ORCID Profile
0000-0001-5912-9720
Current Organisation
Deakin University Geelong - Waterfront Campus
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Publisher: Springer Science and Business Media LLC
Date: 22-06-2021
DOI: 10.1186/S12966-021-01151-6
Abstract: Environments within schools including the physical, social-cultural and policy ractice environments have the potential to influence children’s physical activity (PA) behaviours and weight status. This Australian first study comprehensively examined the association(s) of physical, social-cultural and policy ractice environments with PA, active transport (AT) and weight status among regional primary school children. Data were from two childhood obesity monitoring systems in regional Victoria, Australia. Measured height and weight were collected from students in Year 2 (aged approx. 7–8 years), Year 4 (9–10 years), and Year 6 (11–12 years). Self–reported PA behaviour, including AT were collected from students in Year 4 and 6 and a sub-s le wore an ActiGraph (wGT3X-BT) accelerometer for 7-days. A school physical activity environment audit was completed by the school principal and responses were used to calculate school physical activity environment scores (PAES) and active transport environment scores (ATES). Mixed effects logistic regression was used to assess the relationship between the proportion of students meeting the PA guidelines (≥60mins/day of moderate-to-vigorous PA) and PAES tertiles (low, medium, high) and those using AT and school ATES tertiles, controlling for gender, school size/type and socioeconomic composition. The analysed s le included 54/146 (37%) schools and 3360/5376 (64%) students. In stratified analysis, girls in schools with a medium PAES score were more likely to meet the objectively measured PA guideline compared to low PAES score (OR 2.3, 95%CI 1.27, 4.16). Similarly, students in schools with a medium or high ATES score had higher odds of self-reported AT (medium OR 3.15, 95%CI 1.67, 5.94 high OR 3.71, 95%CI: 1.80, 7.64). No association between PAES or ATES and weight status were observed. Self-reported AT among boys (OR 1.59, 95%CI 1.19, 2.13) and girls (OR 1.56, 95%CI 1.08, 2.27) was associated with higher odds of meeting self-reported PA guidelines on all 7-days than those who did not report using AT. In this study of regional Victorian primary schools, PA environments were only associated with girls’ adherence to PA guidelines. School AT environments were strongly associated with students’ AT behaviours and with increased likelihood of students being physically active.
Publisher: Mary Ann Liebert Inc
Date: 07-2023
Publisher: Mary Ann Liebert Inc
Date: 10-2022
Abstract: Background: Access to green space ( e.g., parks and gardens) has been associated with child health and wellbeing, whereas blue space ( e.g., coasts, lakes, and rivers) is understudied. Our aim was to determine whether proximity to the coast was associated with primary school children's weight status, modifiable health-related behaviors, and health-related quality of life (HRQoL). Methods: Exploratory cross-sectional analysis of baseline data from the Whole of Systems Trial of Prevention Strategies for Childhood Obesity (WHOSTOPS) study, to estimate gender-specific differences in weight and behaviors across four bands of distance from the coast ( km, 5 to km, 25 to km, ≥50 km). Linear and logistic models, with robust standard errors, adjusted for school year level, area-level socioeconomic position and rurality, and allowing for distance by gender interaction were fitted on data from 1216 children (aged 8.5-13 years). Main outcomes were weight status (categorical), physical activity (PA) (categorical), and global HRQoL score (continuous). Results: Compared with girls living in towns ≥50 km from the coast, those living within 5 km had lower odds for overweight/obesity [odds ratio (OR) = 0.50 95% confidence interval (CI): 0.37-0.67] and higher mean moderate-to-vigorous PA minutes (accelerometry) ( β = 8.7 95% CI: 2.0-15.5) and global HRQoL ( β = 3.2 95% CI: 1.4-5.0). Compared with boys living ≥50 km from the coast, those living within 5 km had higher odds of meeting self-reported PA guidelines (≥60 minutes/day) for ≥5 days (OR = 2.33 95% CI: 1.75-3.10), and higher mean global HRQoL scores ( β = 5.6 95% CI: 1.9-9.3). Conclusions: Living close to the coast was associated with some favorable health outcomes and behaviors, which differed between girls and boys.
Publisher: MDPI AG
Date: 13-04-2018
Publisher: MDPI AG
Date: 24-10-2023
DOI: 10.3390/NU15214503
Publisher: BMJ
Date: 12-2022
DOI: 10.1136/BMJOPEN-2022-068190
Abstract: To present an approach to build capacity for the use of systems science to support local communities in municipal public health and well-being planning. Case study. Local government authorities participating in the VicHealth Local Government Partnership in Victoria, Australia. Local government staff members were trained in community-based system dynamics (CBSD), and group model building (GMB) techniques to mobilise local community efforts. The trained local government facilitation teams then delivered GMB workshops to community stakeholder groups from 13 local government areas (LGA)s. Training in CBSD was conducted with council facilitation teams in 13 LGAs, followed by the local delivery of GMB workshops 1–3 to community stakeholders. Causal loop diagrams (CLD) representing localised drivers of mental well-being, healthy eating, active living or general health and well-being of children and young people were developed by community stakeholders. Locally tailored action ideas were generated such as well-being classes in school, faster active transport and access to free and low-cost sporting programmes Overall, 111 local government staff participated in CBSD training. Thirteen CLDs were developed, with the stakeholders that included children, young people and community members, who had participated in the GMB workshops across all 13 council sites. Workshop 3 had the highest total number of participants (n=301), followed by workshop 1 (n=287) and workshop 2 (n=171). Local facilitation of the CBSD process has developed community informed and locally relevant CLDs that will be used to lead local action to improve the well-being of children and young people. Training employees in CBSD is one approach to increase systems thinking capacity within local government.
Publisher: MDPI AG
Date: 19-02-2020
Abstract: Obesity prevalence is inequitably distributed across geographic areas. Food environments may contribute to health disparities, yet little is known about how food environments are evolving over time and how this may influence dietary intake and weight. This study aimed to analyse intra-city variation in density and healthiness of food outlets between 2008 and 2016 in Melbourne, Australia. Food outlet data were classified by location, type and healthiness. Local government areas (LGAs) were classified into four groups representing distance from the central business district. Residential population estimates for each LGA were used to calculate the density of food outlets per 10,000 residents. Linear mixed models were fitted to estimate the mean density and ratio of ‘healthy’ to ‘unhealthy’ food outlets and food outlet ‘types’ by LGA group over time. The number of food outlets increased at a faster rate than the residential population, driven by an increasing density of both ‘unhealthy’ and ‘healthy’ outlets. Across all years, ratios of ‘unhealthy’ to ‘healthy’ outlets were highest in LGAs located in designated Growth Areas. Melbourne’s metropolitan food environment is saturated by ‘unhealthy’ and ‘less healthy’ food outlets, relative to ‘healthy’ ones. Melbourne’s urban growth areas had the least healthy food environments.
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: Wiley
Date: 04-12-2020
DOI: 10.1111/OBR.12941
Abstract: There is strong support across multiple sectors for the implementation of policies to create healthier food environments as part of comprehensive strategies to address obesity and improve population diets. The existing evidence base describing food retail environments and their relationship with health outcomes is limited in several respects. This systematic review examines the current evidence regarding food retail environments in Australia, including associations with diet and people with obesity, and socioeconomic and geographic disparities. Three databases were searched and independently screened. Studies were included if they were undertaken in Australia and objectively measured the food retail environment. Sixty papers were included. The broad range of methodological approaches used across studies limited the ability to synthesize the evidence and draw conclusions. Results indicated that there is some evidence that disparities exist in food retail environments across measures of socioeconomic position and geographic area in parts of Australia. Overall, there were inconsistent findings regarding the association between the healthiness of food retail environments and diet or people with obesity. Findings support previous calls for standardized tools and measures for monitoring the healthiness of food retail environments. This is imperative to inform evidence-based policy and evaluation in this critical component of recommended obesity prevention strategies.
Publisher: MDPI AG
Date: 20-05-2019
Abstract: Background: Behavioral factors such as physical activity, sedentary behavior and diet have previously been found to be key modifiable determinants of childhood overweight and obesity, yet require further investigation to provide an understanding of their potential influence on sleep outcomes along with the sleep-obesity nexus. Methods: The study included 2253 students (ages 8.8–13.5) from two monitoring studies across regional Victoria. Students completed a self-report electronic questionnaire on demographic characteristics, health behaviors (including sleep, physical activity, screen time and diet) and well-being, and were invited to have anthropometric measurements (height and weight) taken. Regression models were used to assess the associations between sleep, behavioral factors and BMI z-scores. Results: Screen time (particularly in bed) and sugar-sweetened beverage (SSB) consumption were shown to increase the likelihood of having more than three sleep problems, while physical activity and other dietary factors were not. After controlling for these behaviors, significance remained for having two or more than three sleep problems and an increased odds of overweight/obesity. Conclusions: This study highlights how the usage of screen devices and SSB consumption behaviors might influence children’s weight status via the sleep-obesity nexus.
Publisher: Wiley
Date: 05-05-2021
DOI: 10.1002/OBY.23130
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: 14-08-2019
Abstract: (1) Background: Childhood overweight and obesity is a significant and preventable problem worldwide. School environments have been suggested to be plausible targets for interventions seeking to improve the quality of children’s dietary intake. The objective of this study was to determine the extent to which the current characteristics of the school food environment were associated with primary school students’ dietary intake and Body Mass Index (BMI) z scores in a representative s le in regional Victoria. (2) Methods: This study included 53 schools, comprising a s le of 3,496 students in year levels two (aged 7–8 years), four (9–10 years) and six (11–12 years). Year four and six students completed dietary questionnaires. Principals from each school completed a survey on school food environment characteristics. Mixed-effects logistic regression was used to assess the relationship between students’ dietary intake and school food environment scores, controlling for confounders such as socio-economic status, school size and sex. Food environment scores were also analysed against the odds of being healthy weight (defined as normal BMI z score). (3) Results: Mixed associations were found for the relationship between students’ dietary intake and food environment scores. Meeting the guidelines for vegetable intake was not associated with food environment scores, but students were more likely (OR: 1.68 95% CI 1.26, 2.24) to meet the guidelines if they attended a large school ( enrolments) and were female (OR: 1.28 95% CI: 1.02, 1.59). Healthy weight was not associated with school food environment scores, but being a healthy weight was significantly associated with less disadvantage (OR: 1.24 95% CI 1.05, 1.45). Conclusion: In this study, the measured characteristics of school food environments did not have strong associations with dietary intakes or BMI among students.
Publisher: Informa UK Limited
Date: 14-08-2019
DOI: 10.1080/02640414.2018.1508399
Abstract: Children's fundamental movement skill levels (FMS) predict moderate-to-vigorous physical activity (MVPA). Asian children have been reported as less active than English-Europeans, possibly due to poorer skills. This study compared the FMS of children from Culturally and Linguistically Diverse (CALD) backgrounds and examined FMS correlates. A total of 261 children (122 males) aged 9-to-11 years were ided based on language spoken at home: English-European (n = 105) and Asian (n = 156). Height, mass, FMS (Test of Gross Motor Development-2), MVPA (accelerometer) and cardio-respiratory fitness (20m multistage shuttle run) were directly measured. Sex, age, language and perceived sport competence (CY-PSPP) were self-reported. Independent s le t-tests assessed age, BMI, FMS and perception by CALD group. Linear mixed models examined FMS correlates. Asian-speaking children had lower object control skill (35.5 v 37.2 CI [0.17, 3.18] p < 0.03) compared to English-European- children, but no between-group differences in locomotor skills were observed. Fitness, physical activity and sport competence perception were positively associated with object control, yet adjusting for these variables (and age and BMI) did not remove the CALD effect (B = -2.02, SE = 0.69, p = 0.004). Cultural factors may affect object control competence in Asian-Australian children.
Publisher: Wiley
Date: 06-2005
DOI: 10.1002/OBY.22970
Abstract: This study examined the prevalence and risk of overweight/obesity among expanded ethnicity categories within boys and girls in England and the differential influence of socioeconomic position using the 2015/2016 and the 2016/2017 cycles of the National Child Measurement Programme. This cross‐sectional and descriptive study examined surveillance data of weight status among primary school children in England. Data were pooled across data collection years, representing 1.25 million children in Reception (aged 4‐5 years) and 1.1 million children in Year 6 (aged 10‐11 years). Ethnicity was classified according to National Health Service definitions, and child residence was used to calculate quintiles of Income Deprivation Affecting Children Index. Measured weight status was classified using the International Obesity Task Force’s definition. Logistic regression models were run for each sex and year group. Within each sex, ethnicity‐ and socioeconomic‐specific differentials in overweight/obesity prevalence were evident. For ex le, among the five most populous ethnic groups in the most deprived quintile, 26.8% of White British girls in Reception had overweight/obesity compared with 20.7% of girls with Pakistani, 31.2% with Black African, 17.1% with Indian, and 22.2% with any Any Other White (e.g., White European) background. Ethnicity had an independent influence on overweight/obesity risk after adjustment for socioeconomic position.
Publisher: BMJ
Date: 09-2022
DOI: 10.1136/BMJOPEN-2021-057187
Abstract: Systems science methodologies have been used in attempts to address the complex and dynamic causes of childhood obesity with varied results. This paper presents a protocol for the Reflexive Evidence and Systems interventions to Prevention Obesity and Non-communicable Disease (RESPOND) trial. RESPOND represents a significant advance on previous approaches by identifying and operationalising a clear systems methodology and building skills and knowledge in the design and implementation of this approach among community stakeholders. RESPOND is a 4-year cluster-randomised stepped-wedge trial in 10 local government areas in Victoria, Australia. The intervention comprises four stages: catalyse and set up, monitoring, community engagement and implementation. The trial will be evaluated for in iduals, community settings and context, cost-effectiveness, and systems and implementation processes. In idual-level data including weight status, diet and activity behaviours will be collected every 2 years from school children in grades 2, 4 and 6 using an opt-out consent process. Community-level data will include knowledge and engagement, collaboration networks, economic costs and shifts in mental models aligned with systems training. Baseline prevalence data were collected between March and June 2019 among children from 91 primary schools. Ethics approval: Deakin University Human Research Ethics Committee (HREC 2018-381) or Deakin University’s Faculty of Health Ethics Advisory Committee (HEAG-H_2019-1 HEAG-H 37_2019 HEAG-H 173_2018 HEAG-H 12_2019) Victorian Government Department of Education and Training (2019_003943) Catholic Archdiocese of Melbourne (Catholic Education Melbourne, 2019-0872) and Diocese of Sandhurst (24 May 2019). The results of RESPOND, including primary and secondary outcomes, and emerging studies developed throughout the intervention, will be published in the academic literature, presented at national and international conferences, community newsletters, newspapers, infographics and relevant social media. ACTRN12618001986268p.
No related grants have been discovered for Claudia Strugnell.