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Vaillancourt C, Ahmed M, Kirk S, Labonté MÈ, Laar A, Mah CL, Minaker L, Olstad DL, Potvin Kent M, Provencher V, Prowse R, Raine KD, Schram A, Zavala-Mora D, Rancourt-Bouchard M, Vanderlee L. Food environment research in Canada: a rapid review of methodologies and measures deployed between 2010 and 2021. Int J Behav Nutr Phys Act 2024; 21:18. [PMID: 38373957 PMCID: PMC10875887 DOI: 10.1186/s12966-024-01558-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 01/03/2024] [Indexed: 02/21/2024] Open
Abstract
Numerous research methodologies have been used to examine food environments. Existing reviews synthesizing food environment measures have examined a limited number of domains or settings and none have specifically targeted Canada. This rapid review aimed to 1) map research methodologies and measures that have been used to assess food environments; 2) examine what food environment dimensions and equity related-factors have been assessed; and 3) identify research gaps and priorities to guide future research. A systematic search of primary articles evaluating the Canadian food environment in a real-world setting was conducted. Publications in English or French published in peer-reviewed journals between January 1 2010 and June 17 2021 and indexed in Web of Science, CAB Abstracts and Ovid MEDLINE were considered. The search strategy adapted an internationally-adopted food environment monitoring framework covering 7 domains (Food Marketing; Labelling; Prices; Provision; Composition; Retail; and Trade and Investment). The final sample included 220 articles. Overall, Trade and Investment (1%, n = 2), Labelling (7%, n = 15) and, to a lesser extent, Prices (14%, n = 30) were the least studied domains in Canada. Among Provision articles, healthcare (2%, n = 1) settings were underrepresented compared to school (67%, n = 28) and recreation and sport (24%, n = 10) settings, as was the food service industry (14%, n = 6) compared to grocery stores (86%, n = 36) in the Composition domain. The study identified a vast selection of measures employed in Canada overall and within single domains. Equity-related factors were only examined in half of articles (n = 108), mostly related to Retail (n = 81). A number of gaps remain that prevent a holistic and systems-level analysis of food environments in Canada. As Canada continues to implement policies to improve the quality of food environments in order to improve dietary patterns, targeted research to address identified gaps and harmonize methods across studies will help evaluate policy impact over time.
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Affiliation(s)
- Caroline Vaillancourt
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Mavra Ahmed
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Sara Kirk
- School of Health and Human Performance, Dalhousie University, 6230 South Street, Kjipuktuk (Halifax), NS, B3H 4R2, Canada
| | - Marie-Ève Labonté
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Amos Laar
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, P. O. Box LG 13, Legon, Accra, Ghana
| | - Catherine L Mah
- School of Health Administration, Dalhousie University, 5850 College Street, Halifax, NS, B3H 4R2, Canada
| | - Leia Minaker
- School of Planning, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3T1, Canada
| | - Dana Lee Olstad
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Monique Potvin Kent
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| | - Véronique Provencher
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Rachel Prowse
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
| | - Kim D Raine
- School of Public Health, University of Alberta, 11405 87 Ave Northwest, Edmonton, AB, T6G 1C9, Canada
| | - Ashley Schram
- School of Regulation and Global Governance (RegNet), ANU College of Asia & the Pacific, The Australian National University, 8 Fellows Road, Canberra, Australian Capital Territory, 2600, Australia
| | - Daniela Zavala-Mora
- Science Library, Université Laval, 1045 Avenue de La Médecine, Québec, QC, G1V 0A6, Canada
| | - Maryka Rancourt-Bouchard
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada
| | - Lana Vanderlee
- École de Nutrition, Centre de Nutrition, Santé et Société (NUTRISS), Université Laval, 2425 Rue de L'Agriculture, Québec, QC, G1V 0A6, Canada.
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Ferdinands AR, Brown JA, Nielsen CC, Nykiforuk CIJ, Raine KD. What counts? Adding nuance to retail food environment measurement tools in a Canadian context. Public Health Nutr 2023; 26:1326-1337. [PMID: 37073692 PMCID: PMC10346037 DOI: 10.1017/s1368980023000733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 02/20/2023] [Accepted: 03/24/2023] [Indexed: 04/20/2023]
Abstract
OBJECTIVE Limitations of traditional geospatial measures, like the modified Retail Food Environment Index (mRFEI), are well documented. In response, we aimed to: (1) extend existing food environment measures by inductively developing subcategories to increase the granularity of healthy v. less healthy food retailers; (2) establish replicable coding processes and procedures; and (3) demonstrate how a food retailer codebook and database can be used in healthy public policy advocacy. DESIGN We expanded the mRFEI measure such that 'healthy' food retailers included grocery stores, supermarkets, hypermarkets, wholesalers, bulk food stores, produce outlets, butchers, delis, fish and seafood shops, juice/smoothie bars, and fresh and healthy quick-service retailers; and 'less healthy' food retailers included fast-food restaurants, convenience stores, coffee shops, dollar stores, pharmacies, bubble tea restaurants, candy stores, frozen dessert restaurants, bakeries, and food trucks. Based on 2021 government food premise licences, we used geographic information systems software to evaluate spatial accessibility of healthy and less healthy food retailers across census tracts and in proximity to schools, calculating differences between the traditional v. expanded mRFEI. SETTING Calgary and Edmonton, Canada. PARTICIPANTS N/A. RESULTS Of the 10 828 food retailers geocoded, 26 % were included using traditional mRFEI measures, while 53 % were included using our expanded categorisation. Changes in mean mRFEI across census tracts were minimal, but the healthfulness of food environments surrounding schools significantly decreased. CONCLUSIONS Overall, we show how our mRFEI adaptation, and transparent reporting on its use, can promote more nuanced and comprehensive food environment assessments to better support local research, policy and practice innovations.
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Affiliation(s)
- Alexa Rae Ferdinands
- School of Public Health; 3-300 Edmonton Clinic Health Academy, 11405 – 87 Ave, University of Alberta, EdmontonT6G 1C9, AB, Canada
| | - Jennifer Ann Brown
- School of Public Health; 3-300 Edmonton Clinic Health Academy, 11405 – 87 Ave, University of Alberta, EdmontonT6G 1C9, AB, Canada
| | - Charlene C Nielsen
- School of Public Health; 3-300 Edmonton Clinic Health Academy, 11405 – 87 Ave, University of Alberta, EdmontonT6G 1C9, AB, Canada
| | - Candace IJ Nykiforuk
- School of Public Health; 3-300 Edmonton Clinic Health Academy, 11405 – 87 Ave, University of Alberta, EdmontonT6G 1C9, AB, Canada
| | - Kim D Raine
- School of Public Health; 3-300 Edmonton Clinic Health Academy, 11405 – 87 Ave, University of Alberta, EdmontonT6G 1C9, AB, Canada
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Aylward BL, Milford KM, Storey KE, Nykiforuk CIJ, Raine KD. Citizen science in monitoring food environments: a qualitative collective case study of stakeholders' experiences during the Local Environment Action on Food project in Alberta, Canada. BMC Public Health 2022; 22:665. [PMID: 35387614 PMCID: PMC8985336 DOI: 10.1186/s12889-022-13030-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 03/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Citizen science bears potential to build a comprehensive view of global food environments and create a broader discussion about how to improve them. Despite its potential, citizen science has not been fully utilised in food environment research. Thus, we sought to explore stakeholders' experiences of the Local Environment Action on Food (LEAF) project, a community-based intervention that employs a citizen science approach to monitoring food environments. METHODS We used a qualitative collective case study design to explore citizen science through the LEAF process in seven communities in Alberta, Canada. Data generating strategies included semi-structured interviews with citizen scientists (n = 26), document review of communities' Mini Nutrition Report Cards (n = 7), and researcher observation. Data were analyzed in a multi-phase process, using Charmaz's constant comparison analysis strategy. RESULTS Analysis revealed two main themes: relationship building and process factors. Communities used three interconnected strategies, engaging the right people, treading lightly, and reaching a consensus, to navigate the vital but challenging relationship building process. Process factors, which were influences on the LEAF process and relationship building, included the local context, flexibility in the LEAF process, and turnover among LEAF community groups. CONCLUSION Citizen science through the LEAF project supported the creation and application of food environment evidence: it enabled residents to collect and interpret local food environment data, develop realistic recommendations for change, and provided them with an evidence-based advocacy tool to support the implementation of these recommendations. We recommend a web application that enables independent community food environment assessments. Such a tool could stimulate and sustain citizen involvement in food environment efforts, helping to build the necessary evidence base and promote the creation of healthy food environments.
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Affiliation(s)
- Breanne L Aylward
- School of Public Health, University of Alberta, 4-308 Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Krista M Milford
- School of Public Health, University of Alberta, 4-308 Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Kate E Storey
- School of Public Health, University of Alberta, 8303-112 Street, Edmonton, AB, T6G 2T4, Canada
| | - Candace I J Nykiforuk
- School of Public Health, University of Alberta, 4-308 Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Kim D Raine
- School of Public Health, University of Alberta, 4-308 Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada.
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Aylward BL, Milford KM, Storey KE, Nykiforuk CIJ, Raine KD. Local Environment Action on Food project: impact of a community-based food environment intervention in Canada. Health Promot Int 2021; 37:6346793. [PMID: 34373905 PMCID: PMC9053459 DOI: 10.1093/heapro/daab127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Children are exposed to food environments that make nutrient-poor, energy-dense food cheap, readily available and heavily marketed; all conditions with potential negative impacts on diet and health. While the need for programmes and policies that improve the status of food environments is clear, greater public support is needed for governments to act. The purpose of this qualitative collective case study was to examine if community engagement in the Local Environment Action on Food (LEAF) project, a community-based food environment intervention in Alberta, Canada, could build public support and create action to promote healthy food environments. Semi-structured interviews with a purposeful sample of 26 stakeholders from 7 communities explored LEAF’s impact and stakeholder experiences creating change. Data collection and analysis were iterative, following Charmaz’s constant comparative analysis strategy. Participants reported environmental and community impacts from LEAF. Notably, LEAF created a context-specific tool, a Mini Nutrition Report Card, that communities used to promote and support food environment action. Further, analysis outlined perceived barriers and facilitators to creating community-level food environment action, including level of engagement in LEAF, perceived controllability, community priorities, policy enforcement and resources. Findings from this study suggest that community-based interventions, such as LEAF, can help build community capacity and reduce existing barriers to community-level food environment action. Thus, they can provide an effective method to build public awareness, demand and action for healthier food environments.
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Affiliation(s)
- Breanne L Aylward
- School of Public Health, University of Alberta, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada
| | - Krista M Milford
- School of Public Health, University of Alberta, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada
| | - Kate E Storey
- School of Public Health, University of Alberta, 8303-112 Street, Edmonton, Alberta T6G 2T4, Canada
| | - Candace I J Nykiforuk
- School of Public Health, University of Alberta, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada
| | - Kim D Raine
- School of Public Health, University of Alberta, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada
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Brown JA, Ferdinands AR, Prowse R, Reynard D, Raine KD, Nykiforuk CI. Seeing the food swamp for the weeds: Moving beyond food retail mix in evaluating young people's food environments. SSM Popul Health 2021; 14:100803. [PMID: 34041350 PMCID: PMC8142271 DOI: 10.1016/j.ssmph.2021.100803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 04/16/2021] [Accepted: 04/18/2021] [Indexed: 12/12/2022] Open
Abstract
Nutritional health of children and youth is an increasing cause for concern in Canada. Through food and beverage messaging in multiple environments, young people develop eating behaviours with ramifications throughout their life course. Unhealthy food retailers near schools, recreation facilities, and childcare centres-key activity settings for healthy eating promotion-present repeated, compounding exposures to commercial geomarketing. Geomarketing impacts nutritional health by promoting highly processed, calorie-dense, and nutrient-poor foods and beverages across urban landscapes. While food retail mix (as a ratio of healthy to unhealthy food retailers) can be used to assess food environments at multiple scales, such measures may misrepresent young people's unique experience of these geographic phenomena. Moving beyond uniform conceptualization of food environments, new research methods and tools are needed for children and youth. We investigated young people's food environments in the major Canadian cities of Calgary and Edmonton. Using government-initiated nutrition guidelines, we categorized 55.8% of all food retailers in Calgary, and 59.9% in Edmonton as 'unhealthy'. A Bernoulli trial at the 0.05 alpha level indicated few differences in prevalence proximal to activity settings versus elsewhere in both cities, demonstrating the limited applicability of food retail mix for characterizing young people's food environments. To model unhealthy food retailers geomarketing to children and youth, we considered their proximity to multiple activity settings, using overlapping radial buffers at the 250 m, 500 m, 1000 m, and 1500 m scales. Examining young people's food environments relative to the spaces where they learn and play, we determined that as many as 895 out of 2663 unhealthy food retailers fell within 1500 m of 21+ activity settings. By conceptualizing, measuring, and problematizing these "super-proximal" unhealthy food retailers, urban planners and public health researchers can use these techniques to pinpoint unhealthy food retailers, or "weeds in the food swamp," as a critical site for healthy eating promotion in municipalities.
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Affiliation(s)
- Jennifer Ann Brown
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | | | - Rachel Prowse
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Darcy Reynard
- Department of Earth and Atmospheric Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Kim D. Raine
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Enabling Food Environment in Kindergartens and Schools in Iran for Promoting Healthy Diet: Is It on the Right Track? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084114. [PMID: 33924728 PMCID: PMC8070383 DOI: 10.3390/ijerph18084114] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 01/06/2023]
Abstract
Enabling policies related to kindergarten and school food environments can be effective approaches in preventing childhood obesity. This study investigated policies and/or programs with direct or indirect effects on the food environment in kindergartens and schools in Iran. In this scoping review, we systematically searched PubMed, Scopus, and Web of science, as well as Iranian scientific search engines, including Scientific Information Database and Magiran from January 1990 to October 2020, to identify literature on policies/programs affecting the food environment in kindergartens and schools in Iran. A total of 30 studies and policy documents were included in this review relevant to eight policies/programs. These programs have helped to control food availability in schools, increase nutritional awareness, positively influence physical function and school performances, and reduce malnutrition in rural kindergartens. However, improving the food environment in schools and kindergartens requires proper revisions and local adaptation of many of these policies, strengthening of cross-sectoral collaborations, provision of necessary financial and human resources, and ensuring regular monitoring and evaluation. Reflecting on Iran's health policies and interventions provides insight into the progress achieved and challenges faced. Lessons can benefit the country itself, as well as other countries with similar contexts.
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Toure D, Herforth A, Pelto GH, Neufeld LM, Mbuya MNN. An Emergent Framework of the Market Food Environment in Low- and Middle-Income Countries. Curr Dev Nutr 2021; 5:nzab023. [PMID: 33948531 PMCID: PMC8075774 DOI: 10.1093/cdn/nzab023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/28/2021] [Accepted: 03/09/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Food systems are increasingly recognized as critical for advancing nutrition, and the food environment is viewed as the nexus between those systems and dietary consumption. Developing a measurement framework of the market food environment is a research priority, particularly for low- and middle-income countries (LMICs), which face rapid shifts in markets, dietary patterns, and nutrition outcomes. OBJECTIVES In this study, we sought to assess current conceptions and measures of the market food environment that could be adapted for use in LMICs. METHODS We conducted a narrative review of the literature to identify measures of the market food environment in recent use. First, we identified and reviewed frameworks of the food environment for LMICs with a specific focus on the market food environment. Second, we compiled 141 unique measures of the market food environment from 20 articles into a list that was pile-sorted by 5 nutrition experts into domains. We then categorized the measures based on percentage agreement across all sorts. Finally, we compared measured and conceptual domains of the market food environment to identify measurement gaps and needed adaptations. RESULTS Conceptual frameworks provide differing definitions of the market food environment but conform in their definitions of food availability, price, marketing, and product characteristics. Greater clarity is needed in defining relevant vendor and product characteristics. Eight measured domains of the market food environment emerged from the literature review, with significant overlap among conceptual domains. Measurement gaps exist for food quality, safety, packaging, desirability, and convenience. Personal characteristics also emerged as measured domains, although these are not part of the food environment per se. CONCLUSIONS These results are a step toward elucidating how, why, and where we measure the market food environment in LMICs. Future research should focus on prioritizing the most meaningful methods and metrics and on developing new measures where gaps exist.
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Affiliation(s)
- Djeinam Toure
- Global Alliance for Improved Nutrition, Washington, DC, USA
- Helen Keller International, Dakar, Senegal
| | - Anna Herforth
- Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Gretel H Pelto
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
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Strengthening public health nutrition: findings from a situational assessment to inform system-wide capacity building in Ontario, Canada. Public Health Nutr 2020; 23:3045-3055. [PMID: 32618239 PMCID: PMC7557118 DOI: 10.1017/s1368980020001433] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: To assess public health nutrition practice within the public health system in Ontario, Canada to identify provincial-wide needs for scientific and technical support. Design: A qualitative descriptive study was conducted to identify activities, strengths, challenges and opportunities in public health nutrition practice using semi-structured key informant interviews (n 21) and focus groups (n 10). Recorded notes were analysed concurrently with data generation using content analysis. System needs were prioritised through a survey. Setting: Public health units. Participants: Eighty-nine practitioners, managers, directors, medical officers of health, researchers and other stakeholders were purposively recruited through snowball and extreme case sampling. Results: Five themes were generated: (i) current public health nutrition practice was broad, complex, in transition and collaborative; (ii) data/evidence/research relevant to public health needs were insufficiently available and accessible; (iii) the amount and specificity of guidance/leadership was perceived to be mismatched with strong evidence that diet is a risk factor for poor health; (iv) resources/capacity were varied but insufficient and (v) understanding of nutrition expertise in public health among colleagues, leadership and other organisations can be improved. Top ranked needs were increased understanding, visibility and prioritisation of healthy eating and food environments; improved access to data and evidence; improved collaboration and coordination; and increased alignment of activities and goals. Conclusions: Collective capacity in the public health nutrition can be improved through strategic system-wide capacity-building interventions. Research is needed to explore how improvements in data, evidence and local contexts can bridge research and practice to effectively and efficiently improve population diets and health.
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A Nutrition Report Card on food environments for children and youth: 5 years of experience from Canada. Public Health Nutr 2020; 23:2088-2099. [PMID: 32434601 PMCID: PMC7358701 DOI: 10.1017/s1368980020000130] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE In 2014, a Nutrition Report Card (NRC) was developed as a sustainable, low-cost framework to assess the healthfulness of children's food environments and highlight action to support healthy eating. We summarise our experiences in producing, disseminating, evaluating and refining an annual NRC in a Canadian province from 2015 to 2019. DESIGN To produce the NRC, children's food environment indicator data are collected, analyzed and compiled for consensus grading by an Expert Working Group of researchers and practitioners. Knowledge translation activities are tailored annually to the needs of target audiences: researchers, practitioners, policymakers and the public. Evaluation of reach is conducted through diverse strategies, including tracking media coverage and website traffic. Assessment of impact on diets and health outcomes is planned. SETTING Alberta, Canada. PARTICIPANTS Not applicable. DISCUSSION The grading process has facilitated refining the NRC to enhance its relevance and utility as a tool for its target audiences. Its public release consistently captures media interest and policymakers' attention. The importance of partnerships in revealing data sources and in strategising to enhance policy approaches to improve food environments is apparent. The NRC has benchmarked progress and stimulated dialogue regarding healthy food environments for children. CONCLUSIONS The NRC may help to foster a supportive climate for improving the quality of children's food environments. As an engaging and accessible document, the NRC represents a key mechanism for collating data related to children's food environments and ensuring it reaches the audiences best positioned to use it. Efforts are underway to expand the NRC across Canada.
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Vanderlee L, L'Abbé M. Commentary - Food for thought on food environments in Canada. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2018; 37:263-265. [PMID: 28902475 DOI: 10.24095/hpcdp.37.9.01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Lana Vanderlee
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Mary L'Abbé
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
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Boucher BA, Manafò E, Boddy MR, Roblin L, Truscott R. The Ontario Food and Nutrition Strategy: identifying indicators of food access and food literacy for early monitoring of the food environment. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2018; 37:313-319. [PMID: 28902480 DOI: 10.24095/hpcdp.37.9.06] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION To address challenges Canadians face within their food environments, a comprehensive, multistakeholder, intergovernmental approach to policy development is essential. Food environment indicators are needed to assess population status and change. The Ontario Food and Nutrition Strategy (OFNS) integrates the food, agriculture and nutrition sectors, and aims to improve the health of Ontarians through actions that promote healthy food systems and environments. This report describes the process of identifying indicators for 11 OFNS action areas in two strategic directions (SDs): Healthy Food Access, and Food Literacy and Skills. METHODS The OFNS Indicators Advisory Group used a five-step process to select indicators: (1) potential indicators from national and provincial data sources were identified; (2) indicators were organized by SD, action area and data type; (3) selection criteria were identified, pilot tested and finalized; (4) final criteria were applied to refine the indicator list; and (5) indicators were prioritized after reapplication of selection criteria. RESULTS Sixty-nine potential indicators were initially identified; however, many were individual-level rather than system-level measures. After final application of the selection criteria, one individual-level indicator and six system-level indicators were prioritized in five action areas; for six of the action areas, no indicators were available. CONCLUSION Data limitations suggest that available data may not measure important aspects of the food environment, highlighting the need for action and resources to improve system-level indicators and support monitoring of the food environment and health in Ontario and across Canada.
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Affiliation(s)
- Beatrice A Boucher
- Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada.,Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Meaghan R Boddy
- Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Lynn Roblin
- Ontario Public Health Association, Toronto, Ontario, Canada
| | - Rebecca Truscott
- Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada
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Doonan R, Field P. How Nutrition Sensitive Are the Nutrition Policies of New Zealand Food Manufacturers? A Benchmarking Study. Nutrients 2017; 9:E1373. [PMID: 29257049 PMCID: PMC5748823 DOI: 10.3390/nu9121373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 12/13/2017] [Accepted: 12/13/2017] [Indexed: 11/16/2022] Open
Abstract
Nutrition sensitive policy addresses the underlying determinants of nutrition-related disease and is a powerful tool in reducing the incidence of non-communicable disease. Some members of the food industry have long standing commitments to health-oriented nutrition policies. The aim of this study was to develop and apply a balanced scorecard of nutrition sensitive indicators to the policies of influential New Zealand food and beverage manufacturers and explore factors affecting policy processes. RESULTS The average nutrition sensitivity score of the twenty influential manufacturers policies was 42 against a benchmark of 75. Some manufacturers performed well whilst others had substantial scope for improvement, the largest variation was in policy development and implementation, whereas nutrition quality was relatively consistent. Manufacturers with written policy (n = 11) scored on average three times higher than their counterparts with verbal policy. The value a manufacturer placed on nutrition influenced whether formal nutrition policies were developed. The reputational risk of failing to deliver on publicly declared nutrition commitments acted as an informal accountability mechanism. We conclude the balanced scorecard offers a useful tool for assessing the nutrition sensitivity of influential food and beverage manufacturers' policies. Our results provide a baseline for repeat assessments of the nutrition sensitivity of food manufacturers' policies.
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Affiliation(s)
- Rebecca Doonan
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| | - Penny Field
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
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Moreno-Black G, Boles S, Johnson-Shelton D, Evers C. Exploring Categorical Body Mass Index Trajectories in Elementary School Children. THE JOURNAL OF SCHOOL HEALTH 2016; 86:495-506. [PMID: 27246674 PMCID: PMC5055398 DOI: 10.1111/josh.12402] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 11/07/2015] [Accepted: 11/10/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Studies of body mass index (BMI) change have focused on understanding growth trajectories from childhood to adolescence and adolescence to adulthood, but few have explored BMI trajectories solely in elementary (grades K-5) school children. This report complements these studies by exploring changes in obesity status using analytic methods developed to investigate categorical changes in life-course events. METHODS Sequences of a 4-state BMI variable (underweight, normal, overweight, and obese) were calculated using height and weight data collected annually (2008-2013) from 414 kindergarten and first-grade students participating in the Community and Schools Together (CAST) project. These sequences were explored using the TraMineR software package to investigate the distribution of sequences and states, calculate transition rates among states, and examine clustering of sequences. RESULTS Aggregated cluster solutions were identified consisting of either 4 clusters (normal, stepped, mixed, and obese) or 3 clusters (aggregation of obese cluster cases into stepped cluster) with membership in the former predicted by ethnicity and socioeconomic status (SES) and the latter by SES alone. Transition rate patterns among states varied markedly by cluster and state. CONCLUSION The finding of early emergence of stable obesity states, especially in Hispanic children confirms the need for early childhood interventions to influence BMI.
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Affiliation(s)
| | - Shawn Boles
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403.
| | | | - Cody Evers
- Portland State University, PO Box 751, Portland, OR 97207.
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Phulkerd S, Lawrence M, Vandevijvere S, Sacks G, Worsley A, Tangcharoensathien V. A review of methods and tools to assess the implementation of government policies to create healthy food environments for preventing obesity and diet-related non-communicable diseases. Implement Sci 2016; 11:15. [PMID: 26846789 PMCID: PMC4743239 DOI: 10.1186/s13012-016-0379-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 01/31/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Policies to create healthy food environments are recognized as critical components of efforts to prevent obesity and diet-related non-communicable diseases. There has not been a systematic review of existing methods and tools used to assess the implementation of these government policies. The purpose of this study was to review methods and tools used for assessing the implementation of government policies to create healthy food environments. The study conducted a systematic literature search. Multiple databases as well as the grey literature were searched. All study designs and review papers on assessing the implementation of government policies to create healthy food environments were included. A quality assessment of the methods and tools identified from relevant studies was carried out using the following four criteria: comprehensiveness, relevance, generalizability and feasibility. This quality assessment was completed by two independent reviewers. RESULTS The review identified 52 studies across different policy areas, levels and settings. Self-administered questionnaires and policy checklists were most commonly applied to assess the extent of policy implementation, whereas semi-structured interviews were most commonly used to evaluate the implementation process. Measures varied widely, with the existence of policy implementation the aspect most commonly assessed. The most frequently identified barriers and facilitators for policy implementation were infrastructure support, resources and stakeholder engagement. The assessment of policy implementation on food environments was usually undertaken in combination with other policy areas, particularly nutrition education and physical activity. Three tools/methods were rated 'high' quality and 13 tools/methods received 'medium' quality ratings. CONCLUSIONS Harmonization of the available high-quality methods and tools is needed to ensure that assessment of government policy implementation can be compared across different countries and settings and over time. This will contribute to efforts to increase government accountability for their actions to improve the healthiness of food environments.
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Affiliation(s)
- Sirinya Phulkerd
- School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Victoria, Australia.
| | - Mark Lawrence
- Centre for Physical Activity and Nutrition Research, Faculty of Health, Deakin University, Victoria, Australia.
| | - Stefanie Vandevijvere
- Department of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Gary Sacks
- WHO Collaborating Centre for Obesity Prevention, Deakin University, Victoria, Australia.
| | - Anthony Worsley
- Centre for Physical Activity and Nutrition Research, Faculty of Health, Deakin University, Victoria, Australia.
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