Community engagement
Obesity is a public health issue globally as around 1.9 billion adults come under either the category of overweight or obese (1). The prevalence of overweight and obesity in Australia is a major public health concern (2). Considering the data from Australia, it is found in the National Health Survey 2014-15 that 36% of adults in Australia are overweight and 28% are obese. For children, it was found that children between 5 and 17yrs, 20% were overweight and 7% were obese which is alarming for this population (3). The causes of obesity are numerous ranging from genetic disposition to physical inactivity, which can be responsible for the condition singly, or in combination. In Australia specifically, unhealthy food and nutrition, less physical activity and the increase of the obesogenic environment are regarded as chief contributor to this health issue (4). The City of Melton is a local government area in Victoria, Australia, in western side of Melbourne’s rural–urban fringe. In the City of Melton, 16.9% adolescents were eating the minimum recommended serves of fruit and vegetables each day in 2009 which was lower than the proportion reported across Western Metropolitan Region (18.3%). Also. Residents of Melton considerably have more chances of being obese. This report focuses on the action plan to reduce the consumption of high calorific food item among the children between 5 and 17 years in the City of Melton.
A collaborated effort from the State Government, State Education department and the City Councils of the City of Melton is required either update previous policies or make new policies to remove high caloric temptation from children and adolescent. Subsidies on purchase of healthy food items such as fruits and vegetables in the form of discounts, vouchers or coupons can be planned (5). Further, the fast food serving settings can be zoned through local council bylaws (6). Guidelines can be passed to ban the advertisement of unhealthy food at outdoor sites. Strict policies against incorrect labeling of calorie values or false claims over the junk food items should also be made. Children between 5 and 16 are school-going so school canteen policies can be updated to promote selling of healthy food items at reasonable price and lower the availability of high calorific value products (7). Another collaborative work is required from the school authorties of the City of Melton with the teachers, students and parents to plan and conduct nutrition awareness curriculum sessions, meetings and workshops. Modules covering the health impacts of high calorie consumption can be included in the school curriculum. In addition, school newsletter articles focused on discouraging consumption of high calorie food and adopting healthy food habits targeted at adolescence and parents can also be taken up. It can increase efforts from parents as well as children’s own side to avoid fast food. Further, it should be ensured that a professional development orientation is provided to the teachers, canteen supervisors and sports coaches so that the new policies are implemented efficiently. The community of the City of Melton can act to develop community level social media campaign which points out towards the short-term and long-term adverse effects of consuming high calorie food items so that its temptation among children between 5 and 16 years can be reduced.
Program design and evaluation
Program design and evaluation
Goal of this obesity prevention initiative is to prevent or reduce the incidence of obesity by reducing calorie temptation among children between 5 and 17 years in the City of Melton. Specifically, the objective is to reduce the consumption of junk food by 40% and to increase the consumption of fruits and vegetables by 30% in children between 5 and 17 years in the City of Melton within 4 years.
By reducing the temptation of high calorie food among children, its consumption can be decreased which will help tremendously in lowering the incidence of obesity among the children of the City of Melton. An article from the Independent stated that several Government across the world are using subsiding schemes to generate healthy habits among their population (8). Another study conducted by the economists at Bath University, revealed that by subsidising healthy foods by up to 10% will switch eating habits of overweight and obese individuals than a taxing scheme on unhealthy products, and could be cost-effective in long-term. Further, it is found that while attempting to reduce the access to unhealthy foods municipal zoning codes may hold unique potential especially in the school vicinity. In addition, the zoning laws ascertain how the City of Melton land may be used and where these different uses may take place (9). A Research Paper no. 9 published in 2010–11 by Parliament of Australia which suprted the idea that the environement of Australia demanded the need for more standardising advertising policies for junk foods. It also stated that the need that Government should effectively balance ultimately several complex issues such as safeguarding children from corruption, the rights of commercial interests to endorse their goods and to trade legally, and differing conceptual views (10). Further, a study demonstrated that media campaigns about unhealthy foods such as sugary drinks and obesity can be useful for raising awareness about added sugars in beverages, increasing knowledge about health issues related to too much sugar consumption, and inducing behavioral intents to decrease soda and sugary drink intake (11). Professional development orientation for teachers, canteen managers, sports coaches to implement new policies. Evidence suggest that policies and regulations ensure healthy nutrition environments and practical professional training and education of the involved professionals is required to translate policies into competent practices (12). Inclusion of modules discussing the health impacts of high calorie consumption in the school curriculum will also be a useful strategy. One study suggested that the formal health curriculum that offers students the significant knowledge and social skills that will facilitate them to make informed decisions influencing their physical, psychological and social health (13).
Best Practice Principles: program strategies and process evaluation methods
Several methods can be utilized to check, that whether the objective of reducing the consumption of junk food by 40% and to increase the consumption of fruits and vegetables by 30% in children between 5 and 17 years in the City of Melton within 4 years is met or not. To check the food subsidy scheme, audits can be done at the supermarkets and other shops near the school vicinity to check the number of food items on which subsidies have been applied after the application of the scheme. Survey can be conducted to find out the number (%) of schools complying with the Healthy canteen policy pre and post updating of the policies (14). The success of social media campaign to raise awareness can be measured by checking the number of likes and shares on Facebook and Instagram posts. Evaluation of professional development training can be done by assessing the number (%) of teachers and canteen managers taking part in professional development orientations. A survey can be conducted of adolescence regarding consumption of high calorie food attitudes and knowledge after updating their curriculum with lessons of nutrition and healthy habits. To verify the results of this survey a school curriculum audit can be performed pre and post the curriculum update (15). Another survey of parents can be conducted regarding consumption of high calorie food at home after distributing school newsletter articles.
Various steps will need to be taken to ensure that the recommended intervention strategies are rooted into the current systems, procedures and policies to promote sustainability so that the positive outcomes gained are continued beyond the funded period of four years.
A Reference Committee must be constructed to give higher level of directed guidance and assistance. It will also evaluate progress and give high-end budget approvals. Members in this community can include personnel from Department of Human Services, Department of Education and the principals from the schools who can meet bimonthly. A Project Management Group also needs to be formed to push the execution of the project’s action plan which should be led by the Project Coordinator. The Project Management Group will include School Project Officers who can meet monthly during school term. The Project Coordinator will give training, assess and guide the schools with a reporting line back to the Reference Committee. In addition he/she will also coordinate meetings for the project management Group and the Reference Committee. Lastly, student Ambassadors Group will be formed by elected Students from all the schools by the Project Officers. Student Ambassadors will play the role of project guardian and inform the formation and application of suitable interventions.
References
World Health Organisation (WHO). Obesity and Overweight[Internet]. [Geneva: WHO]; c2018 [revised 2018 Feb 16; cited 2018 Sep 26].
Australian Institute of Health and Welfare. A picture of overweight and obesity in Australia 2017. Canberra: Australian Institute of Health and Welfare, 2017.
Australian Bureau of Statistics. National Health Survey: First Results, 2014-15CAT 4364.0.55.001 Canberra: Australian Bureau of Statistics; 2015 [cited 2018 Sep 26]].
Australian Institute of Health and Welfare. A picture of overweight and obesity in Australia 2017 [Internet]. Canberra: AIHW; 2017 [cited 2018 Sep 26].
An R. Effectiveness of subsidies in promoting healthy food purchases and consumption: a review of field experiments. Public health nutrition. 2013;16(7):1215-28.
Nixon H, Doud L. Do fast food restaurants cluster around high schools? A geospatial analysis of proximity of fast food restaurants to high schools and the connection to childhood obesity rates. Journal of Agriculture, Food Systems, and Community Development. 2016;2(1):181-94.
Raulio S, Roos E, Prättälä R. School and workplace meals promote healthy food habits. Public health nutrition. 2010;13(6A):987-92.
Rivas J. Subsidies for healthy foods are a price worth paying to tackle obesity. The Conversation. 2017
Davis B, Carpenter C. Proximity of fast-food restaurants to schools and adolescent obesity. American Journal of Public Health. 2009;99(3):505-10.
Jolly R. Marketing Obesity?: Junk Food, Advertising and Kids. Parliamentary Library; 2011.
Boles M, Adams A, Gredler A, Manhas S. Ability of a mass media campaign to influence knowledge, attitudes, and behaviors about sugary drinks and obesity. Preventive medicine. 2014;67:S40-5.
Tovar A, Risica P, Mena N, Lawson E, Ankoma A, Gans KM. Peer reviewed: An assessment of nutrition practices and attitudes in family child-care homes: Implications for policy implementation. Preventing chronic disease. 2015; 12.
Melo H, de Moura AP, Aires LL, Cunha LM. Barriers and facilitators to the promotion of healthy eating lifestyles among adolescents at school: the views of school health coordinators. Health education research. 2013; 28(6):979-92.
Robson C. Small-scale evaluation: Principles and practice. Sage; 2017
Ivers NM, Sales A, Colquhoun H, Michie S, Foy R, Francis JJ, Grimshaw JM. No more ‘business as usual’with audit and feedback interventions: towards an agenda for a reinvigorated intervention. Implementation Science. 2014; 9(1):14.
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