This is far from ideal and clearly was very dependent on the assumptions made. These results prompt the question whether these programs represent viable health promotional strategies in the future, and, assuming that they do, in what form and on what scale. Rothman, J. Health Educ Res. Retrieved articles were screened independently by two reviewers. 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. Br J Nutr. The principal goal of this phase was to promote public policy initiatives that promoted healthy diet, supported by changes in community opinion and interest in healthy diet. Am J Public Health. Their purpose, however, will be to generate sufficient community support for the initiatives to be taken up and succeed, rather than as in the past, to achieve short-term individual behaviour change. Am J Public Health. http://www.who.int/dietphysicalactivity/diet/en/(2014). Socioeconomic factors and cardiovascular disease: a review of the literature. 2008;108:202130. Where possible, we used statistical significance to identify differential effects of interventions. This has led to an increase in systematic reviews assessing health equity effects [14,15]. Upon fulfilling these criteria, studies were assessed utilising a PICOS (Participants, Interventions, Comparators, Outcomes and Study design) [23]. This paper presents the overall results of the evaluation of the Towards a Healthy Diet phase of the project. Several of the included studies were modelling studies. No previously developed instruments existed which addressed the above purpose. SUN is a municipality in North-western Victoria, based around the city of Mildura. Dallongeville J, Dauchet L, Mouzon O, Rquillart V, Soler L-G. Increasing fruit and vegetable consumption: a cost-effectiveness analysis of public policies. An examination of the impact of Towards a Healthy Diet on school nutrition policy and practices was conducted. PubMed This is true for other alternative approaches to community-based programs so far implemented for promoting healthy diet. Google Scholar. Part of RCTs. In Cox, F., Erlich, J. L., Rothman, J. and Tropman, J. E. (eds) Strategies of Community Organization: A Book of Readings. We did not find any Prescriptive interventions and only one Product intervention that presented differential results and had no impact by SEP. More Place interventions were identified and none of these interventions were judged as likely to widen inequalities. Results from a randomised, controlled trial. Our search identified 31,887 articles. Bristol: Policy Press; 2009: 6481. Community development approaches in which the community, rather than external agencies or groups, initiate and undertake programs, are a clear alternative. WHO. We aspired to undertake a meta-analysis of the results. Thomas H. Quality Assessment Tool for Quantitative Studies. 2010;376:177584. There was a significantly greater increase in the number of fruit dishes offered in Shepparton eating places as well as customer requests for fruit. 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. The studies are then grouped by outcome regarding socioeconomic differential effects (reduced, no preferential impact by SEP and widened). 2006;60:95101. Their goal has been to produce behaviour and risk factor change, and ultimately to reduce morbidity and mortality among individuals in the intervention communities. Lancet. explicitly concluded that downstream interventions actually worsen health inequalities [82]. Food Econ - Acta Agriculturae Scandinavica, Section C. 2005;2:16774. Two-year outcomes. Hence structural, universally delivered upstream interventions which create a healthier environment therefore tend to circumvent voluntary behaviour change may well reduce inequalities [18]. 1996;86:20613. In addition, we excluded studies aimed solely at lower SEPs. Seven hundred and three residents, aged 1874 years, responded. Learning outcomes Identify what is meant by healthy eating Explain what is meant by healthy eating Evaluate national and local initiatives which promote healthy eating Describe food and drink requirements in relation to current . The methodological quality of each included study was assessed independently by two reviewers using the criteria for the Community Guide of the US Task Force on Community Preventive Services and a six-item checklist of quality of execution adapted from the criteria developed for the Effective Public Health Practice Project [27,28]. School Health Guidelines At a Glance. However, there is a lack of evidence concerning the health equity impact of dietary interventions to promote health. Plachta-Danielzik S, Pust S, Asbeck I, Czerwinski-Mast M, Langnase K, Fischer C, et al. . J Nutr Educ. remain the major cause of disease, disability and death, accounting for over 63% of deaths worldwide in 2012 [1]. Assessment criteria: Evaluate national and local initiatives which promote children's exercise Exercise and physical activity are key components of maintaining a healthy lifestyle. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. Perceptions of change in community interest in healthy diet, GS (n = 591) and SUN (n = 546), Change in individual's diet behaviour, GS (n = 591) and SUN (n = 546), Individual responses to the campaign in GS (n = 703), Changes in eating places' practices and customer behaviour, GS (n = 27) and SUN (n = 24), Canteen nutrition policies at end of Project period, GS (n = 16) and SUN (n = 13). PubMed Central 1.3 Evaluate national and local initiatives which promote children's 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. 2011;65:9028. Conversely, those of lower SEP tend to be harder to reach, and find it harder to change behaviour due to a lack of access to the resources previously outlined [19]. Health Policy (Amsterdam, Netherlands). 2023 BioMed Central Ltd unless otherwise stated. This category included health education and dietary counselling. Accelerating risk factor changes will likely require a sustained community effort with reinforcement from state, regional, and national policies and programs. In addition, there were some impacts on organizational practice (public policy initiatives). 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 It is possible that Towards a Healthy Diet with its established community impacts, has impacts on individual behaviours, such as these, which are most influenced by community norms. Carleton, R. A., Lasater, T. M., Assaf, A. R., Feldman, H. A. and McKinlay, S. (, Farquhar, J. W., Fortmann, S. P., Flora, J. Understand children's need for exercise Assessment criteria: 1.3 Evaluate national and local initiatives which promote children's exercise National initiatives can be government or organisational led and target the whole nation Change 4 Life - promotes family health Sunraysia (SUN) was selected as the comparison community. Get 1 hour or more of physical activity every day. Jouret B, Ahluwalia N, Dupuy M, Cristini C, Ngre-Pages L, Grandjean H, et al. Am J Public Health. Preventive interventions may not benefit all sub groups of the population equally [16,17]. Evaluate national and local initiatives which promote children's Traditional health educational strategies will still be necessary. JAMA. https://doi.org/10.1186/s12889-015-1781-7, DOI: https://doi.org/10.1186/s12889-015-1781-7. Health Technol Assess. This phase of the Project, and consequently its evaluation, was multifaceted. The purpose of this study is to help researchers and restaurant owners gain an understanding of healthy sustainable initiatives within restaurant businesses. There are initiatives taken by different organizations in this regard, all concentrating at child health and benefit. The effect on inequalities was classified as follows: Intervention likely to reduce inequalities: the intervention preferentially improved healthy eating outcomes in people of lower SEP, Intervention likely to widen inequalities: the intervention preferentially improved healthy eating outcomes in people of higher SEP. They also included statewide services, e.g. Programs based on public policy initiatives supported by social learning principles ultimately value the communityand its organizations, groups and key individualsbecause they reinforce or enhance the program's primary social marketing approach. 2010;34:111624. These include intervention efficacy, service provision or access, uptake, and compliance [15]. The evidence base revealed a striking lack of studies quantifying the differential effectiveness of dietary interventions by SEP [83]. Evaluate national and local initiatives which promote healthy eating. The evaluation was commissioned and funded by the Heart Foundation with additional support from the Victorian Health Promotion Foundation (VHPF) through its program grant to the Centre for Health Program Evaluation. The use of the adapted marketing 4 Ps approach provides a simple conceptual framework to categorise and evaluate policy interventions, which may have otherwise been difficult to group. The participation of eating places in the program and their conformity to Heart Foundation's healthy diet recommended practices were recognized by wall plaques that could be mounted. Addressing health disparities in middle school students nutrition and exercise. This was done using a scale (+4 to 4), created by subtracting pre- from post-intervention questionnaire scores for variables with ordinal rankings from 1 to 5. Indeed, evidence from tobacco control suggests that comprehensive strategies involving multiple interventions at multiple levels may be more powerful than narrower approaches [84,85]. J Public Health Med. Int J Obes. Assessment criteria: Evaluate national and local initiatives which promote healthy eating. PDF Unit 1.1: Support healthy lifestyles for children through the provision A diet relatively high in energy is generally less expensive than a diet consisting of less energy dense products, such as vegetables [6]. By using this website, you agree to our Community awareness and response to Towards a Healthy Diet were assessed at its completion in a separate cross-sectional mail questionnaire survey of 703 residents of Shepparton. 1999;89:13906. CAS (, Winkleby, M. A., Taylor, C. B., Jatulis, D. and Fortmann, S. P. (, Oxford University Press is a department of the University of Oxford. The two communities also share similar socio-demographic characteristics. Table tents' with healthy diet messages were also used. EYE 11 - 1.2 Evaluate local and national initiatives which promote Choosing indicators to evaluate Healthy Cities projects: a political However, these common transversal approaches also carry a risk of perverse effects, especially when the effect of market-oriented regulatory . Oliver A, Nutbeam D. Addressing health inequalities in the United Kingdom: a case study. There is an urgent need for the development of a quality assessment tool comparable to those used in empirical studies [27,28]. I wonder if anyone can help me. The interviews were undertaken at the beginning of the overall Project and 2 years later at the end (rather than at the end of Towards a Healthy Diet). Finkelstein Ea ZC. Tiffin R, Salois M. Inequalities in diet and nutrition. LO, MMW and SC contributed to the search strategy. 2002;22:26784. UK [9]. There is a need for comparable studies in other areas such as alcohol and physical activity in order to examine differential impact. Some climatic differences did exist, however, between the two communities. We have adapted and strengthened this framework in order to categorise policy interventions relating to healthy eating by their mechanisms of underlying change. whether there has been a community or a Project effect. The evaluation of the Pawtucket Program concluded that achieving cardiovascular risk reduction (including cholesterol and body mass index) at the community level was feasible, but maintaining statistically significant differences between cities was not (Carleton et al., 1995). Smith AM, Owen N, Baghurst KI. 2009;15:57885. Thomas S, Fayter D, Misso K, Ogilvie D, Petticrew M, Sowden A, et al. These are summarised in Table3. Explain what is meant by healthy eating. A. We searched five bibliographic databases using a pre-piloted search strategy. Compliance may be higher among more advantaged groups because of better access to resources such as time, finance, and coping skills. Prevention of overweight in preschool children: results of kindergarten-based interventions. Change in relevant parameters across the Project period towards practices supporting Heart Health was compared for GPs in GS and SUN. Prevention of Cardiovascular Disease. Within the Harvest Plot, each intervention was represented as a single bar in one of three categories: those that were more effective in more disadvantaged groups (reduce), had the same effect in all groups (no preferential impact by SEP), or were less effective in disadvantaged groups (widen) (Figure1). Participation in community-originated interventions is associated with positive changes in weight status and health behaviors in youth. Extracted data were compared for accuracy and completeness. Int J Epidemiol. Responses of black and white males to the special intervention program of the Multiple Risk Factor Intervention Trial. 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). Conversely, interventions categorised as Person had a greater impact with increasing SEP, and may therefore appear likely to reduce inequalities. 2013;14 Suppl 2:15968. 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]. Four-year follow-up of school-based intervention on overweight children: the KOPS study. Haerens L, Deforche B, Maes L, Brug J, Vandelanotte C, De Bourdeaudhuij I. NICE. 1984;108:83949. Preventing cardiovascular disease through community-based risk reduction: the Bootheel Heart Health Project. An annual Fruit Salad Day as well as poster displays and cookbooks for sale in fruit and vegetable retailers were organized. These included quantitative results presented by a measure of SEP for 47 interventions.
