strategies for promoting healthy eating in the community

Studies were then excluded if they were not: a) randomised controlled trials; b) quasi-experimental studies; or c) cluster-controlled trials. minimal, small, medium, large) and/or if Md>.40. Any policy strategy related to increasing availability/identification of healthy foods, Community gardens zoning or other ordinance/bylaw, Farmers markets zoning or other ordinance/bylaw, Doubling Supplemental Nutrition Assistance Program benefits on fresh produce, Menu labeling at unhealthy retail food outlets, Healthy food retail zoning or other ordinance/bylaw, Urban agriculture zoning or other ordinance/bylaw, Any policy strategy related to reducing access to unhealthy foods, Regulation of promotion or advertising of unhealthy food or beverages in schools, government buildings, or community, Regulation of sale of unhealthy food or beverages in schools, government buildings, or community, Fast-food outlets zoning or other ordinance/bylaw, Any policy strategy related to improving school food environment, School district nutrition, procurement, and vending policies, Municipal (city or town) health department, Public Health Accreditation Board accreditation status, The current study found that a low proportion of LHDs that served less than 500 000 residents participated in a recent. Parental involvement was incorporated into 10 studies that reported against 23 FV consumption or preference outcomes in primary school children. Institute of Medicine. If your institution is not listed or you cannot sign in to your institutions website, please contact your librarian or administrator. Encouraging Health Behavior Change: Eight Evidence-Based Strategies - AAFP Variance inflation factors were examined for each LHD characteristic to assess collinearity, with a cutoff of more than 10. This would enable all Victorians to enjoy the highest standards of health and wellbeing. Local jurisdictions would benefit from stronger and more concise guidance on which types of policy strategies to improve diet are available for implementation, evidence for such policies, and the context in which such policies have been successfully adopted and implemented. Engage social network. Eleven studies reported on outcomes of food consumption and the overall energy intake of primary school-aged children. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (http://www.JPHMP.com). Offer a wide range of foods. As such, they represent some of the most developed and advanced economies on the planet and should be taken into serious consideration when seeking to generalise these findings. Cooke LJ, Chambers LC, Anez EV, Croker HA, Boniface D, Yeomans MR, et al. All four (100%) of these studies reported achieving statistical significance of at least p<.05. Data pertaining to teaching strategies that reported on healthy eating outcomes for primary school children was extracted from the 49 eligible papers. 2. board/card games played by students at school designed to promote positive behaviour and learning of new knowledge) (n=2); and 8) web-based approaches (i.e. and transmitted securely. Gardening increases vegetable consumption in school-aged children: a meta-analytical synthesis. School infrastructure, physical environment, policies, curricula, teaching and learning, and staff all have the potential to positively influence child health. Measures of knowledge included: questionnaires or tests on food-related knowledge (i.e., Recommended Dietary Intakes, ingredients, nutritional knowledge). The standardized effect sizes were interpreted as minimal (<.02), small (0.2), medium (0.5), and large (0.8) [14]. In fact, 8 of the 13 studies reported statistical significance of p<.001. Canberra: Australian Government; 2013. Sahota et al. Additional funding was provided by the UMass Center for Clinical and Translational Science (grant #UL1TR001453) (M.S.) White House Task Force on Childhood Obesity. 2007) [12 Midcourse Report: Implementation Strategies for Older Adults 2017;14(11):pii:E1366. Although we did not ask about every possible healthy eating policy strategy such as healthy food financing models and the evidence supporting the strategies we selected is variable, we purposefully incorporated an array of recommended strategies.820 Outcome misclassification could have occurred for multiple reasons. Am J Prev Med. Boone-Heinonen J, Gordon-Larsen P, Kiefe CI, Shikany JM, Lewis CE, Popkin BM. Researchers were able to calculate 7 effect sizes (3 large, 1 medium, 3 minimal) with the mean effect size being Md=0.75. This is because excessive consumption of fruit-based sugars (i.e. The first step in fostering a healthy office culture is encouraging . Cooksey-Stowers K, Schwartz MB, Brownell KD. Randomisation procedure clearly and explicitly described and adequately carried out (generation of allocation sequence, allocation concealment and implementation), Validated measures of food consumption/energy intake and/or fruit and vegetable consumption or preference and/or reduced sugar consumption or preference and/or nutritional knowledge (validation in same age group reported and/or cited), Drop out reported and 20% for <6-month follow-up or 30% for 6-month follow-up, Food consumption/energy intake and/or fruit and vegetable consumption or preference and/or reduced sugar consumption or preference and/or nutritional knowledge assessed a minimum of 6months after pre-test, Intention to treat analysis for food consumption/energy intake and/or fruit and vegetable consumption or preference and/or reduced sugar consumption or preference and/or nutritional knowledge outcomes(s) (participants analysed in group they were originally allocated to, and participants not excluded from analyses because of non-compliance to treatment or because of some missing data), Potential confounders accounted for in outcome analysis (e.g. Experiential Learning (Gardening + Food Prep), Perry et al. The Secretary's Advisory Committee recommended that the focus of Healthy People 2030 expand beyond health promotion to the broader purpose of promoting "health and well-being ." literature read by/to children whereby a character promotes/exemplifies positive behaviours) (n=3); 7) games-based approaches (i.e. 2012;126(12):15141563. James J, Thomas P, Cavan D, Kerr D. Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomised controlled trial. The formula for calculating Cohens d is: where M1 is the mean of one group of study participants, M2 is the mean of a second group of study participants, and SDP is the pooled standard deviation for both groups of study participants. ASTHO profile of state public health, volume three. The three researchers then reviewed each of the articles independently and each identified the teaching approaches employed in the intervention phase of the studies. Given that all the articles were identified from the peer-reviewed literature, there is some possibility of publication bias on the nature of evidence available to inform the review. However, the findings have been supported in other literature, with experiential learning strategies, such as garden-enhanced learning strategies, positively influencing vegetable preferences and consumption among primary school children, which has been found to be the strongest predictor of future consumption [36-39]. Wolters Kluwer Health, Inc. and/or its subsidiaries. J Public Health Manag Pract. However, it is important to note that many of the studies that used curriculum-based approaches (especially those with stronger p values) also coupled their interventions with secondary approaches (e.g., experiential-learning, parental-involvement). (2004) UK, Horticultural Development Council, Fresh Produce Consortium, ASDA, Co-operative Group, Safeway, Sainsbury, Somerfield, Tesco, Birds Eye [, Animation abstraction and contingent reinforcement for F&V consumption, Experiential learning (Cooking, environment and community garden), Food intake based on teacher visual estimates (%), Manios et al. The site is secure. Promoting healthy body image - Mayo Clinic Health System Statement of policy 18-04 nutrition and chronic disease prevention. Future qualitative research should be conducted to understand whether and how smaller local jurisdictions prioritize and implement healthy eating policies. Local Government Actions to Prevent Childhood Obesity. Reducing access to unhealthy foods included regulation of advertising or sales of unhealthy food or beverages in schools, government buildings, or community; sodium reduction or trans fat ban at retail food outlets; fast-food outlets zoning or other ordinance/bylaw; and taxation of sugar-sweetened beverages. Thus, the principal aims of this study were a) to promote healthy diets by increasing healthy food offerings and b) to increase the number of foods offered specifically as gluten-free and lactose-free and to inform patrons by including nutritional and allergen . Prev Med Rep. 2017;6:7479. Agreement between reviewers for each article was set a priori at 80% [12]. The CHIP process is one way to help foster long-term sustainable collaborations necessary to address multifactorial public health issues. The final analytic sample included 176 LHDs, which was representative of 2390 US LHDs (<500 000 residents) after weights were applied. Sreedhara, Meera MPH; Goins, Karin Valentine MPH; Frisard, Christine MS; Rosal, Milagros C. PhD; Lemon, Stephenie C. PhD. Eating Healthier at School Communications Center Features Eating Healthier at School Kids can practice better eating habits when schools provide healthy foods. (2011) New Zealand, Health Research Council NZ [, Curriculum approach with Healthy Homework Teaching Resource, - Unhealthy food consumption (Servings per/day), - Unhealthy drink consumption (Servings/per day), Foster et al. PDF Promoting Healthy Eating and Physical Activity for a Healthier Nation The survey was part of a larger Physical Activity Policy Research Network Plus (PAPRN+) project that aimed to study LHD engagement in built environment policy decision making. Having nutrition information and caloric content on restaurant and . Rothman KJ, Greenland S, Lash TL. Domel SB, Baranowski T, Davis H, Thompson WO, Leonard SB, Riley P, et al. Health at a Glance 2013: OECD Indicators. HHS Vulnerability Disclosure, Help One way to promote child health is to identify early modifiable factors that affect child eating and weight. All authors read and approved the final manuscript. official website and that any information you provide is encrypted National Association of County & City Health Officials (NACCHO). There were eight dominant teaching strategies or approaches to teaching exhibited across the 49 studies that addressed the pre-determined areas of healthy eating for primary school students (i.e. Luepker RV, Perry CL, McKinlay SM, Nader PR, Parcel GS, Stone EJ, et al. Chicago, IL: Bridging the Gap Program and the National Wellness Policy Study, Institute for Health Research and Policy, University of Illinois at Chicago. Day ME, Strange KS, McKay HA, Naylor P. Action schools! How to Market Your Healthy Food to Attract Health Enthusiasts This authentication occurs automatically, and it is not possible to sign out of an IP authenticated account. 33. Community-based interventions aiming to improve cooking skills are a popular strategy to promote healthy eating. These approaches warrant greater investigation to reduce the amount of variance in the calculated effect but show promise in their ability to reduce food consumption and energy intake. Strategies for Promotion of a Healthy Lifestyle in Clinical Settings Hoffman et al. The accreditation process is one approach to help LHDs engage in policy decision making related to improving local food environments, but future research should investigate how to improve voluntary national accreditation among LHDs with fewer resources. Add taking the medication to an existing habit to increase the likelihood patients will remember (e.g., use inhaler before brushing teeth). Kids Choice Program (KCP), contingent reinforcement supported by parental involvement. community gardens), Health/nutrition education programs related to improving dietary habits, Environmental school change strategies implemented by classroom teachers, Environmental interventions/industry partnerships focused on point-of-purchase consumption linked through classroom based education; this might include campaigns to draw attention to healthier products in school canteens or school lunch choices. Policies that seek to improve dietary habits of elementary school children (i.e. Future research is warranted to investigate how smaller local jurisdictions and LHDs with fewer resources prioritize policy strategies to improve food environments. lentils and beans), nuts and whole grains (e.g. We reviewed current evidence on the effectiveness of these interventions on different confidence aspects and fruit and vegetable intake. No systematic review or meta-analysis have been undertaken to date which ascertain the strategies teachers should employ in order to yield maximum effect from their teaching interventions when it comes to fostering healthy eating behaviours in primary school-aged children. Local health departments must submit a CHIP dated within 5 years when applying for accreditation from the Public Health Accreditation Board.29 Therefore, we recoded LHDs' categorical responses to Has your local health department participated in developing a Community Health Improvement Plan? into a dichotomous variable of Yes, participated in a CHIP less than five years ago or No CHIP, or participated in a CHIP five or more years ago. We recoded responses of Don't know as missing. Ask your employees what kind of items are requested the most, such as vegan, gluten-free, or food without certain ingredients, and how it compares to your current menu. Wayne G Cotton, Email: ua.ude.dysu@nottoc.enyaw. Key baseline characteristics are presented separately for treatment groups (age, and one relevant outcome (food consumption/energy intake; fruit and vegetable consumption or preference; reduced sugar consumption or preference; nutritional knowledge) and for randomised controlled trials and controlled trials, positive if baseline outcomes were statistically tested and results of tests were provided. For children ages 6 and older, set consistent limits on media time. Promoting physical activity and a healthful diet among children: results of a school-based intervention study. This meta-analysis of school-based teaching interventions that have focused on improving the eating habits of primary school children found that experiential learning approaches had the greatest effect on reducing the food consumption, energy intake and nutritional knowledge of primary school children, and a smaller effect on primary school childrens FV consumption or preference. Local health department characteristics included size of population served, US Census geographic region, structure, State and LHD governance, and Public Health Accreditation Board status. Researchers met and cross-referenced their identification of each teaching approach and decided though consensus how each approach would be classified as a wider teaching strategy (if appropriate) that would allow for comparison between studies. Reducing sugar consumption and preference was most influenced by cross-curricular approaches embedded in the interventions. Federal government websites often end in .gov or .mil. Received 2014 Oct 2; Accepted 2015 Feb 3. J Public Health Manag Pract. Based on these two studies, the average effect size for contingent reinforcement in promoting FV consumption or preference is Md=1.34. In regards with improving primary school childrens FV consumption or preferences, both cross-curricular and quality curriculum interventions were effective. 8. Taylor RW, McAuley KA, Barbezat W, Strong A, Williams SM, Mann JI. National Association of County & City Health Officials. Association of State and Territorial Health Officials (ASTHO). Whilst some studies reported multiple theoretical approaches (see Table1), Social Cognitive Theory was the most frequently used theoretical framework and was reported in 16 of 27 studies. Journal of Public Health Management and Practice, Get new journal Tables of Contents sent right to your email inbox, Creative Commons Attribution-Non Commercial-No Derivatives License 4.0, http://health.gov/dietaryguidelines/2015/guidelines/, http://nrs.harvard.edu/urn-3:HUL.InstRepos:11189975, http://www.pvpc.org/sites/default/files/Food%20Access_160928.pdf, https://www.naccho.org/uploads/downloadable-resources/18-04-Nutrition-and-Chronic-Disease-Prevention.pdf, https://www.naccho.org/uploads/downloadable-resources/Programs/Community-Health/09-11-Menu-Labeling-Trans-Fat-Salt.pdf, https://www.hhs.gov/sites/default/files/disease-prevention-wellness-report.pdf, https://www.thecommunityguide.org/findings/obesity-multicomponent-interventions-increase-availability-healthier-foods-and-beverages, http://www.nacchoprofilestudy.org/wp-content/uploads/2017/01/Main-Report-Final.pdf, http://www.phaboard.org/wp-content/uploads/SM-Version-1.5-Board-adopted-FINAL-01-24-2014.docx.pdf, http://www.astho.org/Profile/Volume-Three/, https://www.fda.gov/food/news-events-cfsan/cfsan-constituent-updates, JPHMP_2019_11_13_SREEDHARA_1900193_SDC1.docx; [Word] (31 KB), Healthy Eating Policy Strategies in Community Health Improvement Plans: A Cross-Sectional Survey of US Local Health Departments, Articles in PubMed by Meera Sreedhara, MPH, Articles in Google Scholar by Meera Sreedhara, MPH, Other articles in this journal by Meera Sreedhara, MPH, Health Equity and Implementation Science and Practice: Making the Implicit Explicit, Developing Core Capabilities for Local Health Departments to Engage in Land Use and Transportation Decision Making for Active Transportation, A Glossary for Dissemination and Implementation Research in Health, Evolution of Diffusion and Dissemination Theory, Privacy Policy (Updated December 15, 2022). Local health department structure was collapsed because of small cell sizes into a 3-category variable of municipal (city or town), county and city-county, or other health department (including regional, state-run, and public health network). Health districts as quality improvement collaboratives and multijurisdictional entities. On review of the full-text paper, another 6 studies were excluded for not meeting the inclusion criteria (i.e. Select your institution from the list provided, which will take you to your institution's website to sign in. Of the 10 studies using cross-curricular approaches, 90% of these yield statistical significance at p<.05 or better and of the 6 effect sizes calculated by the researchers, 50% had large effect sizes and the remaining 50% had a small or medium effect size. Promoting Health and Well-being in Healthy People 2030 - LWW The finding that policies that improve access to or identification of healthy foods were infrequently included in CHIPs is not surprising. This was within the Zone of Desired Effects [11], but more investigation may be required given the small number of studies included in the analysis. Making Education a Priority in the Post-2015 Development Agenda. Intervention locations had to include elementary schools and/or their immediate community settings. More than one-third of LHDs in this sample served small jurisdictions (<25 000 residents) (see Supplemental Digital Content Table 1, available at https://links.lww.com/JPHMP/A626). Population approaches to improve diet, physical activity, and smoking habits: a scientific statement from the American Heart Association. 13. United Nations Educational, Scientific and Cultural Organization. Curr Atheroscler Rep. 2018;20(5):25. The AIM-HI approach to fitness promotion involves the following strategies. Less than half of all US LHDs, including those serving populations of 500 000 residents or more, surveyed in 2016 reported involvement in land use planning activities that supported access to healthy food resources.25 A policy inventory found that few US municipal and town zoning ordinances permitted urban agriculture including community gardens or farmers' markets, although most ordinances permitted supermarkets.34 Another inventory of US diet-based policies found a limited number of locally proposed or adopted subsidies for fruit and vegetable purchases at farmers' markets for Supplemental Nutrition Assistance Program recipients despite the strategy's effectiveness,22,35 potentially due to lack of capacity at the local level or it may be managed at the state-level depending on the public health infrastructure. 3. These primary outcomes were then grouped into four dominant healthy eating outcomes that the authors determined aligned with the National Health and Medical Research Council (NHMRC) and their Healthy Eating for Children [10] Guidelines. Manios Y, Moschandreas J, Hatzis C, Kafatos A. The final 49 studies were all in the form of peer-reviewed journal publications. View the institutional accounts that are providing access. Before The WHO Global Strategy on Diet, Physical Activity and Health was adopted in 2004 by the World Health Assembly. APPLE Project - Community driven healthy eating & physical activity initiative. In light of these findings, it is important to note that the high levels of heterogeneity among the included primary school healthy eating programs, does not make it possible to make firm conclusions. Strategies that discourage the intake of specific dietary components such as trans fat, sugar, and sodium were notably low in our study. Liquori T, Koch PD, Contento IR, Castle J. The results of the systematic review indicate that several dominant evidence-based approaches to teaching healthy eating in the randomised controlled trial, quasi-experimental and cluster controlled trial literature. American Academy of Pediatrics Policy Statement. Visible Learning: A synthesis of over 800 Meta-Analyses Relating to Achievement. Louisa R Peralta, Email: ua.ude.dysu@atlarep.asiuol. Office of the Surgeon General. Equity and Quality in Education: Supporting Disadvantaged Students and Schools. Victorian public health and wellbeing plan The vision of the Victorian public health and wellbeing plan 2019-2023 is for a Victoria free of the avoidable burden of disease and injury. This work is a product of a Prevention Research Center in collaboration with the Division of Nutrition, Physical Activity, and Obesity and was supported by Cooperative Agreement Number U48 DP005031-05 from the Centers for Disease Control and Prevention (C.F., M.C.R., S.C.L.) Abstract. A nutrition education program at three grade levels. For each included article, three reviewers independently assessed whether the assessed item was present or if the assessed item was absent. Policy activity and policy adoption in rural, suburban, and urban local health departments. Data pertaining to each study were initially collated and described in a narrative summary (see Table1). Experiential learning strategies were associated with the largest effects across the reduced food consumption or energy intake; increased fruit and vegetable consumption or preference; and increased nutritional knowledge outcomes. Dietary Interventions to Promote Healthy Eating among Office Workers: A Search for Similar Articles School of Education, Faculty of Human Sciences, Macquarie University, Sydney, NSW Australia, Faculty of Education and Social Work, University of Sydney, Sydney, NSW Australia. Targeted internet searching using Google Scholar was also used. Public Health Accreditation Board. The mean effect size for curriculum-based approaches was Md=0.45 indicating that having a nutrition curriculum delivered in primary schools makes an important investment in improving FV consumption or preference based on the educational hinge-point of effect sizes described by Hattie [11]. Outcomes of a field trial to improve childrens dietary patterns and physical activity: the child and adolescent trial for cardiovascular health CATCH collaborative group. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. The final weight was the inverse of the realized sampling probability, the production of the sampling probability, response probability, and completion probability of each stratum. Strategies to Prevent Obesity and Other Chronic Diseases: The CDC Guide to Strategies to Increase the Consumption of Fruits and Vegetables. Increasing childrens fruit and vegetable consumption: a peer-modelling and rewards-based intervention. 31. School gardens: an experiential learning approach for a nutrition education program to increase fruit and vegetable knowledge, preference, and consumption among second-grade students. an intervention), d is a measure of the magnitude of effect of the experience on the group receiving the enhanced teaching and learning experience. For more information, please refer to our Privacy Policy. Merlo CL, Michael S, Brener ND, Blanck H. State-level guidance and district-level policies and practices for food marketing in US school districts. Four Strategies for Promoting Healthy Lifestyles in Your Practice This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, Community programs linked to curricula or delivered by schools (e.g. Background. 6. To our knowledge, it is the first to describe the extent to which CHIPs contain healthy eating policy strategies and fills an important research gap.
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