Lesley King

Current international attention to Health in all policies (HiAP) has its origins in a more sophisticated understanding of the impact of public policies on health, and a recognition that policies across government have an impact on the social and environmental determinants of health and related inequalities in health. As an emerging field, there has been limited attention focused on comprehensive approaches to the evaluation of HiAP to date, and the research focus around HiAP has mainly examined the processes of cross-sectoral policy development, rather than their health-related impacts or outcomes. The purpose of this paper is to explore issues in assessing the implementation of HiAP and describe an expanded evaluation framework for assessing the potential intermediate and end-point effects of HiAP actions, using a planning logic model for 'complex programs'. This meets the needs of public sector policy-makers who express an interest in understanding the relationship between...

ABSTRACT Aim:  The aim of this study was to describe key nutritional characteristics of food and beverage products registered with the product registration scheme of Healthy Kids Association (formerly the New South Wales School Canteen Association). Methods:  The nutritional characteristics of Healthy Kids Association's registered products as of October 2009 were examined. Nutrient content data were obtained from product nutrition information panels, for each product within popular product subcategories. The level of key nutrients (including saturated fat, sugar, calcium and fibre) was identified and analysed in relation to the nutrient criteria threshold levels for green and amber food categories. The distribution of nutrients in relation to the food category thresholds was examined. Results:  For most product subcategories, the nutrient content of products clustered just below the nutrient criteria thresholds for total energy, saturated fat, sodium and sugar. The nutrient content for the positive nutrients calcium and fibre frequently clustered just above the threshold. In addition, small package sizes were found to be common among food classified as amber. Conclusion:  This study illustrates a method for analysing and describing the range and nutrient profile of products registered with a product registration or nutrition signposting scheme. The distribution of key nutrients around criteria thresholds suggests that products are formulated with reference to the nutrient thresholds of the product registration scheme. However, nutrient thresholds may also be achieved through manufacturing smaller portion sizes. The potential of nutrient thresholds as levers to influence the nutritional profile of foods needs further research and industry dialogue.

There is an established link between food promotions and children's food purchase and consumption. Children in developing countries may be more vulnerable to food promotions given the relative novelty of advertising in these markets. This study aimed to determine the scope of television food advertising to children across the Asia-Pacific to inform policies to restrict this marketing. Six sites were sampled, including from China, Indonesia, Malaysia and South Korea. At each site, 192 h of television were recorded (4 days, 16 h/day, three channels) from May to October 2012. Advertised foods were categorized as core/healthy, non-core/unhealthy or miscellaneous, and by product type. Twenty-seven percent of advertisements were for food/beverages, and the most frequently advertised product was sugar-sweetened drinks. Rates of non-core food advertising were highest during viewing times most popular with children, when between 3 (South Korea) and 15 (Indonesia) non-core food advertisem...

Issue addressed: Overweight and obesity in Australia is an emerging health concern. Obesity prevention initiatives must consider both physical activity and nutrition to be effective. Community sports venues have the capacity to promote healthy lifestyles through physical activity as well as healthy food choices. Methods: A telephone survey was conducted on parents of children aged 5-17 years in NSW to

This study evaluated the impact of the Australian Food and Grocery Council (AFGC) self-regulatory initiative on unhealthy food marketing to children, introduced in January 2009. The study compared patterns of food advertising by AFGC and non-AFGC signatory companies in 2009, 2007 and 2006 on three Sydney commercial free-to-air television channels. Data were collected across seven days in May 2006 and 2007, and four days in May 2009. Advertised foods were coded as core, non-core and miscellaneous. Regression for counts analyses was used to examine change in rates of advertisements across the sampled periods and differential change between AFGC-signatory or non-signatory companies between 2007 and 2009. Of 36 food companies that advertised during the 2009 sample period, 14 were AFGC signatories. The average number of food advertisements decreased significantly from 7.0 per hour in 2007 to 5.9 in 2009. There was a significant reduction in non-core food advertising from 2007 to 2009 by AFGC signatories compared with non-signatory companies overall and during peak times, when the largest numbers of children were viewing. There was no reduction in the rate of non-core food advertisements by all companies, and these advertisements continue to comprise the majority during peak viewing times. While some companies have responded to pressures to reduce unhealthy food advertising on television, the impact of the self-regulatory code is limited by the extent of uptake by food companies. The continued advertising of unhealthy foods indicates that this self-regulatory code does not adequately protect children.

INTRODUCTION .............................................................................................................. 3 Background ....................................................................................... ... ... Background Child obesity rates in Australia are among the highest in the world and continue to increase, with the most recent ...

To investigate the perceptions of parents of young children aged 2-5 years regarding childhood overweight and obesity. Parents with children in seven pre-schools and long day-care centres from diverse socio-economic areas across metropolitan Sydney and one rural area were recruited for focus groups. Focus group transcripts were analysed using content analysis. Providing food was an emotional issue for the mothers in this study. They were more concerned about their young children being underweight than overweight, and this increased their stress around children's eating. Food treats were perceived as entitlements. Mothers did believe that they were responsible for their children's eating, but acknowledged the influence of other environmental factors related to food retail and marketing. Practical and safety issues limited opportunities for their children to be physically active beyond the formal child-care setting. Parents had practical suggestions for solutions to some of the barriers they experienced, and wanted support for their role. The emotional intensity of the mothers' perceptions about their children's eating and weight status suggests that interventions, including communications, need to go beyond information and engage with parents' emotions. Some food concerns were actually related to broader parenting issues and indicate the potential value for interventions to focus on behavioural parenting techniques. Preventive interventions need to acknowledge the issues faced by parents and support their role directly, such as through making healthy and active behaviours easily available, and indirectly, through providing local services, including early childhood services.

Today's generation of young adults are gaining weight faster than their parents; however, there remains insufficient evidence to inform interventions to prevent this weight gain. Mobile phones are a popular means of communication that may provide a convenient, inexpensive means to deliver health intervention programmes. This pilot study aimed to measure the effect of a 12-week mobile health (mHealth) intervention on body weight, body mass index and specific lifestyle behaviours addressed by the programme. University students and staff aged 18-35 years (n = 51) were randomised (ratio 1 : 1, intervention : control). Both groups received a printed diet booklet with instructions prepared by a dietitian. The intervention group also received Short Message Service (SMS) text messages (four per week), e-mails (four per week), and had access to smartphone applications and Internet forums. Pre- to post-intervention, participants in the intervention group decreased their body weight [mean (SD)] [-1.6 (2.6) kg], increased their light intensity activity [34 (35) min day(-1)] and reported an increased vegetable (1.0 median serving day(-1)) and decreased sugar-sweetened beverage intake [-355 (836) mL week(-1)]. Despite this, post-intervention changes in outcomes were not significantly different from controls. The piloted mHealth programme provided some short-term positive changes in weight, nutrition and physical activity using a low cost, convenient delivery method for this population. However, changes were no different from those observed among controls. This might partly be explained by intervention participants' low engagement with the programme, which is likely to require further modification to provide more regular, personalised, monitored support.

Community-based programs that affect healthy environments and policies have emerged as an effective response to high obesity levels in populations. Apart from limited individual reports, little is currently known about these programs, limiting the potential to provide effective support, to promote effective practice, prevent adverse outcomes and disseminate intervention results and experience. The aim of the present study was to identify the size and reach of current community-based obesity prevention projects in Australia and to examine their characteristics, program features (e.g. intervention setting), capacity and approach to obesity prevention. Detailed survey completed by representatives from community-based obesity prevention initiatives in Australia. There was wide variation in funding, capacity and approach to obesity prevention among the 78 participating projects. Median annual funding was Au$94900 (range Au$2500-$4.46 million). The most common intervention settings were schools (39%). Forty per cent of programs focused on a population group of ≥50000 people. A large proportion of respondents felt that they did not have sufficient resources or staff training to achieve project objectives. Community-based projects currently represent a very large investment by both government and non-government sectors for the prevention of obesity. Existing projects are diverse in size and scope, and reach large segments of the population. Further work is needed to identify the full extent of existing community actions and to monitor their reach and future 'scale up' to ensure that future activities aim for effective integration into systems, policies and environments. SO WHAT? Community-based programs make a substantial contribution to the prevention of obesity and promotion of healthy lifestyles in Australia. A risk of the current intervention landscape is that effective approaches may go unrecognised due to lack of effective evaluations or limitations in program design, duration or size. Policy makers and researchers must recognise the potential contribution of these initiatives, to both public health and knowledge generation, and provide support for strong evaluation and sustainable intervention designs.