ORCID Profile
0000-0003-2731-9858
Current Organisation
Deakin University - Geelong Campus at Waurn Ponds
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Health Promotion | Public Health and Health Services
Publisher: MDPI AG
Date: 30-01-2018
DOI: 10.3390/NU10020155
Publisher: Hindawi Limited
Date: 27-08-2017
DOI: 10.1155/2017/5013670
Abstract: Objectives . To compare the knowledge of Australian dietary recommendations to the dietary practices of first-year medical students. Design . Over a period of four years, anonymous online surveys were completed by medical students attending a first-year nutrition lecture. Background . There is little information on the nutritional knowledge and dietary practices of medical students. Setting . First-year postgraduate university medical students, Geelong, Victoria, Australia. Participants . Between the years 2012 and 2016, 32%–61% of first-year students completed the survey. Phenomenon of Interest . Student’s knowledge of dietary guidelines and related practices. Analysis . The frequency of response was assessed across the different year cohorts using descriptive statistics. Results . Between 59% and 93% of first-year students correctly identified the recommended daily servings for fruit, and between 61% and 84% knew the vegetable recommendations. In contrast only 40%–46% met the guidelines for fruit and 12%–19% met the guidelines for vegetables. Conclusions and Implications . Discrepancies between students’ nutrition knowledge and behavior can provide learning opportunities. With low rates of fruit and vegetable consumption in medical students, increased awareness of links between nutrition and health, together with encouragement to make behavioral changes, may increase the skills of graduates to support patients in improving dietary intake.
Publisher: Springer Science and Business Media LLC
Date: 20-05-2021
DOI: 10.1186/S40795-021-00416-4
Abstract: Nutrition-related chronic diseases are the major cause of illness and death in Pacific Island countries. Imports of sweetened beverages (SBs) are likely to be contributing but there is limited analysis of the quantities imported or the source countries of such beverages. The purpose of this study was to describe trends in the amount and types of SBs imported to Pacific Island countries and the impact of SB taxes on imports in Fiji and Tonga. A repository of official international trade statistics was used to collect data on the volume, dollar value and source countries of SBs exported to Pacific Island countries from 2000 to 2015. Corresponding population data was sourced from the Secretariat of the Pacific Community for per capita analyses. We also explored which countries earned the most from exporting SBs to the Pacific. Descriptive and regression analyses were used to describe trends over time for each country and for the region as a whole. Imports of SBs to Pacific Island Countries from 2000 to 2015 increased by an average of 0.30 kg per person per year ( p 0.001). New Zealand and the USA were the largest income earners from SB exports to the Pacific over this period. The introduction of a tax did not impact the volume of SBs imported to Fiji. More data is needed to assess the impact of SBs tax on imports in Tonga. Exports of SBs to Pacific Island countries are increasing. Both importing and exporting countries should consider the health implications of trade in these products.
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: Wiley
Date: 31-10-2023
DOI: 10.1111/OBR.13651
Publisher: Springer Science and Business Media LLC
Date: 31-05-2019
Publisher: Wiley
Date: 08-02-2023
DOI: 10.1111/OBR.13555
Abstract: Obesity, undernutrition, and climate change constitute a global syndemic that disproportionately affects vulnerable populations, including children. Double‐ and triple‐duty actions that simultaneously address these pandemics are needed to prevent further health, economic, and environmental consequences. Evidence describing the implementation and evaluation of such actions is lacking. This review summarized the literature on whole‐of‐population actions targeting children that were designed or adapted to be double or triple duty. Six academic databases were searched (January 2015–March 2021) using terms related to ‘children’, ‘intervention’, ‘nutrition’, ‘physical activity’, and ‘climate change’. Data were extracted from 43/15,475 studies, including six randomized controlled trials. Most (58%) described triple‐duty actions targeting food systems in schools such as implementing guidelines for healthier and environmentally sustainable school meals programs, and 51% reported engaging community in the design, implementation, and/or evaluation of actions. Changes in dietary intake, diet composition, greenhouse gas emissions, and food waste were the most frequently reported outcomes and 21 studies (three randomized controlled trials) showed positive double‐ or triple‐duty effects. This review is the first to demonstrate that double‐ and triple‐duty actions for addressing the global syndemic in childhood have been implemented and can have a positive impact on obesity, undernutrition, and climate change.
Publisher: Cambridge University Press (CUP)
Date: 24-09-2020
DOI: 10.1017/S1368980019002660
Abstract: To describe the development of Fiji’s fruit and vegetable fiscal policies between 2010 and 2014 and explore the impact they have had on import volumes. Qualitative case study and in-depth analysis of policy process. Policy impact was assessed using publicly available import volume data and prices of food products. Fiji. Senior government policy makers, non-communicable disease officers from the Ministry of Health and Medical Services (MoHMS) and supermarket managers. In 2011, the Fijian Government introduced an import excise of 10 % on vegetables and reduced the import fiscal duty on fruit that was also grown in Fiji by 10 %. The import tax on vegetables was removed in 2012 in response to a MoHMS request. Policy makers from several sectors supported the MoHMS request, recognized their leadership and acknowledged the importance of collaboration in achieving the removal of the excise. Tariff reductions appear to have contributed to increases in the volume of vegetables (varieties not grown in Fiji) and fruit (varieties grown in Fiji) imported, but it is not clear if this increased population consumption. Reductions in import duties appear to have contributed to increases in volumes of vegetables and fruit imported into Fiji. This case study has demonstrated that governments can use fiscal policy to meet the needs of a range of sectors including health, agriculture and tourism.
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: 16-11-2016
Publisher: Hindawi Limited
Date: 20-03-2023
DOI: 10.1155/2023/9989552
Abstract: Objective. The Victorian Government in Australia has developed Healthy Choices guidelines to ensure that healthy foods and drinks are offered and promoted in places such as hospitals. This brief report aims to present complex theoretical attributes related to cocreation through an accessible ex le of a competition to create a new name for the previously understated hospital “kiosk.” Methods. A mixed-methods approach using an online survey and semistructured interviews were used to obtain detailed insights from hospital staff members to engage in a naming competition for a hospital-based cafe. Results. The level of engagement in this activity was higher than anticipated by the management staff. Conclusions. Active involvement of staff members through a cocreation process can enable the development of innovative healthy eating strategies and increase staff engagement to further changes in the cafe. Implications for public health cocreation in public health promises effective stakeholder engagement and requires significant scientific advancement. This brief report illustrates theoretical constructs of cocreation through a naming competition activity that occurred as part of a larger project to improve Wimmera Base Hospital’s food environment.
Publisher: Cambridge University Press (CUP)
Date: 30-01-2023
DOI: 10.1017/S1368980023000198
Abstract: To determine whether primary school children’s weight status and dietary behaviours vary by remoteness as defined by the Australian Modified Monash Model (MMM). A cross-sectional study design was used to conduct secondary analysis of baseline data from primary school students participating in a community-based childhood obesity trial. Logistic mixed models estimated associations between remoteness, measured weight status and self-reported dietary intake. Twelve regional and rural Local Government Areas in North-East Victoria, Australia. Data were collected from 2456 grade 4 (approximately 9–10 years) and grade 6 (approximately 11–12 years) students. The final s le included students living in regional centres (17·4 %), large rural towns (25·6 %), medium rural towns (15·1 %) and small rural towns (41·9 %). Weight status did not vary by remoteness. Compared to children in regional centres, those in small rural towns were more likely to meet fruit consumption guidelines (OR: 1·75, 95 % CI (1·24, 2·47)) and had higher odds of consuming fewer takeaway meals (OR: 1·37, 95 % CI (1·08, 1·74)) and unhealthy snacks (OR = 1·58, 95 % CI (1·15, 2·16)). Living further from regional centres was associated with some healthier self-reported dietary behaviours. This study improves understanding of how dietary behaviours may differ across remoteness levels and highlights that public health initiatives may need to take into account heterogeneity across communities.
Publisher: Cambridge University Press (CUP)
Date: 13-07-2023
DOI: 10.1017/S136898002300126X
Abstract: Government policy guidance in Victoria, Australia, encourages schools to provide affordable, healthy foods in canteens. This study analysed the healthiness and price of items available in canteens in Victorian primary schools and associations with school characteristics. Dietitians classified menu items (main, snack and beverage) using the red, amber and green traffic light system defined in the Victorian government’s School Canteens and Other School Food Services Policy. This system also included a black category for confectionary and high sugar content soft drinks which should not be supplied. Descriptive statistics and regressions were used to analyse differences in the healthiness and price of main meals, snacks and beverages offered, according to school remoteness, sector (government and Catholic/independent) size, and socio-economic position. State of Victoria, Australia A convenience s le of canteen menus drawn from three previous obesity prevention studies in forty-eight primary schools between 2016 and 2019. On average, school canteen menus were 21 % ‘green’ (most healthy – everyday), 53 % ‘amber’ (select carefully), 25 % ‘red’ (occasional) and 2 % ‘black’ (banned) items, demonstrating low adherence with government guidelines. ‘Black’ items were more common in schools in regional population centres. ‘Red’ main meal items were cheaper than ‘green’% ‘black’ (banned) items, demonstrating low adherence with government guidelines. ‘Black’ items were more common in schools in regional population centres. ‘Red’ main meal items were cheaper than ‘green’ (mean difference –$0·48 (95 % CI –0·85, –0·10)) and ‘amber’ –$0·91 (–1·27, –0·57)) main meal items. In about 50 % of schools, the mean price of ‘red’ main meal, beverages and snack items were cheaper than ‘green’ items, or no ‘green’ alternative items were offered. In this s le of Victorian canteen menus, there was no evidence of associations of healthiness and pricing by school characteristics except for regional centres having the highest proportion of ‘black’ (banned) items compared with all other remoteness categories examined. There was low adherence with state canteen menu guidelines. Many schools offered a high proportion of ‘red’ food options and ‘black’ (banned) options, particularly in regional centres. Unhealthier options were cheaper than healthy options. More needs to be done to bring Victorian primary school canteen menus in line with guidelines.
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: 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: 05-12-2022
DOI: 10.1017/S1368980022002531
Abstract: Childhood obesity prevention is critical to reducing the health and economic burden currently experienced by the Australian economy. System science has emerged as an approach to manage the complexity of childhood obesity and the ever-changing risk factors, resources and priorities of government and funders. Anecdotally, our experience suggests that inflexibility of traditional research methods and dense academic terminology created issues with those working in prevention practice. Therefore, this paper provides a refined description of research-specific terminology of scale-up, fidelity, adaptation and context, drawing from community-based system dynamics and our experience in designing, implementing and evaluating non-linear, community-led system approaches to childhood obesity prevention. We acknowledge the importance of using a practice lens, rather than purely a research design lens, and provide a narrative on our experience and perspectives on scale-up, fidelity, context and adaptation through a practice lens. Communities. Practice-based researcher experience and perspectives. Practice-based researchers highlighted the key finding that community should be placed at the centre of the intervention logic. This allowed communities to self-organise with regard to stakeholder involvement, capacity, boundary identification, and co-creation of actions implemented to address childhood obesity will ensure scale-up, fidelity, context and adaptation are embedded. We need to measure beyond primary anthropometric outcomes and focus on evaluating more about implementation, process and sustainability. We need to learn more from practitioners on the ground and use an implementation science lens to further understand how actions work. This is where solutions to sustained childhood obesity prevention will be found.
Location: Australia
Start Date: 02-2014
End Date: 06-2016
Amount: $390,114.00
Funder: Australian Research Council
View Funded Activity