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