Early Childhood Education and Care (ECEC) settings have a pivotal role in shaping children's dietary food habits by providing the contextual environment within which they develop these behaviours. ...This study examines systematic reviews for (1) the effectiveness of interventions to promote healthy eating in children aged 2-5 years attending centre-based childcare; (2) intervention characteristics which are associated with promoting healthy eating and; (3) recommendations for child-health policies and practices. An Umbrella review of systematic reviews was undertaken using a standardized search strategy in ten databases. Twelve systematic reviews were examined using validated critical appraisal and data extraction tools. Children's dietary food intake and food choices were significantly influenced. Interventions to prevent obesity did not significantly change children's anthropometric measures or had mixed results. Evidence was more convincing if interventions were multi-component, addressed physical activity and diet, targeted individual-level and environmental-level determinants and engaged parents. Positive outcomes were mostly facilitated by researchers/external experts and these results were not replicated when implemented in centres by ECEC providers without this support. The translation of expert-led interventions into practice warrants further exploration of implementation drivers and barriers. Based on the evidence reviewed, recommendations are made to inform child-health directed practices and policies.
The family meal has been associated with numerous health and wellbeing benefits for both adults and children. However, the majority of the research in this area is correlational, unable to prove a ...causal relationship between family meals and health and wellbeing outcomes. The objectives of this systematic review were to determine the causal relationship between family meals and health and wellbeing and explore family members’ perceptions of the family meal. A systematic search across five databases was undertaken to identify both intervention studies and qualitative studies investigating the family meal. Thirty-two articles were deemed eligible for inclusion in this review. Qualitative data were synthesised via the meta-aggregation approach; however, the quantitative data were too heterogeneous to perform meta-analysis. Only one intervention included in this review exclusively targeted the family meal, the remaining studies had other target strategies as part of their intervention (e.g. physical activity, snacking, sleep routines). Only two of the eight interventions reported a statistically significant difference between control and intervention groups for family meal frequency or quality, therefore we were unable to fully explore the causal relationship between family meals and health and wellbeing outcomes. The qualitative studies identified multiple barriers to the family meal, including scheduling conflicts, exhaustion and lack of time, and reported family connection and communication as the main perceived benefits of the family meal. There is a gap between the benefits and barriers to the family meal identified through qualitative research, and current intervention strategies, with few interventions exclusively targeting the family meal. Interventions that are informed by qualitative literature and exclusively target the family meal are needed to further investigate the causal relationship between family meals and potential health and wellbeing outcomes.
ObjectiveTo summarise quantitative evaluations of interventions designed to support the careers of women in academia of any discipline.MethodA systematic search of English entries in PubMed, CINAHL ...and Google Scholar was conducted in September 2017. Methodological quality of the studies was independently assessed by two authors using the Joanna Briggs Institute quality appraisal checklists. Meta-analysis was not possible due to heterogeneity in methods and outcomes; results were synthesised and displayed narratively.ResultsEighteen eligible studies were identified, mostly evaluating programmes in academic medicine departments. The most common interventions were mentoring, education, professional development and/or networking programmes. All programmes took a ‘bottom-up’ approach in that women were responsible for opting into and devoting time to participation. Study quality was low overall, but all studies reported positive outcomes on at least one indicator. Most often this included improvements in self-rated skills and capabilities, or satisfaction with the programme offered. Results regarding tangible outcomes were mixed; while some studies noted improvements in promotion, retention and remuneration, others did not.ConclusionsThis review suggests that targeted programmes have the potential to improve some outcomes for women in academia. However, the studies provide limited high-quality evidence to provide information for academic institutions in terms of the best way to improve outcomes for women in academia. The success of an intervention appears to be undermined when it relies on the additional labour of those it is intending to support (ie, ‘bottom-up’ approaches). As such, academic institutions should consider and evaluate the efficacy of ‘top-down’ interventions that start with change in practice of higher management.
Explore the level of general nutrition knowledge and demographic influences of knowledge levels in a community sample.
A sample of volunteers, recruited from community centres in two suburbs of ...differing socio-economic status, in Adelaide, South Australia.
Two hundred and one people, aged 18 years and older, completed a modified and validated version of the General Nutrition Knowledge Questionnaire (113 items). The questionnaire was self-administered and completed under supervision.
Basic messages about eating more fruit, vegetables and fibre, and less fatty and salty foods were best understood. Confusion was evident with more detailed nutrition information. For example, 90 % of the people were aware of the recommendations to eat more fruit and vegetables, but 56 % and 62 % knew the recommended number of servings of fruit and vegetables, respectively. Descriptive statistics showed significant demographic variation in nutrition knowledge levels; multiple regression analysis confirmed the significant independent effects of gender, age, highest level of education and employment status on nutrition knowledge level (P < 0.01 level). The model accounted for 40 % of the variance in nutrition knowledge scores.
There is demographic variation in nutrition knowledge levels and a broad lack of awareness of some public health nutrition recommendations. Having a detailed understanding of the deficiencies in community knowledge should allow for future nutrition education programmes to target subgroups of the population or particular areas of nutrition education, to more efficiently improve knowledge and influence dietary behaviour.
Reducing consumption of free sugars, such as those found in high concentrations in manufactured products such as sugar-sweetened beverages (SSBs) and 100% fruit juices, is a global public health ...priority. This study aimed to measure prevalence of widely available pre-packaged non-alcoholic water-based beverages (carbonated sodas, sports drinks, energy drinks, artificially-sweetened sodas, fruit juices (any type), and bottled water) and to comprehensively examine behavioral, environmental, current health, and demographic correlates of consumption. A cross-sectional, nationally-representative population survey of 3430 Australian adults (18+ years) was conducted using computer-assisted telephone (mobile and landline) interviewing. Past week prevalence of pre-packaged drinks containing free sugar was 47.3%; daily prevalence was 13.6%. Of all the pre-packaged drinks assessed, consumption of fruit juices (any type) was the most prevalent (38.8%), followed by bottled water (37.4%), soda (28.9%), artificially-sweetened soda (18.1%), sports drinks (8.1%), and energy drinks (4.2%). Higher soda consumption was associated with males, younger age, socio-economic disadvantage, frequent takeaway food consumption, availability of soda in the home, obesity, and a diagnosis of heart disease or depression. A diagnosis of Type 2 Diabetes was associated with increased likelihood of consuming artificially-sweetened sodas and decreased likelihood of consuming sugar-sweetened soda. SSB consumption is prevalent in Australia, especially among young adults and males, foreshadowing continued population weight gain and high burdens of chronic disease. To reduce consumption, Australia must take a comprehensive approach, incorporating policy reform, effective community education, and active promotion of water.
Access to healthy food has become an important area of investigation for researchers interested in health disparities and inequalities. The debate about the existence and characteristics of ‘food ...deserts’ has increased the interest in food availability and equity in health research. This debate is crucial to an understanding of the factors leading to food security. Research reported here used in-depth interviews with respondents without private transport living within and outside food deserts in Adelaide, South Australia. The respondents came from a variety of households, including single and double parent families, and people living alone. The research found that living in a food desert did not, by itself, impose food access difficulties. Far more important was the access to independent transport to shops. A number of features were identified in this research including reliance on supermarkets, difficulties with public transport, and the provision of government schemes and systems that for some made food shopping much easier. The research suggests that food access problems in Adelaide are not so much the product of geographic distance between home and shop, as the social or welfare networks that allow people to access private transport.
Issue addressed: Considerable public effort has been directed at centre-based childcare as an early childhood education and care (ECEC) setting to promote healthy food-related behaviours in young ...children. However, in the real-world setting, best practice, evidence-based guidelines are not always well-translated into usual, day-today routines. This study aims to understand what factors influence the centre-based childcare cooks' food and nutrition decisions for children aged 2-5 years.
Methods: Semi-structured qualitative interviews were conducted with cooks in centre- based childcare using purposeful maximum variation sampling and data analysed thematically.
Results: Fourteen cooks were interviewed from 14 services across South Australia. Central to providing a healthy food environment was expert-led knowledge and training gained through the workplace over several years and the embodiment of the service's healthy food and nutrition policy, evidenced through menu planning to maintain a focus on healthy eating. Threatening these positive, routine practices and decisions were pressures to modify menus in response to increasing food allergies and changing cultural and family preferences, in the absence of ongoing relevant training and expertise at the system-level.
Conclusions: Children in ECEC benefit from cooks' commitment to providing nutritious foods; however, the requirements to extend their role to respond to increasing demands without relevant system-level support and training puts the children at risk of not being exposed to health-promoting menus and possible errors in providing dietary modifications. ECEC cooks urgently need access to system-level support and training.
So What?: Understanding and addressing the barriers experienced by cooks and the complexity of factors that inform their food-related decision-making will sustain the implementation of effective, healthy eating guidelines and nutrition practices in ECEC.
To say that humans have a profound relationship with the food they produce and eat is a mere truism. What is new derives from the recognition that in Western cultures, over time, our deep ...relationship with food has been replaced by a scientistic version of what we eat, and what we should eat. In many ways, this has dis-enchanted our relationship with food, in that it has rendered food as the sum total of a calculus based on vitamins, minerals, and energy content. The movements that are now growing around food – ethical, plant based, provenance aware – speak to new understandings of food which acknowledge that food is actually more than its sum of parts. These new movements share a common goal and that is to seek a re-enchantment with food. This article, which speaks very much from an anglo-tradition, discusses this ways in which dis- and re-enchantment of food has developed.
Although communities have long been exhorted to make efforts to enhance their own health, such approaches have often floundered and resulted in little or no health benefits when the capacity of the ...community has not been adequately strengthened. Thus being able to assess the capacity building process is paramount in facilitating action in communities for social and health improvement. The current review aims to i) identify all domains used in systematically documented frameworks developed by other authors to assess community capacity building; and ii) to identify the dimensions and attributes of each of the domains as ascribed by these authors and reassemble them into a comprehensive compilation.
Relevant published articles were identified through systematic electronic searches of selected databases and the examination of the bibliographies of retrieved articles. Studies assessing capacity building or community development or community participation were selected and assessed for methodological quality, and quality in relation to the development and application of domains which were identified as constituents of community capacity building. Data extraction and analysis were undertaken using a realist synthesis approach.
Eighteen articles met the criteria for this review. The various domains to assess community capacity building were identified and reassembled into nine comprehensive domains: "learning opportunities and skills development", "resource mobilization", "partnership/linkages/networking", "leadership", "participatory decision-making", "assets-based approach", "sense of community", "communication", and "development pathway". Six sub-domains were also identified: "shared vision and clear goals", "community needs assessment", "process and outcome monitoring", "sustainability", "commitment to action" and "dissemination".
The set of domains compiled in this review serve as a foundation for community-based work by those in the field seeking to support and nurture the development of competent communities. Further research is required to examine the robustness of capacity domains over time and to examine capacity development in association with health or other social outcomes.
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