c-pan centre for physical activity and nutrition research centre for physical activity and nutrition...

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Centre for Physical Activity and Nutrition ResearchCentre for Physical Activity and Nutrition Research

Children’s Healthy EatingChildren’s Healthy Eating from research to practicefrom research to practice

Tony Worsley and David Crawford

Centre for Physical Activity and Nutrition Research Deakin University

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Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research

Acknowledgement

The Department of Human Services Victoria funded the review of the children’s healthy eating literature on which this presentation is based.

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Overview

Interventions on Children’s eating

Lessons from intervention research

Issues facing Australian families

Experimental and Practice examples

From interventions to action research

System change – food policies & monitoring

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Children’s Eating Interventions

Most interventions: Not evaluated Mainly primary children and peri natal

mothers and babies < 3 months duration Many effective in short term (1/3) -

some long term Not clear which method is best

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Lessons from interventions

EVALUATE - document all activities

Interventions often “work”

Parents are targets, like children

Sustainability a big problem - system

management, policy, resource issues

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Gaps in Intervention Research

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Gaps: Healthy eating poorly defined & measured

Focus on biomedical & nutrient

outcomes

Food and eating underemphasised

Whole diet studies absent

Meals and timing ignored

Physical activity often absent

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Gaps: Limited theoretical basis Baranowski review Psychophysiology

Timing of food consumption - de Castro Satiety and appetite regulation - Blundell Food, mood & cognition systems - Benton Food choice motivation – Steptoe, Grunert

Learning & cybernetic theory – Birch,

Rozin, Carver, Powers Social theory – family theory

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Gaps: Few evaluated studies of:

Parental behaviours and family influence Preschoolers Teenagers Child oriented community programs Long term interventions Food consumption vs biomedical outcomes Integrated broad health outcomes Effects of local food policies

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Many interventions have failed to take account of economic, organisational, and social contexts

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Issues facing Australian FamiliesAE Griffiths, 2003

Resources – finance, housing

Behavioural problems – physical, substance

abuse, etc

Parental expertise & knowledge

Support structures – internal & external

External pressures - govt policies, employment,

unemployment, technology & transport

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Experimental Research & Practice

Work of non-interventionists is crucial

Rozin & Birch - food exposure, modelling, reward

important

Tapper et al – Food Dudes

Practitioners’ experiences crucial

Social environment

Food policies

Green – PRECEDE/PROCEED

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Practice Examples

Food Dudes – show parents how to feed children

Start Right Eat Right – healthy eating education for child care workers

FoodCent$ - inexpensive eating for low income families

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Practice Examples

Tooty Fruity – school policy based program

Maribyrnong Fruit breaks & and Water bottles – classroom food policies – restructure the school day

Colac and Barwon community development programs

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A clash of paradigms:

From Interventions to Action Research & System Change

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Children’s health and education systems

Several “systems” responsible for children:

Families

Pre-school day care

Schools

Health facilities

Communities & local government

Are they responsible for food and nutrition?

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Action research for system change

Formative evaluation What’s the problem? Who are the stakeholders? What are the influences on children’s eating? What are our goals? How are changes made & institutionalised?

>> Food policies

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Action research for system change

Process evaluation

What are the barriers to our goals?

How do we get around them?

Do we alter our goals?

How do we know if the system is

helping children eat more healthily?

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Monitoring - Process & Impact EvaluationWhat do we monitor?

Food consumption, preferences, knowledge, skills, eating behaviour, nutrient status, body mass, growth, social interactions?

Who monitors and who is monitored? Children, teachers, parents, food services?

How often do we monitor?How extensively/intensively do we monitor?

Food bought during each quarter? Lunch content , consumption for a day or a week?

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FEEDBACK

How is monitored information used?

By child

By teacher/ day carer

By parent

By institution

By education and health systems

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How to influence children’s healthy eating Make food policies – set expectations

• State & Federal govt systems• Local govt• Institution• Family

Partnerships – make environments and organisations supportive

Inform, demonstrate, motivate, feedback, reward, monitor

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New DHS materials

Review of Children’s Healthy Eating Interventions

Data base of publications

Practitioners’ Guide to the Promotion of Children’s Healthy Eating

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Thank you!Thank you!

[email protected]@deakin.edu.au

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