evaluate local initiatives which promote healthy eating

Cardiovascular risk factors in multi-ethnic middle school students: the HEALTHY primary prevention trial. Price interventions remained the most likely to reduce inequalities, however Person interventions now showed mixed results with a more even distribution of effects by SEP when being more selective by only including interventions where statistical significance values were given. Capacci S, Mazzocchi M. Five-a-day, a price to pay: an evaluation of the UK program impact accounting for market forces. PubMed Central PubMed In addition, there were some impacts on organizational practice (public policy initiatives). Jeffery RW, French SA. Am J Health Promot. http://www.who.int/dietphysicalactivity/diet/en/(2014). When the screening process was made more selective, the general trends seen in the main Harvest plot were essentially unchanged. Ogilvie and colleagues suggest adapting the Harvest Plot to display differential effectiveness of policy interventions [32]. Finally, none of the current studies address the more fundamental issue of the inequitable social and economic environments which create health inequalities in the first place [87]. 2002;102:80917. Disagreements in methodological quality assessment for all the included studies were resolved by consensus or by recourse to a senior member of the review team. PubMed The measurement of SEP within the intervention was carefully noted and included: education level, level of household income, occupational status and ethnicity, as determined by the authors [24,25]. 2011;65:9028. In order to determine the impact of Towards a Healthy Diet on GPs' interactions with their patients, GPs in the two communities were canvassed using a mail questionnaire. Tugwell P, Petticrew M, Kristjansson E, Welch V, Ueffing E, Waters E, et al. 1.3 Evaluate national and local initiatives which promote children's The Harvest plot shows each intervention illustrated as an individual bar. Individual approaches also exist in which individual practitioners offer dietary education to individuals, either in a clinical or community setting. Study of these products also had other methodological advantagesstandard packaging, easy to identify as Heart Healthy or not, amenable to numerical analysis and not subject to widely fluctuating seasonal variations in price or demand. Only secondly was its objective to change short-term, individual behaviour, which was also to be achieved by the same traditional health education program. 2007;15:315969. The two communities also share similar socio-demographic characteristics. Provided by the Springer Nature SharedIt content-sharing initiative. Int J Obes. However, these common transversal approaches also carry a risk of perverse effects, especially when the effect of market-oriented regulatory . A. However no one framework has been used consistently. Ogilvie D, Fayter D, Petticrew M, Sowden A, Thomas S, Whitehead M, et al. Socioeconomic status and health: mediating and moderating factors. Carcaise-Edinboro P, McClish D, Kracen AC, Bowen D, Fries E. Fruit and vegetable dietary behavior in response to a low-intensity dietary intervention: the rural physician cancer prevention project. 4 The Action Plan - Healthy Eating, Active Living: An action plan to Strategies such as the Healthy Cities project aim to place health at the centre of urban interventions.1 Such programmes seek to create cities with adequate housing and public transportation, quality health care, and safe places to exercise and play. Grier S, Bryant CA. These included quantitative results presented by a measure of SEP for 47 interventions. 2012;380:222460. remain the major cause of disease, disability and death, accounting for over 63% of deaths worldwide in 2012 [1]. Preventing weight gain in adults: design, methods and one year results from the Pound of Prevention study. Food Policy. HI. Results relating to both the public policy initiative and short-term behaviour change are presented amongst these and their relative impact compared. In response to the childhood obesity epidemic, much research has been conducted on school-based obesity prevention and healthy eating and physical activity promotion and intervention since the last publication of the Guidelines for School and Community Programs to Promote Lifelong Physical Activity Among Young People (1997) and the Guidelines . 2009;15:57885. Policy, systems, and environmental approaches are recommended for preventing childhood obesity. This was insufficient, however, to have any marked impact on either individual dietary behaviour or indeed intention to change dietary behaviour, as assessed in either the panel questionnaire or supermarket sales figures for milk and table spreads. However the studies identified were heterogeneous, addressing different research questions, with diverse theoretical underpinnings study designs and study outcomes. It also provides resources for Early Years providers on healthy eating and activity for toddlers and pre-school children. Allais O, Bertail P, Nichle V. The effects of a fat tax on french households purchases: a nutritional approach. Three of these were conducted in Europe [35,50,51] and one in the USA [52]. David Dunt and others, Evaluation of a community-based health promotion program supporting public policy initiatives for a healthy diet, Health Promotion International, Volume 14, Issue 4, December 1999, Pages 317327, https://doi.org/10.1093/heapro/14.4.317. 2000;30:30919. What a healthy, balanced diet is The Eatwell Guide Government advice on a healthy, balanced diet is encapsulated in the UK's national food model, the Eatwell Guide. proportion of menu items not deep fried; number of salad and fruit dishes; type of cooking oil used); presence of health messages on menus or posters or in table tents. (, Winkleby, M. A., Taylor, C. B., Jatulis, D. and Fortmann, S. P. (, Oxford University Press is a department of the University of Oxford. 1 There has been an increase in consumption of foods prepared outside the home (eg, fast food) and many of these foods have increased in portion size, which . explicitly concluded that downstream interventions actually worsen health inequalities [82]. Privacy Diet. As such, many countries have implemented various initiatives to encourage children and adolescents to stay physically active. Sorensen G, Linnan L, Hunt MK. Department of Public Health and Policy, University of Liverpool, Liverpool, UK, Rory McGill,Elspeth Anwar,Lois Orton,Helen Bromley,Ffion Lloyd-Williams,Martin OFlaherty,David Taylor-Robinson,Maria Guzman-Castillo,Duncan Gillespie,Patricia Moreira,Kirk Allen,Lirije Hyseni,Nicola Calder,Margaret Whitehead&Simon Capewell, Public and Environmental Health Research Unit, London School of Hygiene and Tropical Medicine, Liverpool, UK, UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK, You can also search for this author in This may reflect the dependence on an individual choosing to behave differently, and sustain that change [78]. Learn More Stories from the Field In GS, 26% of eating place proprietors reported increased requests for fruit on the part of their customers between Project start and Project end (Table 4). For each of the included interventions, if the outcome was split by more than one socioeconomic proxy measure, we took the quantitative effect on inequalities from the stratified results that best represented SEP [24,25]. Interventions categorised by a 6 Ps framework show differential effects on healthy eating outcomes by SEP. Upstream interventions categorised as Price appeared to decrease inequalities, and downstream Person interventions, especially dietary counselling seemed to increase inequalities. This questionnaire was sent to a separate, randomly selected sample of 1105 residents registered on the electoral roll in GS only. Two interventions had no preferential impact by SEP [35,52] while one intervention was judged as likely to reduce inequalities [50] and the other intervention judged as likely to widen inequalities [51]. Sales of these products were relevant to the Flavour Without Fat campaign. In response to these requests, 40% of GS proprietors reported an increase in the number of fruit dishes offered in their establishments, compared with only 17% in SUN. Greater Shepparton (GS) was selected as the intervention community. Article It is striking that we did not find any studies investigating the effects of Prescriptive interventions by SEP and only one Product intervention that presented differential results which had no preferential impact by SEP. Br Med Bull. Our review included 36 studies allowing expansion upon these conclusions. We then present seven proposed intervention strategies to promote healthy eating, and use an economic framework to discuss the relative merits of the interventions. The recent evaluation of the most methodologically adequate of thesethe Minnesota Heart Health Programhowever, reported disappointing results (Luepker et al., 1994). Connett JE, Stamler J. These programs generally include community risk factor education in relation to diet, smoking and physical activity. Eighteen Price interventions were identified. Article Like the rest of the Project, Towards a Healthy Diet was conducted by the Victorian Division of the Heart Foundation in conjunction with locally based working parties. Four Promotion interventions were identified. cardiovascular disease (CVD), chronic obstructive pulmonary disease, diabetes, cancer, etc.) Google Scholar. 1993;88:197398. However, it represents a potentially important topic for future analyses. 2010;100:5905. Thomas S, Fayter D, Misso K, Ogilvie D, Petticrew M, Sowden A, et al. Am J Prev Med. These are summarised in Table4. The full text was also retrieved for any abstracts where a decision could not be made based on the information given. In order to assess changes in patterns of food purchases across the Project period, a supermarket food purchases study was conducted. Poor nutrition causes a greater population burden of morbidity and mortality from NCDs than tobacco, alcohol and physical activity combined [2]. 1.2 Evaluate national and local initiatives which promote healthy eating Accelerating risk factor changes will likely require a sustained community effort with reinforcement from state, regional, and national policies and programs. 2008;108:202130. Google Scholar. WHO. Given the considerable heterogeneity of the studies, undertaking a meta-analysis was not deemed appropriate. 2010;7, e1000320. Reynolds KD, Franklin FA, Binkley D, Raczynski JM, Harrington KF, Kirk KA, et al. This may have meant we failed to identify potentially relevant articles published in another language. A higher proportion of Shepparton residents reported recent increases in the number of eating places offering healthy food and local residents eating healthy food. Equity-specific effects of 26 Dutch obesity-related lifestyle interventions. White M, Adams J, Heywood P. How and why do interventions that increase health overall widen inequalities within populations? Structured interviews of eating place proprietors/ managers and on-site observations were undertaken in order to determine whether Towards a Healthy Diet had resulted in eating places adopting healthy diet practices. We categorised interventions based on the underlying theories about how the interventions might have worked to bring about change in healthy eating outcomes. J Community Health Nurs. 2012;9:001333. Cappuccio FP, Capewell S, Lincoln P, McPherson K. Policy options to reduce population salt intake. Significant differences in nutritional knowledge have been shown between differing socioeconomic groups, with knowledge declining with lower socioeconomic status [10]. 2010;170:202834. Implementing tobacco control policies. The extracted data was then checked independently by a second reviewer to ensure all the correct information was recorded. In Cox, F., Erlich, J. L., Rothman, J. and Tropman, J. E. (eds) Strategies of Community Organization: A Book of Readings. Food selection is not only a behavioural choice, but also an economic one [7]. . The long-term goal of these initiatives would need to remain individual Heart Healthy behaviour change, but this is assumed to occur beyond the period of the program's implementation. This intervention is summarised in Table3. J Epidemiol Community Health. Structural and organizational change supporting healthy diet, Awareness of campaign (very much/somewhat), Advertisements (daily plus/every couple days), Personal reactions to the campaign (yes/a lot). Evaluation of the Healthy Lifestyles Initiative for Improving Community Lorenc T, Petticrew M, Welch V, Tugwell P. What types of interventions generate inequalities? Holme I, Hjermann I, Helgeland A, Leren P. The Oslo study: diet and antismoking advice. Evaluate national and local initiative which promote healthy eating Prevention of Cardiovascular Disease. In Social inequality and public health. The evaluation employed a two-community, quasi-experimental study design which assessed process, formative and impact (but not outcome) dimensions relevant to the program's objectives. 2003;37:40616. Following abstract and full text screening, 36 studies met the inclusion criteria (Figure2). Interventions at this stage aim to modify NCD risk factors through the promotion of healthier diets. Am J Public Health. Over the last 40 years global eating patterns have changed in significant ways. This is consistent with results of the dietary impacts of the US community-based Heart Health Programs (Jacobs et al., 1986; Lefebvre et al., 1987; Farquhar et al., 1990). location of supermarkets and fast food outlets) or community-based health education, Product modification of food products to make them healthier/less harmful e.g. If not, some other secondary outcomes were acceptable (see Table1). Eat at least 5 fruits and vegetables a day. The change in perceived influence of local groups on healthy diet and weight reduction, measured at the beginning and end of the Project, did not differ significantly between the two communities. volume15, Articlenumber:457 (2015) Thomas H. Quality Assessment Tool for Quantitative Studies. Conversely, interventions categorised as Person had a greater impact with increasing SEP, and may therefore appear likely to reduce inequalities. Swimming upstream? This was a community-based rural Heart Health Program in the community of Shepparton in Victoria, Australia. Get 1 hour or more of physical activity every day. We are indebted to project implementation staffparticularly Andrew Jones-Roberts and other Heart Foundation colleagues. 1 The Nutrition and Healthy Eating objectives also aim to help people get recommended amounts of key nutrients, like calcium and potassium. suggest that how an intervention is delivered is crucial. To complete the revision of the Malta Food and Nutrition Policy and to formulate an Action Plan. Data from all included studies were extracted by one reviewer using pre-designed and piloted forms. Five supermarkets in GS and four in SUN had suitable scanning equipment, and all of these agreed to participate. Public health policies to encourage healthy eating habits: recent Intervention which had no preferential impact by SEP (this also includes interventions where there was an overall benefit but where there was no effect on healthy eating outcomes for any SEP sub-group). The examination of these studies is warranted as this will add to our understanding of interventions that may be effective within this sub-group. Manchester: NICE Public Health Guidance 25; 2010. Lowe CF, Horne PJ, Tapper K, Bowdery M, Egerton C. Effects of a peer modelling and rewards-based intervention to increase fruit and vegetable consumption in children. Otherwise there was no consistent increase in strategies in GS than SUN GPs relating to the other seven dietary fat and cholesterol change strategies or the other seven weight reduction strategies. Introduction. The role of the program or initiative is to harness and enhance the natural problem solving and helping processes in the community with regard to their health needs and health promotion priorities (Hawe et al., 1997). Evaluate national and local initiatives which promote healthy eating. Am J Public Health. In both . Childhood socioeconomic status and adult health. Indicators of socioeconomic position (part 2). Are interventions to promote healthy eating equally effective for all Are interventions to promote healthy eating equally effective for all? The authors of the Minnesota Program as well as an editorialist in the American Journal of Public Health have argued that these community-based strategies are viable but that their program content, goals and objectives will need to be redefined (Luepker et al., 1994; Winkleby, 1994).
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