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Policy entrepreneurs

NSW Childhood Obesity Summit:

  • NSW Government were hoping for funding
  • Pushback from industry
  • Public support from community and parents
  • Considerable media coverage

National Guidelines:

  • National Obesity Task Force
  • Australian Health Ministers Council
  • Considerable consultation

SA N, E D, N G, AB Z. An Australian childhood obesity summit: the role of data and evidence in 'public' policy making. Australia and New Zealand Health Policy. 2005;2(1):17.

Policy in comparison

Alternative policies

  • Mandatory policies
  • Pricing policies
  • Menu labelling and promotion strategies
  • Integrate practical skills in growing and cooking foods
  • Fruit and vegetable breaks in schools
  • External school environment

BEHAVIOUR CHANGE

FOOD ENVIRONMENT

  • Limited uptake of NHSCG
  • WA has 62% Compliance
  • Others range between 5-35%
  • Mandatory policies have higher compliance
  • Recommend mandatory monitoring and provision of resources for guideline implementation

FOOD SUPPLY

Vine MM, Elliot SJ, Raine KD. Exploring implementation of Ontario’s School food and beverage policy. Can J Diet Pract Res. 2014 Sep;75(3) 118-24.

Jaime PC, Lock K. Do school based food and nutrition policies improve diet and reduce obesity? American Journal of Preventive Medicine. 2009;48:45-53.

Yoong et al. Assessment of the School Nutrition Environment: A Study in Australian Primary School Canteens. American Journal of Preventive Medicine. 2015;49:215-222.

Wyse et al. The price of healthy and unhealthy foods in Australian primary school canteens. Australian and New Zealand Journal of Public Health. 2017;41:45-47.

Healthy Eating Advisory Service. Alfred Health Sugary Drinks Trials [cited 2017 Mar 30]. Available from: http://heas.health.vic.gov.au/healthy-choices/case-studies/alfred-health-sugary-drink-trials

Kelly B, Hughes C, Chapman K, Louie K, Dixon H, King L. Front-of-Pack Food Labelling: Traffic Light Labelling Gets the Green Light. Cancer Council: Sydney 2008. Available at: https://www.cancercouncil.com.au/wp-content/uploads/2010/11/foodlabelling_frontofpack_surveyreport.pdf

Eckermann S, Dawber J, Yeatman H, Quinsey K, Morris D. Evaluating return on investment in a school based health promotion and prevention program: The investment multiplier for the Stephanie Alexander Kitchen Garden National Program. Social Science & Medicine. 2014;114:103-12.

Morgan PJ, Warren JM, Lubans DR, Saunders KL, Quick GI, Collins CE. The impact of nutrition education with and without a school garden on knowledge, vegetable intake and preferences and quality of school life among primary-school students. Public Health Nutrition. 2010;13(11):1931-40.

Nathan N, Wolfenden L, Butler M, Bell AC, Wyse R, Campbell E, et al. Vegetable and fruit breaks in Australian primary schools: prevalence, attitudes, barriers and implementation strategies. Health Education Research. 2011;26(4):722-31.

Wolfenden, L. et al. (2014). Enhancing nutritional environments through access to fruit and vegetables in schools and homes among children and youth: A systematic review. BMC Research Notes, 7, 422.

Bae SG, Kim JY, Kim KY, Park SW, Bae J, Lee WK. Changes in Dietary Behavior Among Adolescents and Their Association With Government Nutrition Policies in Korea, 2005-2009. Journal of Preventive Medicine and Public Health. 2012;45(1):47-59.

Lawlis T, Know M, Jamieson M. School Canteens: A systematic review of the policy, perceptions, and use from an Australian perspective. Nutrition & Dietetics. 2016 Sep;73(4):389-398

Woods J, Bressan A, Langelaan C, Mallon A, Palermo C. Australian School Canteen Guidelines: menu guidance adherence or avoidance?. Health Promot J Austr. 2014 Aug;25(2):110-5.

World Cancer Research Fund (WCRF) International. Nourishing framework. WCRF [cited 2017 Mar 30]. Available from: http://www.wcrf.org/int/policy/nourishing-framework.

POLICY

Schools as important setting

Problem: Childhood Obesity

  • Children consume 1/3 of total energy intake during school hours
  • School canteens provide significant amount of food to many students

NATIONAL HEALTHY SCHOOL CANTEEN GUIDELINES

PROBLEM

POLICY ENTREPRENEUR

  • 25% of children aged 5-17 are overweight or obese
  • ‘Wicked’ problem making it extremely difficult to resolve
  • Economic, environmental, health and political issue

Australian Bureau of Statistics. Australian Health Survey: Updated Results, 2011–2012, Cat. No. 4364.0.55.003. Canberra. 2013. (Available from: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4364.0.55.003 Chapter12011-2012, accessed 25 November 2015).

Waters E, de Silva-Sanigorski A, Hall BJ, Brown T, Campbell KJ, Gao Y, Armstrong R, Prosser L, Summerbell CD. Interventions for preventing obesity in children. Cochrane Database of Systematic Reviews 2011, Issue 12.

Waters E, de Silva-Sanigorski A, Hall BJ, Brown T, Campbell KJ, Gao Y, Armstrong R, Prosser L, Summerbell CD. Interventions for preventing obesity in children. Cochrane Database of Systematic Reviews 2011, Issue 12.

Jaime PC, Lock K. Do school based food and nutrition policies improve diet and reduce obesity? American Journal of Preventive Medicine. 2009;48:45-53

Commonwealth of Australia. National Healthy School Canteens Guidelines for healthy foods and drinks supplied in school canteens. In: Department of Health, editor. Canberra 2014.

Politics: A Timeline

2006 - The Australian Better Health Initiative

2008 - Healthy Weight 2008

2008 - National Healthy Schools Canteen project began

2010 - Guidelines finalised

2014 - NHSC Guidelines updated

POLITICS

1997 - NHMRC: Acting on Australia's weight: a strategic plan for the prevention of overweight and obesity'

1998 - World Health Organisation: Health Promoting School Strategy

2002 - NSW Childhood Obesity Summit

2004 - Australian Health Ministers Conference

Kingdon JW. Agendas, Alternatives and Public Policies. The University of Michigan: Little, Brown; 1984. 240p.

Conclusion

• Canteens are a crucial component of school food environment

• NHSCG was the policy solution to the issue of childhood obesity

• Stakeholders recognise canteens as fundamental to development of healthy dietary habits

• NHSCG requires proper implementation including training, monitoring, feedback, and support for schools to achieve compliance

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