: MDPI AG
Date: 29-06-2022
DOI: 10.3390/NU14132705
Abstract: In this paper we report on the development and field-testing of proposed food-based dietary guideline (FBDG) messages among Tanzanian consumers. The messages were tested for cultural appropriateness, consumer understanding, acceptability, and feasibility. In addition, comprehension of the messages was assessed using culturally representative images for low literacy audiences. Focus group discussions were used as method for data collection. Results indicate that the core meaning of the proposed FBDG messages and images were understood and acceptable to the general population. However, participants felt that nutrition education would be required for improved comprehension. Feasibility was affected by some cultural differences, lack of nutrition knowledge, time constraints, and poverty. Suggestions were made for some rewording of certain messages and editing of certain images. It is recommended that the field-tested messages and images, incorporating the suggested changes, should be adopted. Once adopted, the FBDGs can be used to inform and engage various stakeholders, including parents, caregivers, healthcare providers and educators on appropriate nutritional practices for children and adults. They can also be used to guide implementation of relevant policies and programmes to contribute towards the achievement of sustainable healthy diets and healthy dietary patterns.
Publisher: MDPI AG
Date: 07-07-2019
Abstract: Poor diet is a significant contributor to obesity and chronic disease. With all being more prevalent in rural than urban Australia, modifying the food environment is a potential intervention point to improve the health of rural populations. This review examined the applicability of measurement tools used in rural food environment research for rural Australia. Six electronic databases were searched for peer-reviewed literature, published in English between 2006 and 2018, including at least one objective measure of the Community or Consumer Food Environment in a rural or mixed rural/urban context. One-hundred and seventy-seven papers were returned after removal of duplicates, with a final review of 25. Most studies were cross-sectional, with one intervention study of quasi-experimental design. Nine studies employed a conceptual model there was considerable variability in tools used and few described psychometric testing. The most common attribute measured was price, followed by available healthy options. The findings of this review do not offer a suite of ‘gold standard’ measurement tools known to be reliable, valid and sensitive to change to assess the community or consumer food environments in rural Australian towns. However, recommendations are proposed to progress this important area of research within a rural context.
Publisher: MDPI AG
Date: 19-04-2018
DOI: 10.3390/NU10040509
Publisher: Wiley
Date: 04-09-2007
Publisher: Elsevier BV
Date: 02-2022
DOI: 10.1016/J.APPET.2021.105816
Abstract: Families face many barriers in providing nutritious home-cooked family meals. Meal kit subscription services are increasingly popular among families and may address obstacles to cooking at home and facilitate shared family meals. This study aimed to understand why families use meal kits and what they perceived to be the main impacts on family dynamics, nutrition, social and mental health. Sixteen primary meal providers with at least one child 18 years and under living at home, were recruited via social media (e.g., Facebook, Twitter) to participate in a semi-structured interview using Zoom videoconferencing. Interviews were conducted with participants who currently purchased and used commercially available meal kits in Australia (e.g., HelloFresh, Marley Spoon). Thematic analysis of interview transcripts revealed that women, as the primary carers responsible for family meals, primarily reported the role that meal kits played in reducing their mental load through reduced food-related decision making, enhanced family participation in meal preparation, and opportunities for food literacy. Additionally, meal kits were reported to reduce food eaten away-from-home with the majority of participants perceiving meal kits to provide nutritionally dense meals and appropriate portion sizes aligned with National dietary guidelines. This study provides important insights into the potential physical, mental and social health benefits of meal kits in supporting families to cook and eat meals together at home. While meal kits have the capacity to positively influence population health and wellbeing, it is necessary that meal kit subscription services address the nutritional quality of their meals and provide evidence-based nutrition messaging to facilitate improvements in food literacy and nutritional intake.
Publisher: JMIR Publications Inc.
Date: 18-07-2022
DOI: 10.2196/35553
Abstract: Early childhood is a critical period for supporting the development of healthy eating habits, which may affect lifelong health. Childcare services are important settings for promoting early childhood nutrition however, food provision in childcare frequently does not align with dietary guidelines. Web-based menu planning tools are well suited to support healthy food provision in childcare, although little is known about their use. Research is needed to understand how web-based menu planning tools are used in the childcare setting and how they can effectively support healthy menu planning and food provision for children in childcare. We aimed to explore the use of a web-based menu planning tool called FoodChecker, which is available to childcare services in Victoria, Australia. We also aimed to gain insights and perspectives from childcare staff involved in menu planning about their use of the tool to plan healthy menus and guide healthy food provision for children. We conducted a qualitative descriptive study using a cross-sectional web-based survey completed by the staff involved in menu planning in childcare services. Thematic analysis was performed using NVivo software. Emergent themes were mapped against constructs of the Technology Acceptance Model regarding perceived usefulness, perceived ease of use, and external variables influencing perceptions and use. The participants included 30 cooks and 34 directors from 53 childcare services. Participants perceived the web-based menu planning tool as useful for supporting child nutrition and health, improving organizational processes, and aiding the menu planner role. Perceptions regarding ease of use were mixed. External variables influencing perceptions and use included awareness of the tool, perceived need, time, resources, organizational support, and the food budget. Participants made recommendations to improve the tool, particularly the need to integrate functionality to make it easier and faster to use or to include more links to resources to support healthy menu planning. The web-based menu planning tool was perceived as useful for cooks and directors in childcare services. Areas for improvement were identified for ex le, the need for integrated digital features to make the tool easier and faster to use. As the first qualitative study to explore childcare staff experiences with a web-based menu planning tool, these findings inform future research and development of such tools to aid scalable and sustainable support for healthier food provision in the childcare sector.
Publisher: Springer Science and Business Media LLC
Date: 16-06-2021
DOI: 10.1186/S12889-021-11226-5
Abstract: Healthy Beginnings is an established nurse-led early childhood obesity prevention program that promotes healthy infant feeding practices and active play in the early years of life. To improve engagement with culturally and linguistically erse populations, the Healthy Beginnings program delivered by telephone was culturally adapted and implemented with Arabic- and Chinese-speaking mothers in Sydney, Australia. The cultural adaptation process has been published separately. In this article, we aimed to evaluate the feasibility of the culturally adapted program. In 2018–2019, the culturally adapted Healthy Beginnings program was implemented with Arabic- and Chinese-speaking women recruited from antenatal clinics in Sydney. At four staged timepoints (from third trimester until 6 months of age), mothers were sent culturally adapted health promotion booklets and text messages and offered four support calls from bi-cultural child and family health nurses in Arabic and Chinese. A mixed methods evaluation included a) baseline and 6-month telephone surveys, followed by b) semi-structured follow-up interviews with a subset of participating mothers and program delivery staff. Main outcomes of this feasibility study were reach (recruitment and retention), intervention dose delivered (number of nurse support calls completed) and acceptability (appropriateness based on cognitive and emotional responses). At recruitment, 176 mothers were eligible and consented to participate. Of 163 mothers who completed the baseline survey, 95% completed the program ( n = 8 withdrew) and 83% completed the 6-month survey ( n = 70 Arabic- and n = 65 Chinese-speaking mothers). Most mothers ( n = 127, 78%) completed at least one nurse support call. The qualitative analysis of follow-up interviews with 42 mothers (22 Arabic- and 20 Chinese-speaking mothers) and 10 program delivery staff highlighted the perceived value of the program and the positive role of bi-cultural nurses and in-language resources. Mothers who completed more nurse support calls generally expressed greater acceptability. The culturally adapted Healthy Beginnings program was feasible to deliver and acceptable to Arabic- and Chinese-speaking mothers. Our results highlight the importance of in-language resources and in idualised bi-cultural nurse support by telephone for supporting culturally and linguistically erse migrant families with infant feeding and active play. These findings support the potential for program refinements and progression to an effectiveness trial.
Publisher: MDPI AG
Date: 17-09-2020
Abstract: Early childhood is a critical stage for nutrition promotion, and childcare settings have the potential for wide-reaching impact on food intake. There are currently no Australian national guidelines for childcare food provision, and the comparability of existing guidelines across jurisdictions is unknown. This project aimed to map and compare childcare food provision guidelines and to explore perspectives amongst early childhood nutrition experts for alignment of jurisdictional childcare food provision guidelines with the Australian Dietary Guidelines (ADG). A desktop review was conducted and formed the basis of an online survey. A national convenience s le of childhood nutrition experts was surveyed. Existing guideline recommendations for food group serving quantities were similar across jurisdictions but contained many minor differences. Of the 49 survey respondents, most (84–100%) agreed with aligning food group provision recommendations to provide at least 50% of the recommended ADG serves for children. Most (94%) agreed that discretionary foods should be offered less than once per month or never. Jurisdictional childcare food provision guidelines do not currently align, raising challenges for national accreditation and the provision of support and resources for services across jurisdictions. Childhood nutrition experts support national alignment of food provision guidelines with the ADG.
Publisher: Springer Science and Business Media LLC
Date: 20-03-2023
DOI: 10.1186/S12966-023-01433-1
Abstract: Instilling healthy dietary habits and active play in early childhood is an important public health focus. Interventions supporting the establishment of nutrition and active play behaviours in the first years of life have shown positive outcomes and long-term cost-effectiveness, however, most are research trials, with limited evidence regarding real-world application. Implementation science theories, models and frameworks (TMFs) can guide the process of research translation from trial to real-world intervention. The application of TMFs within nutrition and active play intervention studies in early childhood ( 5 years) is currently unknown. This systematic review identified the use of TMFs and barriers/ enablers associated with intervention adoption, implementation, and sustainability in early childhood nutrition and active play interventions implemented under real-world conditions. Six databases were searched for peer-reviewed publications between 2000–2021. Studies were included if primary outcomes reported improvement in diet, physical activity or sedentary behaviours amongst children aged 5 years and interventions were delivered under real-world conditions within a community and/or healthcare setting. Two reviewers extracted and evaluated studies, cross checked by a third and verified by all authors. Quality assessment of included studies was completed by two authors using the Mixed Methods Appraisal Tool (MMAT). Eleven studies comprising eleven unique interventions were included. Studies represented low, middle and high-income countries, and were conducted across a range of settings. Five TMFs were identified representing four of Nilsen’s implementation model categories, predominantly ‘evaluation models’. Ninety-nine barriers/facilitators were extracted across the three intervention phases—Implementation ( n = 33 barriers 33 facilitators), Sustainability ( n = 19 barriers n = 9 facilitators), Adoption ( n = 2 barriers n = 3 facilitators). Identified barriers/facilitators were mapped to the five domains of the Durlak and DuPre framework, with ‘funding’, ‘compatibility’ and ‘integration of new programming’ common across the three intervention phases. Findings demonstrate that there is no systematic application of TMFs in the planning, implementation and/or evaluation of early childhood nutrition and active play interventions in real-world settings, and selective and sporadic application of TMFs occurs across the intervention lifespan. This apparent limited uptake of TMFs is a missed opportunity to enhance real-world implementation success. PROSPERO (CRD42021243841).
Publisher: Springer Science and Business Media LLC
Date: 16-01-2020
DOI: 10.1186/S12966-020-0909-Z
Abstract: Ineffective research-practice translation is a major challenge to population health improvement. This paper presents an international perspective on the barriers and facilitators associated with the uptake of and engagement in Dissemination and Implementation (D& I) research in the fields of physical activity and nutrition. A mixed methods study involving participants from the International Society for Behavioral Nutrition and Physical Activity (ISBNPA) network. Participants completed an online survey (May–July 2018) and/or participated in a focus group during the annual ISBNPA conference (June 2018). Descriptive statistics were generated for quantitative online and pre-focus group survey data. Fisher’s exact tests investigated associations of (i) length of time in academia, (ii) career stage and (iii) country of work, and agreement with ‘perceptions of D& I’. Qualitative data were analysed thematically. In total, 141 participants responded to the survey (76% female, 21% aged 35–39 years, 14 countries represented) and 25 participated in focus groups ( n = 3). Participants self-identified as having knowledge (48%), skills (53%) and experience supporting others (40%) to conduct D& I research. The majority (96%) perceived D& I was important, with 66% having organizational support for D& I, yet only 52% reported prioritizing D& I research. Perceptions of D& I differed by length of time in academia, career stage and country of work. Barriers included: (i) lack of D& I expertise (ii) lack of organisational support/value for D& I (iii) embedded scientific beliefs/culture (iv) methodological challenges with D& I research (v) funding ublishing priorities and (vi) academic performance structures. Facilitators included: (i) increased presence/value of D& I (ii) collective advocacy (iii) organisational support for D& I (iv) recruitment of D& I scientists and (v) restructure of academic performance models, funding ublishing criteria. In idual, organisational and system-wide factors hindered academics’ engagement with and support for D& I research, which was perceived to reduce opportunities for research-practice translation. Factors were mostly consistent across countries and in idual career stages/time spent in academia. Embedding D& I early within academic training, and system-wide reorientation of academic performance and funding structures to promote and facilitate D& I research, are some of the necessary actions to reduce the research-practice gap. Consistent with public health more broadly, these changes are long overdue in the fields of physical activity and nutrition.
Publisher: MDPI AG
Date: 21-10-2018
Abstract: In high-income countries, obesity disproportionately affects those from disadvantaged and rural areas. Poor diet is a modifiable risk factor for obesity and the food environment a primary driver of poor diet. In rural and disadvantaged communities, it is harder to access affordable and nutritious food, affecting both food insecurity and the health of rural residents. This paper aims to describe the food environment in a rural Australian community (approx. 7000 km2 in size) to inform the development of community-relevant food supply interventions. We conducted a census audit of the food environment (ground truthing) of a local government area (LGA). We used the Nutrition Environment Measurement tools (NEMS-S and NEMS-R) to identify availability of a range of food and non-alcoholic beverages, the relative price of a healthy compared to a less healthy option of a similar food type (e.g., bread), the quality of fresh produce and any in-store nutrition promotion. Thirty-eight food retail outlets operated at the time of our study and all were included, 11 food stores (NEMS-S) and 27 food service outlets (NEMS-R). The mean NEMS-S score for all food stores was 21/54 points (39%) and mean NEMS-R score for all food service outlets was 3/23 points (13%) indicative of limited healthier options at relatively higher prices. It is difficult to buy healthy food beyond the supermarkets and one (of seven) cafés across the LGA. Residents demonstrate strong loyalty to local food outlets, providing scope to work with this existing infrastructure to positively impact poor diet and improve food security.
Publisher: MDPI AG
Date: 27-04-2018
DOI: 10.3390/NU10050545
Publisher: MDPI AG
Date: 22-11-2022
DOI: 10.3390/NU14234951
Abstract: Have you thought about what it is you love about food [...]
Publisher: Cambridge University Press (CUP)
Date: 06-2022
DOI: 10.1017/S1368980022001343
Abstract: To explore government support service access, perceived barriers/enablers to menu planning and menu compliance in long day care (LDC) centres in Victoria, Australia, where the Victorian Government-funded Healthy Eating Advisory Service (HEAS) is available to provide free LDC menu planning support. This is a cross-sectional study design. Data were collected from online surveys with the option of uploading 2 weeks of menus and recipes. Menu compliance was scored for quantity, quality and variety. Barriers/enablers to menu planning guideline implementation were determined using the Theoretical Domains Framework (TDF). Independent t tests, one-way ANOVA and chi-square tests assessed relationships between characteristics, barriers/enablers and menu scores. Eighty-nine LDC centres that prepare food onsite. LDC staff responsible for menu planning ( n 89) and menus from eighteen centres. Fifty-five per cent of centres had accessed HEAS. Of eighteen provided menus, only one menu was compliant with menu planning guidelines. HEAS access was associated with higher average scores in four of seven TDF domains, namely knowledge/awareness, skills/role, reinforcement/influence and optimism/intent. There were no correlations between menu score and barriers/enablers however, menu quality scores were higher for those accessing HEAS. Childcare-specific government support services may be an important public health nutrition strategy and may improve menu planning guideline implementation as well as menu quality however, this does not necessarily translate into menu compliance. Research should confirm these findings in larger studies to ascertain uptake of these services. Public health efforts should focus on exploring barriers and enablers to uptake of government support services to increase reach and acceptability.
Publisher: JMIR Publications Inc.
Date: 13-02-2022
Abstract: arly childhood is a critical period for supporting the development of healthy eating habits, which may affect lifelong health. Childcare services are important settings for promoting early childhood nutrition however, food provision in childcare frequently does not align with dietary guidelines. Web-based menu planning tools are well suited to support healthy food provision in childcare, although little is known about their use. Research is needed to understand how web-based menu planning tools are used in the childcare setting and how they can effectively support healthy menu planning and food provision for children in childcare. e aimed to explore the use of a web-based menu planning tool called i FoodChecker /i , which is available to childcare services in Victoria, Australia. We also aimed to gain insights and perspectives from childcare staff involved in menu planning about their use of the tool to plan healthy menus and guide healthy food provision for children. e conducted a qualitative descriptive study using a cross-sectional web-based survey completed by the staff involved in menu planning in childcare services. Thematic analysis was performed using NVivo software. Emergent themes were mapped against constructs of the Technology Acceptance Model regarding perceived usefulness, perceived ease of use, and external variables influencing perceptions and use. he participants included 30 cooks and 34 directors from 53 childcare services. Participants perceived the web-based menu planning tool as useful for supporting child nutrition and health, improving organizational processes, and aiding the menu planner role. Perceptions regarding ease of use were mixed. External variables influencing perceptions and use included awareness of the tool, perceived need, time, resources, organizational support, and the food budget. Participants made recommendations to improve the tool, particularly the need to integrate functionality to make it easier and faster to use or to include more links to resources to support healthy menu planning. he web-based menu planning tool was perceived as useful for cooks and directors in childcare services. Areas for improvement were identified for ex le, the need for integrated digital features to make the tool easier and faster to use. As the first qualitative study to explore childcare staff experiences with a web-based menu planning tool, these findings inform future research and development of such tools to aid scalable and sustainable support for healthier food provision in the childcare sector.
Publisher: Elsevier BV
Date: 04-2015
Publisher: Springer Science and Business Media LLC
Date: 30-10-2019
DOI: 10.1186/S12889-019-7644-X
Abstract: Understanding levels of community readiness can result in prevention efforts that align with communities’ ability and capacity for change and, therefore, be more effective and sustainable. Our study aimed to use baseline (pre-intervention) community readiness scores to assist with the development of obesity prevention strategies, and to assess changes in community readiness over time (pre ost- intervention), to provide evidence of intervention impact. Our study was located in a rural and remote area of Victoria, Australia. Community readiness was part of a broader obesity prevention intervention designed to create healthier food and physical activity environments through the combination of systems thinking and collaborative community-led solutions. Interviews were conducted using the community readiness to change tool in 2016 (pre) and 2018 (post) with a community representative s le. Baseline data informed the development of community relevant strategies and the pre ost results formed part of the overall evaluation. The tool generated both quantitative and qualitative (quotes) data. A final readiness score was calculated that corresponded to one of the nine stages of readiness. Four of the five domains of the community readiness to change tool showed statistically significant improvements over time ( p 0.05): knowledge of effort, knowledge of issue, community climate, and leadership. The resources domain that did not improve pre ost intervention. Community readiness to change interviews, pre- and post- intervention, provided essential information related to the appropriate targeting and pitch of the prevention strategies, as well as providing an overall evaluation of the positive movement in the community’s readiness to implement change.
Publisher: Wiley
Date: 27-07-2023
DOI: 10.1111/AJR.12901
Abstract: Residents of rural areas internationally typically experience chronic disease risk profiles worse than city dwellers. Poor diet, a key driver of chronic disease, has been associated with unhealthy food environments, and rural areas often experience limited access to healthy, fresh and affordable food. This study aimed to evaluate the first three years of a health promoting social enterprise café established in a small rural health service. A mixed‐methods evaluation study. Quantitative sales data, surveys and key informant interviews that included both quantitative and qualitative responses. Three years of sales data were included 111customer surveys and five key informant interviews were conducted. Food and beverages on displayed and sold consistently met or exceeded the healthy criteria set by policy. Stakeholders supported the traffic light system, the social enterprise model and rated the likelihood of sustainability of the café as high. Customers used the ‘traffic light’ system to inform food choices, placed value on the warmth of the staff and on the welcoming environment created through the social enterprise model. Resources remain tight although all stakeholders are committed to the sustainability of the YarriYak café. The study shows the acceptability, feasibility and sustainability of a health promoting social enterprise café in a rural area.
Publisher: MDPI AG
Date: 08-03-2021
Abstract: Objective: To highlight opportunities for future nutrition intervention research within early childhood and education care (ECEC) settings, with a focus on generating evidence that has applicability to real-world policy and practice. Methods: An overview of opportunities to progress the field was developed by the authors using a collaborative writing approach and informed by recent research in the field. The group developed a list of recommendations aligned with the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework. Pairs of authors drafted in idual sections of the manuscript, which were then reviewed by a separate pair. The first and senior author consolidated all sections of the manuscript and sought critical input on the draft iterations of the manuscript. Results: Interventions that employ digital platforms (reach) in ECEC settings, as well as research in the family day care setting (effectiveness) were identified as areas of opportunities. Research understanding the determinants of and effective strategies for dissemination (adoption), the implementation of nutrition programs, in addition to de-implementation (implementation) of inappropriate nutrition practices, is warranted. For maintenance, there is a need to better understand sustainability and the sustainment of interventions, in addition to undertaking policy-relevant research. Conclusions: The ECEC setting is prime for innovative and practical nutrition intervention research.
Publisher: MDPI AG
Date: 05-11-2018
Abstract: Rural communities experience higher rates of obesity and reduced food security compared with urban communities. The perception that healthy foods are expensive contributes to poor dietary choices. Providing an accessible, available, affordable healthy food supply is an equitable way to improve the nutritional quality of the diet for a community, however, local food supply data are rarely available for small rural towns. This study used the Healthy Diets ASAP tool to assess price, price differential and affordability of recommended (healthy) and current diets in a rural Local Government Area (LGA) (pop ≈ 7000 10 towns) in Victoria, Australia. All retail food outlets were surveyed (n = 40). The four most populous towns had supermarkets remaining towns had one general store each. Seven towns had café/take-away outlets, and all towns had at least one hotel ub. For all towns the current unhealthy diet was more expensive than the recommended healthy diet, with 59.5% of the current food budget spent on discretionary items. Affordability of the healthy diet accounted for 30–32% of disposable income. This study confirms that while a healthy diet is less expensive than the current unhealthier diet, affordability is a challenge for rural communities. Food security is reduced further with restricted geographical access, a limited healthy food supply, and higher food prices.
Publisher: Elsevier BV
Date: 07-2020
Publisher: Frontiers Media SA
Date: 08-11-2021
DOI: 10.3389/FENDO.2021.717468
Abstract: Promoting healthy eating and active play in early life is critical, however few interventions have been delivered or sustained at scale. The evaluation of interventions at scale is a crucial, yet under-researched aspect of modifying population-level health behaviours. INFANT is an evidence-based early childhood healthy lifestyle intervention that aims to improve parents’ knowledge and skills around promoting optimal energy balance-related behaviours that, in turn, influence children’s diet, activity and adiposity. It consists of: 1) Four group sessions delivered via first time parent groups across the first 12 months of life 2) access to the My Baby Now app from birth to 18 months of age. This research aims to assess real-world implementation, effectiveness and cost-effectiveness of INFANT when delivered at scale across Victoria, Australia. A hybrid type II implementation-effectiveness trial applying a mixed methods design will be conducted. INFANT will be implemented in collaboration with practice and policy partners including maternal and child health services, population health and Aboriginal health, targeting all local government areas (n=79) in Victoria, Australia. Evaluation is based on criteria from the ‘Outcomes for Implementation Research’ and ‘RE-AIM’ frameworks. Implementation outcomes will be assessed using descriptive quantitative surveys and qualitative interviews with those involved in implementation, and include intervention reach, organisational acceptability, adoption, appropriateness, cost, feasibility, penetration and sustainability. Process measures include organizational readiness, fidelity, and adaptation. Effectiveness outcomes will be assessed using a s le of INFANT participants and a non-randomized comparison group receiving usual care (1,500 infants in each group), recruited within the same communities. Eligible participants will be first time primary caregivers of an infant aged 0-3 months, owning a personal mobile phone and able to communicate in English. Effectiveness outcomes include infant lifestyle behaviours and BMIz at 12 and 18 months of age. This is the first known study to evaluate the scale up of an evidence based early childhood obesity prevention intervention under real world conditions. This study has the potential to provide generalisable implementation, effectiveness and cost-effectiveness evidence to inform the future scale up of public health interventions both in Australia and internationally. Australian and New Zealand Clinical Trial Registry www.anzctr.org.au/ , identifier ACTRN12620000670976.
Publisher: Wiley
Date: 21-07-2022
DOI: 10.1002/HPJA.521
Abstract: Early obesity prevention research interventions in Australia generally expect participants to be able to communicate in English, but do not account for other languages. This study aimed to investigate engagement, satisfaction, retention and behavioural outcomes of linguistically erse participants from a mainstream early childhood obesity prevention trial. Healthy Beginnings is a nurse‐led intervention based in Sydney, supporting families with optimal infant feeding and active play via telephone. This secondary analysis assessed participant engagement in the nurse telephone calls (call completions), satisfaction and behavioural outcomes (6‐ and 12‐month survey data) and retention (survey completions), in the first year of life according to participants’ language spoken at home (English or other language). Of 1155 mothers, 533 (46%) spoke a language other than English at home. Significantly fewer mothers speaking a language other than English completed the 6‐month survey (79%) compared to those speaking English (84%), yet mothers speaking a language other than English who completed the program were more satisfied with the program overall. Significantly fewer mothers speaking a language other than English completed the final four nurse calls (of six) (56%‐65%) compared to those speaking English (70%‐80%). Adjusted odds ratios showed selected behavioural outcomes were significantly more positive for participants speaking English at home. Healthy Beginnings trial participants who spoke a language other than English at home had less favourable engagement, retention and behavioural outcomes compared to those who spoke English. So what? Early obesity prevention interventions should consider cultural adaptations to improve engagement and effectiveness among culturally and linguistically erse families.
Publisher: Wiley
Date: 30-03-2018
DOI: 10.1111/OBR.12675
Abstract: Obesity is a global problem for which sustainable solutions are yet to be realized. Community-based interventions have improved obesity-related behaviours and obesity in the short term. Few papers have explored how to make the interventions and their intended outcomes sustainable. The aim of this paper is to identify factors that contribute to the sustainability of community-based obesity prevention interventions and their intended outcomes. A systematic narrative synthesis review was conducted of published community-based obesity prevention interventions to identify factors contributing to intervention sustainability. Data extracted were included study authors' perspectives of intervention success and sustainability. Eighty-one papers met the inclusion criteria, and from these we identified ten factors that contribute to sustainability: resourcing, leadership, workforce development, community engagement, partnerships, policy, communications, adaptability, evaluation and governance. This review of community-based obesity prevention interventions gives rise to optimism that sustainable change is possible. We propose a framework to help practitioners build sustainability into their interventions and report on them so that others can also benefit.
Publisher: ACER Press
Date: 10-2020
Publisher: Oxford University Press (OUP)
Date: 17-01-2020
Abstract: Schools are regarded as a key setting for obesity prevention, providing an opportunity to reach a large number of children, frequently and over a prolonged period, through formal and informal opportunities to learn about health behaviours. However, the low value placed on health versus academic achievement is a barrier to effective implementation of food and nutrition (F& N) education. This study used a qualitative exploratory approach to explore the views of teachers and key health and education sector stakeholders regarding opportunities for F& N education within the Australian primary school setting. To the best of our knowledge, this is the first study to explore this topic from the perspectives of state-level coordination and development through to local-level implementation and support within the Australian primary school context. Only 2.6% of the Victorian Curriculum related to F& N education, taught through two (of seven) learning outcomes: Health and Physical Education, and Technologies. While stakeholders considered child health a priority, and schools an ideal setting for F& N education, barriers included a lack of strategic policy alignment, limited leadership and coordination, a ‘crowded curriculum’ and poor availability of shelf-ready resources with explicit curriculum links. A cross-curriculum approach was considered essential for F& N education to become embedded as a core component of the curriculum.
Publisher: Wiley
Date: 05-12-2022
DOI: 10.1111/OBR.13402
Abstract: Interventions for obesity prevention can effectively reduce obesity‐related behaviors in young children. Understanding how to leverage and adapt evidence‐based interventions is needed to improve reach among culturally and linguistically erse families. This systematic review aimed to synthesize the approaches and outcomes of culturally adapted early childhood obesity‐related behavioral prevention interventions. Multiple electronic databases were systematically searched in March 2021. All study designs were included if they reported cultural adaptations of an intervention targeting at least one obesity‐related behavior (infant feeding, nutrition, physical activity, and/or sleep) among children aged 0–5 years. Studies that only conducted language translations or that developed new interventions were excluded. Two authors independently conducted critical appraisals using the Mixed Method Appraisal Tool. Findings were synthesized narratively, based on the Stages of Cultural Adaptation theoretical model and the Framework for Reporting Adaptations and Modifications‐Enhanced. Twelve interventions met the inclusion criteria, with varied study designs. Few reported all aspects of cultural adaptation processes, and the cultural adaptation strategies documented varied. The results suggest that cultural adaptation of obesity‐related behavioral prevention interventions targeting young children increases acceptability among target cultural groups, yet effectiveness is inconclusive due to a lack of trials. More detailed reporting of cultural adaptation processes and further effectiveness trials are needed to evaluate future work.
Publisher: The Sax Institute
Date: 03-2019
DOI: 10.17061/PHRP2911904
Abstract: Early childhood provides an opportunity to support parents to promote a range of healthy behaviours at a time of high engagement with family-focused health services. The Infant Program is believed to be the first of its kind to address healthy behaviours and obesity risk in the first year of life using a universally delivered service. The program is an efficacious, low-cost intervention, and many lessons have been learnt across the journey from a randomised controlled trial to small-scale community implementation. The evolution of the Infant Program highlights the value of applying a translational research process to best position interventions to be implemented at scale. It also illustrates the benefits that a sequential approach, a receptive environment and system-level support provide when seeking to integrate new interventions into routine health service delivery. Understanding these processes and factors leads to a better appreciation of the role each step plays in implementing population health interventions at scale.
Publisher: Bristol University Press
Date: 2016
DOI: 10.1332/204674315X14297901956276
Abstract: Coordinated systems are required to ensure evidence-informed practice and evaluation of community-based interventions (CBIs). Knowledge translation and exchange (KTE) strategies show promise, but these require evaluation. This paper describes implementation and evaluation of COOPS, a national KTE platform to support best practice in obesity prevention CBIs. A logic model guides KTE activities including knowledge brokering, networking, tailored communications, training, and needs assessments. A mixed-methods evaluation includes communications data, knowledge brokering database, annual survey of CBIs, pre- and post-event questionnaires, interviews, social network analysis, and case studies. This evaluation will contribute to understanding the process of implementing a KTE platform with CBIs and its reach, quality and effectiveness.
Publisher: MDPI AG
Date: 09-02-2022
DOI: 10.3390/NU14040731
Abstract: Informed by the Innocenti framework, this rapid review of systematic reviews (n = 60) and sentinel grey literature (n = 27) synthesises the evidence of what works to improve nutrition and food sustainability across the first 2000 days. Most systematic reviews focused on interventions targeting the behaviour of parents and caregivers (n = 49), with fewer reviews focusing on the personal (n = 7) and external (n = 4) food environments. No reviews focused on food supply-chain activities. Most reviews were rated as critically low (n = 28, 47%) or low (n = 21, 35%) quality using AMSTAR 2. Evidence supports the effectiveness of multi-component breastfeeding interventions, interventions delivered in home and child-care settings, particularly when involving parents, interactive skill building and repeated exposure to vegetables. Food vouchers and access to local farmers markets and community gardens have potential for improving access and availability to healthier foods, while evidence supports interventions improving the external food environment, including fiscal strategies such as the SSB tax, restrictions on marketing and advertising of discretionary products and improved food labelling. Overall, this review highlights the importance of action across a range of settings and sectors at the international, national and local levels to improve young children’s diets.
Publisher: Frontiers Media SA
Date: 13-01-2023
DOI: 10.3389/FPUBH.2022.1026856
Abstract: Early life parent-focused interventions can effectively improve infant and child nutrition and movement (physical activity and sedentary behavior) as well as parents' health behaviors. Scale-up of such interventions to real-world settings is essential for population-wide benefits. When progressing to scale-up, intervention components may be modified to reflect contextual factors and promote feasibility of scale-up. The INFANT program, an efficacious early life nutrition and movement behavioral intervention began as a randomized controlled trial (RCT), was modified after a small-scale translation, and is currently being scaled-up in Victoria, Australia. This study mapped and compared discrete intervention components of both the original RCT and the scaled-up version of INFANT to examine modifications for scaling up. Discrete intervention components, specifically the target behaviors (child-related and parent-related behaviors), delivery features and behavior change techniques (BCTs) from the RCT and the scaled-up program were coded and mapped using established frameworks and taxonomies. Publications and unpublished materials (e.g., facilitator notes, handouts, videos, app) were coded. Coding was performed independently in duplicate, with final coding validated in a meeting with interventionists. Interventionists reported the rationale for modifications made. The INFANT RCT and scaled-up version targeted the same obesity prevention-related nutrition and movement behaviors. Key modified delivery features at scale-up included reduced number of sessions, a broader range of professionals facilitating groups, the addition of a mobile app for parents replacing hard-copy materials and tangible tools (e.g., pedometers), and broadening of content (e.g., early feeding, updated 24-h movement guidelines). BCTs used across the RCT and scale-up sessions were unchanged. However, the BCTs identified in the between-session support materials were almost double for the scale-up compared with the RCT, primarily due to the reduced number of sessions and the app's capacity to include more content. INFANT is one of few early life nutrition and movement behavioral interventions being delivered at scale. With INFANT as an ex le, this study provides critical understanding about what and why intervention components were altered as the RCT was scaled-up. Unpacking these intervention modifications provides important insights for scale-up feasibility, outcome effects, and how to optimize implementation strategies for population-level benefits.
Publisher: Oxford University Press (OUP)
Date: 23-05-2014
Publisher: The Sax Institute
Date: 10-2022
DOI: 10.17061/PHRP3232226
Abstract: Nutrition across the first 2000 days of life, from conception to age five, is considered critical in shaping lifelong nutrition and health outcomes, with dietary patterns tracking from infancy into later childhood and adulthood. Identifying potential policy, programmatic, and research opportunities is essential to inform action in this area. This research was undertaken to provide an overview of the evidence support, policy mechanisms and stakeholder perspectives on opportunities for improving nutrition across the first 2000 days of life to guide future investments and to inform policy dialogues with relevant government, non-government and external agencies within the state of Victoria, Australia. Underpinned by UNICEF's Innocenti Framework, this research comprised: a) a rapid review of existing systematic reviews (n = 60) supplemented with key grey literature reports b) mapping of potential policy and programmatic levers and partnerships against 14 identified areas and c) qualitative semi-structured interviews with key stakeholders across health (n = 4), education (n = 2), local government (n = 1), non-government organisations/not-for-profits (n = 5), and peak bodies (n = 2). The 'caregiver behaviours' determinant within the Innocenti Framework yielded the largest number of systematic reviews and had the strongest alignment to existing policy frameworks. Victoria has a robust state-level policy mechanism for preventive health. However, policy voids were identified within the 'external food environment' and 'food supply chains' determinants due to a lack of regulation to restrict marketing and advertising by harmful food industries and no national food and nutrition plan. Thematic analysis of interviews revealed three key themes: a) continuity of care from pre-conception to childcare b) consistency and strengthening of early years nutrition messages and c) capacity for early years nutrition initiatives. Numerous opportunities were identified to improve nutrition across the first 2000 days of life within national, state and local government systems, using policy, practice and research mechanisms. More joined-up action and greater program olicy coherence is needed, with funded capacity to facilitate the delivery of coordinated and integrated services to address nutrition in the first 2000 days of life. Further exploration is needed of the feasibility, acceptability and equity impacts, and in some cases effectiveness, of these opportunities in close collaboration with stakeholders.
Publisher: MDPI AG
Date: 25-05-2020
Abstract: Background: Early childhood (2–5 years) is acknowledged as a critical time for the establishment of healthy behaviours. The increasing number of children and amount of time spent in childcare provides strong rationale to explore the important role that childcare services and childcare educators play in influencing healthy eating behaviours of young children in their care. Methods: This study used a qualitative exploratory approach to describe the knowledge, attitudes and practices of Australian childcare trainee educators’ regarding their role in the feeding of young children. Results: All participants agreed that feeding of young children was an important part of their role, but described challenges to the promotion of healthy eating and the adoption of responsive child feeding practices. These included personal beliefs and experiences with food, the bi-directional nature of child feeding, conflicting parental requests and/or unsupportive centre-based policies and procedures. Conclusion: Training about responsive child feeding practices within the childcare sector should include all childcare staff aim to enhance relational efficacy and communication skills with parents and empower childcare staff to lead organisational change. To support this, childcare centres need to provide coherent centre-based healthy eating policies inclusive of healthy food provision and desirable feeding practices.
Publisher: Springer Science and Business Media LLC
Date: 07-08-2018
Publisher: Springer Science and Business Media LLC
Date: 09-09-2022
DOI: 10.1007/S13668-022-00428-X
Abstract: Poor diets are a leading risk factor for chronic disease globally. Research suggests healthy foods are often harder to access, more expensive, and of a lower quality in rural/remote or low-income/high minority areas. Food pricing studies are frequently undertaken to explore food affordability. We aimed to capture and summarise food environment costing methodologies used in both urban and rural settings. Our systematic review of high-income countries between 2006 and 2021 found 100 relevant food pricing studies. Most were conducted in the USA ( n = 47) and Australia ( n = 24), predominantly in urban areas ( n = 74) and cross-sectional in design ( n = 76). All described a data collection methodology, with just over half ( n = 57) using a named instrument. The main purpose for studies was to monitor food pricing, predominantly using the ‘food basket’, followed by the Nutrition Environment Measures Survey for Stores (NEMS-S). Comparatively, the Healthy Diets Australian Standardised Affordability and Price (ASAP) instrument supplied data on relative affordability to household incomes. Future research would benefit from a universal instrument reflecting geographic and socio-cultural context and collecting longitudinal data to inform and evaluate initiatives targeting food affordability, availability, and accessibility.
Publisher: Bristol University Press
Date: 02-2020
DOI: 10.1332/174426418X15260526569269
Abstract: Obesity prevention is an urgent public health priority that requires action at multiple levels. Collaboration between academics, policy and practice is necessary to ensure best-practice implementation. A national knowledge translation and exchange (KT) platform, the Collaboration of Community-based Obesity Prevention Sites (CO-OPS), was delivered and evaluated over three years (2013–15). A mixed-methods evaluation used communications and website data, knowledge-brokering data, event evaluations, interviews and tracer searches to assess process (reach, delivery, quality, cost, uptake) and impact (use of tools/resources, networking, improvements in practice). Results included: 1) average 27% yearly membership growth (330 new members per year) in response to KT activities including tailored communications, stakeholder engagement, knowledge brokering and networking opportunities 2) sustained website use with approximately 1200 visits/month and 73% unique visitors and high access to networking and professional development information (120 hits/month), and best practice guidelines (60 hits/month) 3) higher uptake of face-to-face interactive strategies (for ex le, workshops) than online interactive strategies (for ex le, knowledge broker service) and higher uptake of passive KT (for ex le, website resources) than interactive KT strategies (for ex le, workshops) 4) the KT function of CO-OPS was clearly valued, and appeared to address a gap in implementation. A central coordinating KT platform provided support for best practice and exchange opportunities to a broad network of practice, policy and academic professionals. Simple KT strategies such as tailored, targeted online resources were useful for practice, whilst more intensive KT strategies were important for network engagement. Findings are applicable to other information-sharing networks where professionals address complex public health problems.
Publisher: Informa UK Limited
Date: 2008
Publisher: MDPI AG
Date: 30-03-2022
Abstract: Background: Children aged 2–11 years spend significant hours per week in early childhood education and care (ECEC) and primary schools. Whilst considered important environments to influence children’s food intake, there is heterogeneity in the tools utilised to assess food provision in these settings. This systematic review aimed to identify and evaluate tools used to measure food provision in ECEC and primary schools. Methods: The Preferred Reporting Items for Systematic Reviews (PRISMA) was followed. Publications (2003–2020) that implemented, validated, or developed measurement tools to assess food provision within ECEC or primary schools were included. Two reviewers extracted and evaluated studies, cross checked by a third reviewer and verified by all authors. The Academy of Nutrition and Dietetics Quality Criteria Checklist (QCC) was used to critically appraise each study. Results: Eighty-two studies were included in the review. Seven measurement tools were identified, namely, Menu review Observation Weighed food protocol Questionnaire/survey Digital photography Quick menu audit and Web-based menu assessment. An evidence-based evaluation was conducted for each tool. Conclusions: The weighed food protocol was found to be the most popular and accurate measurement tool to assess in idual-level intake. Future research is recommended to develop and validate a tool to assess service-level food provision.
Start Date: 2017
End Date: 2019
Funder: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
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