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Carmignani F. Why nanny statism matters: evidence from the first wave of COVID-19. BMC Public Health 2024; 24:1963. [PMID: 39044203 PMCID: PMC11265364 DOI: 10.1186/s12889-024-19477-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 07/14/2024] [Indexed: 07/25/2024] Open
Abstract
BACKGROUND A nanny state imposes restrictions on people's liberty and freedom of action in order to advance their interest and welfare. The extent to which this is desirable, or even ethically acceptable, is debated in the literature. This paper formulates and tests the following hypothesis: the more of a nanny a state has been in the past, the more likely it is that the incumbent government will respond to a new, unknown threat with interventions of a paternalist nature, irrespective of other factors that might contribute to shaping government's response. This hypothesis is then taken to the data using the first wave of COVID-19 as an empirical test. METHODS Data are collected from secondary sources for a sample of 99 countries. Nanny statism is measured by the number of paternalist laws and regulations adopted by a country in the past. The response to COVID is proxied by the time of adoption of control and containment measures and their stringency. The public health outcome is measured by the COVID-19 death toll at the end of June 2020. These variables, plus several controls, are then used to estimate a set of linear and probit regressions and a proportional hazard model of the timing of adoption of control and containment measures. RESULTS An increase in nanny statism by 0.1 (on a scale from 0 to 10) on average increases the probability of adoption of control and containment measures by 0.077 (i.e. 7.7 percentage points). The central tenement of the hypothesis is therefore consistent with the empirical evidence. The linear and probit regressions also show that there is no evidence of a significant effect of nanny statism on the stringency of the measures adopted. Irrespective of stringency, however, early adoption of control and containment measures is found to reduce the death toll of COVID-19 in the first half of 2020: an increase in nanny statism by 0.1 reduces the COVID death toll by approximately 7%. CONCLUSIONS A tradition of nanny statism potentially leads to a more timely and effective public policy response to a new, unknown crisis. Further tests of the hypothesis should look at the relationship between nanny statism and public health outcomes from natural disasters.
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Affiliation(s)
- Fabrizio Carmignani
- School of Business, University of Southern Queensland, Toowoomba, Australia.
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2
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Thompson HG, Whitaker KM, Young R, Carr LJ. University stakeholders largely unaware and unsupportive of university pouring rights contracts with companies supplying sugar-sweetened beverages. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:403-410. [PMID: 33760721 DOI: 10.1080/07448481.2021.1891920] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 12/23/2020] [Accepted: 02/14/2021] [Indexed: 06/12/2023]
Abstract
Background: Pouring rights contracts are agreements in which beverage companies pay universities for exclusive marketing and rights to sell sugar-sweetened beverages (SSB) in campus. This study explored university stakeholder's awareness and opinions of university pouring rights contracts. Methods: Nine hundred fifteen university stakeholders self-reported their awareness and support of pouring rights contracts along with several possible determinants of support (age, gender, nutrition education, beliefs about SSBs, beverage intake). Results: About 64.2% of participants reported no awareness of pouring rights contracts whereas only 38% reported agreeing with university pouring rights contracts. Males, undergraduate students, and those who felt individuals are responsible for their SSB consumption were more likely to support pouring rights contracts. Conclusions: University stakeholders were largely unaware of and unsupportive of pouring rights contracts. Universities are encouraged to consider the health impacts and opinions of university stakeholders when deciding whether to enter into pouring rights contracts.
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Affiliation(s)
- H G Thompson
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa
| | - K M Whitaker
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa
| | - R Young
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa
| | - L J Carr
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa
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3
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Howse E, Cullerton K, Grunseit A, Bohn-Goldbaum E, Bauman A, Freeman B. Measuring public opinion and acceptability of prevention policies: an integrative review and narrative synthesis of methods. Health Res Policy Syst 2022; 20:26. [PMID: 35246170 PMCID: PMC8895540 DOI: 10.1186/s12961-022-00829-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 02/15/2022] [Indexed: 11/21/2022] Open
Abstract
Acceptability of and public support for prevention are an important part of facilitating policy implementation. This review aims to identify, summarize and synthesize the methods and study designs used to measure and understand public opinion, community attitudes and acceptability of strategies to prevent chronic noncommunicable disease (NCDs) in order to allow for examination of imbalances in methodological approaches and gaps in content areas. We searched four scientific databases (CINAHL, Embase, Ovid/MEDLINE and Scopus) for peer-reviewed, English-language studies published between January 2011 and March 2020 in high-income, democratic countries across North America, Europe and the Asia–Pacific region. Studies were included if they focused on opinions, attitudes and acceptability of primary prevention strategies and interventions addressing the key NCD risk factors of alcohol use, unhealthy diet, overweight/obesity, tobacco use and smoking, and physical inactivity. A total of 293 studies were included. Two thirds of studies (n = 194, 66%) used quantitative methods such as cross-sectional studies involving surveys of representative (n = 129, 44%) or convenience (n = 42, 14%) samples. A smaller number of studies used qualitative methods (n = 60, 20%) such as focus groups (n = 21, 7%) and interviews (n = 21, 7%). Thirty-nine studies (13%) used mixed methods such as content analysis of news media (n = 17, 6%). Tobacco control remains the dominant topic of public opinion literature about prevention (n = 124, 42%). Few studies looked solely at physical inactivity (n = 17, 6%). The results of this review suggest that public opinion and acceptability of prevention in the peer-reviewed literature is investigated primarily through cross-sectional surveys. Qualitative and mixed methods may provide more nuanced insights which can be used to facilitate policy implementation of more upstream strategies and policies to prevent NCDs.
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Affiliation(s)
- Eloise Howse
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, Australia. .,Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Katherine Cullerton
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, Australia.,School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Anne Grunseit
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, Australia.,Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Erika Bohn-Goldbaum
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, Australia.,Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Adrian Bauman
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, Australia.,Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Becky Freeman
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Kalair N, Mousli LM, Jacobs LM, Schmidt L, Kearns C. Work site access to fluoridated tap water and retail beverages: An assessment of the University of California, San Francisco campuses. J Am Dent Assoc 2022; 153:201-207. [PMID: 34949441 PMCID: PMC8882123 DOI: 10.1016/j.adaj.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/06/2021] [Accepted: 08/15/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Employees with fluoridated drinking water access at work can reap oral health benefits. The purpose of this study was to assess the availability, appeal, and promotion of fluoridated tap water in publicly accessible spaces compared with retail beverages at the University of California, San Francisco. METHODS The authors collected information on beverages available in publicly accessible spaces at University of California, San Francisco hospitals and campuses in San Francisco, California, from December 2019 through February 2020 using a web-based survey tool. Data collected included fluoridated water and retail beverage locations; type of water or retail beverage source; number of water sources per station; cleanliness, flow, and any obstruction of water sources; proximity of water stations to retail beverage locations; signage near the beverage locations about water and beverage consumption; and type of retail beverages available. RESULTS Fluoridated water stations were identified in 230 locations and had 377 water sources (for example, traditional drinking fountain and motion-sensor bottle-filling station). One water station was available for every 80 students and employees; however, 25% were obstructed, dirty, or had unsatisfactory flow. Approximately 1 in 5 watercoolers lacked disposable cups. Of 41 retail beverage locations identified, 29% had a water station within sight. Only 11% of beverage locations had signage encouraging healthier beverage choices. CONCLUSIONS A systematic assessment of work site access to fluoridated water can provide actionable evidence to improve availability, appeal, and promotion. PRACTICAL IMPLICATIONS This study provides a model to assess work site availability of fluoridated drinking water that can be used for future evaluations.
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Affiliation(s)
- Navita Kalair
- Familia Dental, Abilene, Texas, 3469 Cedar Run Rd #302 Abilene Texas 79606
| | - Leyla M Mousli
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, 490 Illinois Street, Box 0936, San Francisco, CA 94158
| | - Laurie M. Jacobs
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, 490 Illinois Street, Box 0936, San Francisco, CA 94158
| | - Laura Schmidt
- Philip R. Lee Institute for Health Policy Studies and Department of Humanities and Social Sciences, University of California, San Francisco, 3333 California Street, San Francisco, CA 94118, 415-476-0440
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Cranney L, Thomas M, Cobcroft M, Drayton B, Rissel C, Bauman A, Phongsavan P. Community support for policy interventions targeting unhealthy food environments in public institutions. Health Promot J Austr 2021; 33:618-630. [PMID: 34921699 DOI: 10.1002/hpja.567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/08/2021] [Accepted: 12/08/2021] [Indexed: 11/08/2022] Open
Abstract
ISSUE ADDRESSED Understanding community support for obesity prevention policy is important for developing effective preventive health action. This study assessed support for a range of obesity prevention interventions, including food environment policies designed to improve healthy food and drink availability and promotion within public institutions. METHODS An online cross-sectional survey was completed by 2,006 NSW adults. Questions explored attitudes and beliefs about obesity, the importance of government-led prevention and support for eight obesity prevention interventions. Regression analyses examined associations between intervention support and sociodemographic, attitudinal, and behavioral characteristics. RESULTS Most respondents (80%) believed obesity was a large problem and that poor individual choices (86%) and the widespread availability of unhealthy food and drink (78%) contributed to the issue. There was moderate to high support for most (n=7) initiatives. Support for food environment policies was highest for schools (76-82%) and hospitals (67-79%). Supporters and opponents rationalised opinions based on perceived effectiveness, the government's role and cost benefits. Opponents were a minority, but principles of autonomy were predominant. Attributing obesity to environment-related factors, and personal lower SSB consumption strongly predicted support. CONCLUSION There is significant recognition of the obesity issue and strong support for policies designed to improve the availability and promotion of healthy food and drink in public institutions, particularly in schools and hospitals. SO WHAT?: Substantial community support for healthy food environment policies in schools and hospitals warrants continued implementation in NSW. This may foster further acceptance for wider implementation. Our findings could inform the framing of policy advocacy messages.
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Affiliation(s)
- Leonie Cranney
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Prevention Research Collaboration, Sydney, New South Wales, Australia.,The University of Sydney, Charles Perkins Centre, Sydney, New South Wales, Australia
| | - Margaret Thomas
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Prevention Research Collaboration, Sydney, New South Wales, Australia.,The University of Sydney, Charles Perkins Centre, Sydney, New South Wales, Australia
| | | | - Bradley Drayton
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Prevention Research Collaboration, Sydney, New South Wales, Australia
| | - Chris Rissel
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Prevention Research Collaboration, Sydney, New South Wales, Australia.,The University of Sydney, Charles Perkins Centre, Sydney, New South Wales, Australia
| | - Adrian Bauman
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Prevention Research Collaboration, Sydney, New South Wales, Australia.,The University of Sydney, Charles Perkins Centre, Sydney, New South Wales, Australia
| | - Philayrath Phongsavan
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Prevention Research Collaboration, Sydney, New South Wales, Australia.,The University of Sydney, Charles Perkins Centre, Sydney, New South Wales, Australia
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Tinney M, Rittinger R, Tomlinson K, Borg D, Warzel A, O'Sullivan M, Nyanhanda T. Removal of sugar sweetened beverages from sale in a hospital setting-Consumer opinion and influence on purchasing behavior. Health Promot J Austr 2021; 33:677-685. [PMID: 34767662 DOI: 10.1002/hpja.557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 09/29/2021] [Accepted: 11/10/2021] [Indexed: 11/05/2022] Open
Abstract
ISSUE ADDRESSED This study investigated the impact of removing sugar sweetened beverages (SSBs) from sale in a regional health service. Drink purchasing patterns were measured by product ordering data. Consumer opinion regarding the intervention, self-reported packaged drink purchase and consumption were also explored. METHODS Packaged drinks were classified into two categories, SSB or non-SSB and drink types. Drink sales were determined by the collection of product ordering data for all packaged drink types sold, six months prior to and twelve months after the removal of SSBs. A consumer survey was undertaken six months after SSB removal to assess consumer opinion regarding SSB removal, self-reported SSB consumption and purchase. Descriptive and Wilcoxon rank-sum tests analyses assessed differences in packaged drinks purchase, self-reported SSB consumption and purchase. Open-ended survey responses were thematically analysed. RESULTS The median monthly number of juices, and diet drinks ordered increased significantly (P = .05). 59% of the survey respondents regularly consumed SSBs and 58% agreed or strongly agreed with removing SSBs from sale. However, some consumers felt it was a removal of their freedom of choice. CONCLUSIONS Removing SSBs from sale can result in consumers making healthier purchases. There was support for the initiative as it is seen as the responsibility of the health service to role model healthy eating behaviours. SO WHAT?: This study indicates removal of SSBs from sale is a promising health promotion intervention that can contribute to positive behaviour change, and potentially influence longer-term health and wellbeing.
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Affiliation(s)
- Melissa Tinney
- Healthy Communities Unit, Kitchener House, Barwon Health, Geelong, Australia
| | - Rowena Rittinger
- Healthy Communities Unit, Kitchener House, Barwon Health, Geelong, Australia
| | - Kate Tomlinson
- King's College Hospital, King's College Hospital NHS Foundation Trust, London, UK
| | - Dan Borg
- Healthy Communities Unit, Kitchener House, Barwon Health, Geelong, Australia
| | - Aleksandra Warzel
- Healthy Communities Unit, Kitchener House, Barwon Health, Geelong, Australia
| | - Mairead O'Sullivan
- Healthy Communities Unit, Kitchener House, Barwon Health, Geelong, Australia
| | - Tafadzwa Nyanhanda
- Melbourne Clinical School, School of Medicine, The University of Notre Dame Australia, Werribee, Vic, Australia
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Miller CL, Dono J, Scully M, Morley B, Ettridge K. Adolescents report low opposition towards policy options to reduce consumption of sugary drinks. Pediatr Obes 2021; 16:e12775. [PMID: 33738982 DOI: 10.1111/ijpo.12775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 01/15/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Policy makers benefit from insight into consumer perceptions of potential sugary drink policy measures. Adolescents are among the highest consumers in Australia, yet their perceptions are unknown. OBJECTIVES To determine adolescents' perceptions of potential policies aimed at reducing sugary drink consumption and explore variation in perceptions. METHODS Data were collected via a nationally representative survey of Australian secondary school students (aged 12-17) using a stratified two-stage probability design (n = 9102). Survey questions assessed receptiveness to five policy options, sugary drink consumption, perceptions of health effects and demographics. RESULTS Low proportions (13%-29%) were somewhat/strongly against policy options, 35% to 45% were neutral, and 27% to 52% were somewhat/strongly in favour. Highest support was observed for text warning labels on sugary drinks (52%), followed by tax with investment in healthy weight programmes (43%), standalone tax (36%), restricting school sales (30%) and restricting advertising to children (27%). Sex, sugary drink consumption and perceptions were significantly associated with most assessed policy options in bivariate analyses (P < .01). Significant associations between sex and consumption with selected policy options persisted in adjusted multilevel models. CONCLUSIONS Opposition towards policy options was low overall and neutrality was common. This creates opportunity for early intervention to increase public support for addressing specific health issues.
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Affiliation(s)
- Caroline Louise Miller
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia.,Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Joanne Dono
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.,School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Maree Scully
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Belinda Morley
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Kerry Ettridge
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.,School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
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Howse E, Hankey C, Bauman A, Freeman B. Are young adults' discussions of public health nutrition policies associated with common food industry discourses? A qualitative pilot study. Aust N Z J Public Health 2021; 45:171-180. [PMID: 33617122 DOI: 10.1111/1753-6405.13074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 10/01/2020] [Accepted: 12/01/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Unhealthy diets are a key risk factor for chronic disease, with young adults (18-30 years old) in high-income countries like Australia and the UK particularly at risk. Improved public health nutrition policies can help address unhealthy diets in the population, but many of the more regulatory policies are opposed by food industry groups. This research explores how young adults in Australia and the UK discuss a range of topical public health nutrition policies and analyses whether and how their views may be associated with food industry discourses. METHODS Eight focus groups were held in Sydney, Australia, and Glasgow, UK, with a total of thirty young adults participating. A deliberative-style method was used in the focus groups to generate discussion about six public health nutrition policies, such as taxation of sugar-sweetened beverages and restrictions on advertising of less-healthy foods. Discourse analysis was used to examine participants' discussions. RESULTS Twenty discourse codes were developed iteratively from the focus group data. These were thematically linked with nine food industry discourses found in the peer-reviewed literature, including industry self-regulation, personal responsibility, corporate social responsibility and challenging nutrition science. CONCLUSIONS These results demonstrate there is an association between common food industry discourses and some young adults' views about public health nutrition policies. Implications for public health: Identifying, engaging with and responding to common industry discourses is a priority in order to build greater public support and acceptability of policies that will improve diet and prevent chronic disease.
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Affiliation(s)
- Eloise Howse
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Prevention Research Collaboration, New South Wales.,The Australian Prevention Partnership Centre, The Sax Institute, New South Wales
| | - Catherine Hankey
- University of Glasgow, School of Medicine, Dentistry and Nursing, United Kingdom
| | - Adrian Bauman
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Prevention Research Collaboration, New South Wales.,The Australian Prevention Partnership Centre, The Sax Institute, New South Wales
| | - Becky Freeman
- The University of Sydney, Faculty of Medicine and Health, Sydney School of Public Health, Prevention Research Collaboration, New South Wales
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Are perceptions of government intervention for prevention different by gender and age? Results from the AUStralian Perceptions Of Prevention Survey (AUSPOPS). Prev Med 2020; 141:106289. [PMID: 33091415 DOI: 10.1016/j.ypmed.2020.106289] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 10/07/2020] [Accepted: 10/10/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Understanding public opinion and community attitudes is needed to help the implementation of chronic disease prevention policies that are acceptable to the population. The AUStralian Perceptions Of Prevention Survey ('AUSPOPS') is a national survey designed to provide evidence on the views of Australians regarding government intervention for prevention. However there is limited evidence whether age and gender have modifying effects on attitudes about prevention. METHODS Using results from the 2018 AUSPOPS dataset, this study examines whether the effect of age on attitudes about prevention is modified by the effect of gender. Survey questions included views about statements for government intervention and whether government had gone far enough for thirteen different preventive interventions. RESULTS 2601 Australian residents aged 18 years or older participated in the survey (response rate 16.7%). Results showed strong support for prevention framed as a shared responsibility between governments and individuals. Interventions where >50% of respondents felt the government had not gone far enough in prevention were restricting unhealthy food advertising for children and setting salt limits on processed food. There were significant age by gender interactions in a small number (n = 4) of questions examining support for government intervention for prevention, suggesting young men were least in favour of more action by government. CONCLUSIONS There is general support in the Australian community for government intervention for prevention. Policymakers could capitalize on this sentiment by prioritizing policies with high levels of support across all groups, and target population subgroups on issues where acceptability appears to be heterogenous.
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Graham F, Barker M, Menon M, Holdsworth M. Acceptability and feasibility of a café-based sustainable food intervention in the UK. Health Promot Int 2020; 35:1507-1518. [PMID: 32243498 DOI: 10.1093/heapro/daaa027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Dietary change is needed to improve health and reduce the environmental burden of food production and consumption. Using an Intervention Mapping approach, this study aimed to explore the views caterers and customers held towards point-of-choice interventions that promote healthy and environmentally friendly (EF) food and beverage choices at the University of Sheffield. Intervention options proposed during focus groups were devised using the Nuffield Bioethics ladder of intervention. Ten focus groups were held involving caterers (n = 16) and customers (n = 45). Thematic analysis was conducted on the transcripts of caterer and customer focus groups seperately, and then comparisons were made to identify concerns about the acceptability and feasibility of intervention options. Attitudes towards intervention options varied considerably amongst stakeholders, with the greatest disparity of opinion in the acceptability of interventions that restrict or limit personal choice, particularly with regards to meat consumption. Information provision was favoured as an acceptable intervention by both customers and caterers. However, labelling products in terms of their environmental impact was considered practically unfeasible. Social norms around eating also emerged as influencing the acceptability and feasibility of interventions with concerns raised about: shaming customers who chose meat, the exclusivity of vegan choices and the limited availability and appeal of meatless café options. Financial considerations were the main priority of caterers when discussing point-of-choice interventions. An acceptable and feasible café-based intervention ought to increase awareness and understanding of healthy and EF food choices, protect customer choice and avoid additional costs.
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Affiliation(s)
- Fiona Graham
- School of Health and Related Research, University of Sheffield, Sheffield S1 4DA, UK.,Population Health Sciences Institute, Baddiley-Clark, Building Richardson Road, Newcastle NE2 4AX, UK
| | - Margo Barker
- Food and Nutrition Group, Sheffield Business School, Sheffield Hallam University, Sheffield S1 1WB, UK
| | - Manoj Menon
- Department of Geography, University of Sheffield, Sheffield S3 7HQ, UK
| | - Michelle Holdsworth
- School of Health and Related Research, University of Sheffield, Sheffield S1 4DA, UK.,NUTRIPASS Unit (IRD-SupAgro-University of Montpellier), IRD, 911 avenue d'agropolis, Montpellier 34394, France
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11
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The University of British Columbia healthy beverage initiative: changing the beverage landscape on a large post-secondary campus. Public Health Nutr 2020; 24:125-135. [PMID: 32943122 DOI: 10.1017/s1368980020003316] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Environmental interventions are more effective at changing nutrition behaviour than educational campaigns alone. As part of their health promotion efforts, the University of British Columbia (UBC) developed the Healthy Beverage Initiative (HBI) to ultimately reduce the consumption of sugar-sweetened beverages (SSB) on campus. We describe the development, implementation, preliminary evaluation and future of the HBI. DESIGN Naturalistic observation of environmental changes to induce behaviour change. SETTING Large urban research university campus. PARTICIPANTS University community members and campus visitors. RESULTS Three main activities have been implemented since the initiation of the UBC HBI: renegotiation of the cold beverage agreement, a media campaign to promote tap water consumption and the removal of SSB from select retail locations on campus (residence dining hall). No significant loss of revenue was observed following the removal of SSB from a residence dining hall compared with similar locations. Compensatory purchasing behaviour of SSB was not observed at the closest retail locations where they were still available. After the removal of SSB, ~75% of survey respondents were not aware that the beverages had been removed. CONCLUSIONS The implementation of the HBI has met little resistance from the UBC community. The removal of SSB from residence dining locations did not result in any significant revenue loss or compensatory purchasing behaviour. This suggests that environmental intervention initiatives appear to be a viable option that may reduce SSB consumption on post-secondary campuses.
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12
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Cranney L, Drayton B, Thomas M, Tang B, O'Connell T, Crino M, Cobcroft M, Chau J, Bauman A, Phongsavan P. Impact and acceptance of a state-wide policy to remove sugar-sweetened beverages in hospitals in New South Wales, Australia. Health Promot J Austr 2020; 32:444-450. [PMID: 32713051 DOI: 10.1002/hpja.390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 07/15/2020] [Indexed: 01/17/2023] Open
Abstract
ISSUE ADDRESSED Policy and environmental approaches can reduce the accessibility and purchasing of sugar-sweetened beverages (SSBs), potentially reducing overweight and obesity. This study examined the impact of a state-wide policy on removal of SSBs from sale in NSW public hospitals (launched July 2017), and explored consumer awareness and support. METHODS A convenience sample of 81 food outlets in 26 hospitals were audited for SSB availability before and after the target date for SSB removal (31 December 2017). An interviewer-administered intercept survey in 10 randomly selected hospitals (March-May 2018), assessed staff and visitors' awareness of and support for SSB removal. Descriptive and χ2 analyses assessed differences in: SSB availability; staff and visitor awareness and support. Open-ended survey responses were thematically analysed. RESULTS The proportion of outlets that removed SSBs increased from 58.0% to 96.3% (P < .001). The majority (79.5%) of the 2394 surveyed supported SSB removal, with nearly half (48.4%) reporting it would improve people's health. A minority (13.4%) did not support SSB removal, more than half (61.4%) of those said individuals should have free choice. More staff than visitors were aware of the change (61.9% vs 31.2%; P < .0001). CONCLUSIONS Availability of SSBs in NSW hospitals was significantly reduced after implementation of a policy to remove them from sale. There was strong staff and visitor support for the initiative. SO WHAT?: This study provides clear evidence that a policy designed to provide a healthy hospital retail drink environment can be successfully implemented at scale with high levels of support from staff and visitors. SUMMARY A state-wide policy initiative to remove SSBs from sale in NSW hospital food outlets in 2017 was successfully implemented, with a sample of outlets having nearly 100% compliance. The majority of staff and visitors (80%) supported the removal of SSBs, mostly because they believed it would improve individual and population health.
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Affiliation(s)
- Leonie Cranney
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Bradley Drayton
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Margaret Thomas
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Beatrice Tang
- Centre for Population Health, NSW Ministry of Health, North Sydney, Australia
| | - Tarli O'Connell
- Centre for Population Health, NSW Ministry of Health, North Sydney, Australia
| | - Michelle Crino
- Centre for Population Health, NSW Ministry of Health, North Sydney, Australia
| | - Megan Cobcroft
- Centre for Population Health, NSW Ministry of Health, North Sydney, Australia
| | - Josephine Chau
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Department of Health Systems and Populations, Macquarie University, Sydney, Australia
| | - Adrian Bauman
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Philayrath Phongsavan
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
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13
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Allman-Farinelli M, Rahman H, Nour M, Wellard-Cole L, Watson WL. The Role of Supportive Food Environments to Enable Healthier Choices When Eating Meals Prepared Outside the Home: Findings from Focus Groups of 18 to 30-Year-Olds. Nutrients 2019; 11:nu11092217. [PMID: 31540273 PMCID: PMC6769704 DOI: 10.3390/nu11092217] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 09/02/2019] [Accepted: 09/10/2019] [Indexed: 01/24/2023] Open
Abstract
Young adults are the highest consumers of food prepared outside home, which has been linked to weight gain. The aim of this qualitative research was to gather opinions from young adults about what influences their food choice when eating out and if they so desired, what might enable healthy choices. Thirty-one adults aged 18 to 30 years participated in four focus groups (females = 24). Predetermined questions were used to guide discussions which were audiotaped then transcribed. The content was organized into themes and sub-themes using NVivo software. Two broad groupings arose—personal behaviors and changes to physical and social food environments. For many, eating out was viewed as a special occasion so that healthy food was not a priority and despite understanding health consequences of poor diets this was not an immediate concern. Price discounts and menu-labelling were suggested and trust in credible organizations and peers’ endorsement of meals and venues expressed. The role of smartphones in the modern food environment emerged as a tool to enable immediate access to many restaurants to order food and access reviews and social media as a source of persuasive food imagery. Current menu-labelling initiatives should continue, food pricing be explored and influence of smartphones on diet further researched. However, these findings may be limited by the high proportion of women and higher socioeconomic status and urban residence of many participants.
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Affiliation(s)
- Margaret Allman-Farinelli
- The University of Sydney, Nutrition and Dietetics Group, Charles Perkins Centre, School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Hassan Rahman
- The University of Sydney, Nutrition and Dietetics Group, Charles Perkins Centre, School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Monica Nour
- The University of Sydney, Nutrition and Dietetics Group, Charles Perkins Centre, School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Lyndal Wellard-Cole
- The University of Sydney, Nutrition and Dietetics Group, Charles Perkins Centre, School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW 2006, Australia.
- Cancer Prevention and Advocacy Division, Cancer Council NSW, Sydney, NSW 2011, Australia.
| | - Wendy L Watson
- Cancer Prevention and Advocacy Division, Cancer Council NSW, Sydney, NSW 2011, Australia.
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14
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Miller CL, Dono J, Wakefield MA, Pettigrew S, Coveney J, Roder D, Durkin SJ, Wittert G, Martin J, Ettridge KA. Are Australians ready for warning labels, marketing bans and sugary drink taxes? Two cross-sectional surveys measuring support for policy responses to sugar-sweetened beverages. BMJ Open 2019; 9:e027962. [PMID: 31248926 PMCID: PMC6597645 DOI: 10.1136/bmjopen-2018-027962] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE To assess public support for 10 potential policy initiatives to reduce sugar-sweetened beverage (SSB) consumption. DESIGN A 2014 historical data set, which employed a face-to-face survey in one Australian state (study 1), provided the basis for comparison with our 2017 nationally representative, cross-sectional, computer-assisted telephone interviewing population survey (study 2). PARTICIPANTS Study 1: South Australians, 15+ years (n=2732); study 2: Australians, 18+ years (n=3430). PRIMARY OUTCOME MEASURES levels of support for SSB-specific policy initiatives. For the 2017 national study (study 2), demographic characteristics, body mass index, knowledge of potential harms caused by consuming SSBs and SSB consumption were included in multivariable regression analyses. RESULTS In 2017, all 10 potential policy initiatives received majority support (60%-88% either 'somewhat' or 'strongly' in favour). Initiatives with educative elements or focused on children received high support (>70%), with highest support observed for text warning labels on drink containers (88%) and government campaigns warning of adverse health effects (87%). Higher support was observed for SSB tax paired with using funds for obesity prevention (77%) than a stand-alone tax (60%). Support for policy initiatives was generally greater among those who believed SSB daily consumption could cause health problems in adults (4%-18% absolute difference) and/or in children (8%-26% absolute difference) and lower among SSB high consumers (7+ drinks per week; 9%-29% absolute difference). State-specific data comparison indicated increased support from 2014 to 2017 for taxation (42%vs55%; χ2=15.7, p<0.001) and graphic health warnings (52%vs68%; χ2=23.4. p<0.001). CONCLUSIONS There is strong public support for government action, particularly regulatory and educational interventions, to reduce SSB consumption, which appears to have increased since 2014. The findings suggest that framing policies as protecting children, presenting taxation of SSBs in conjunction with other obesity prevention initiatives and education focused on the harms associated with SSB consumption will increase support.
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Affiliation(s)
- Caroline L Miller
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Joanne Dono
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Melanie A Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Simone Pettigrew
- School of Psychology, Curtin University, Perth, Western Australia, Australia
| | - John Coveney
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - David Roder
- Cancer Epidemiology and Population Health, University of South Australia, Adelaide, South Australia, Australia
| | - Sarah J Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Gary Wittert
- Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
- Centre for Nutrition and GI Diseases, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Jane Martin
- Obesity Policy Coalition and Alcohol and Obesity Policy, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Kerry A Ettridge
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
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15
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It Is Time to Make Policy for Healthier Food Environments in Australian Universities. Nutrients 2018; 10:nu10121909. [PMID: 30518049 PMCID: PMC6316519 DOI: 10.3390/nu10121909] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 11/30/2018] [Indexed: 11/16/2022] Open
Abstract
The obesogenic food environment is likely driving excessive weight gain in young adults. Our study aimed to investigate the nutritional quality of current food and drink offerings in an Australian university. This cross-sectional study included baseline environmental audits of 30 food outlets and 62 vending machines across campus. A recent food and drink benchmark for health facilities by state government was used to classify the food and beverage offerings. It recommended food outlets and vending machines to offer at least 75% 'Everyday' (healthy) and less than 25% 'Occasional' (less healthy) foods and drinks. Sugary drinks and options with large portion sizes and unhealthy ingredients should be removed from sale. Only two beverage vending machines and none of the food outlets met the full recommendations. The overall proportions of Everyday and Occasional foods in food outlets were 35% and 22%, respectively with 43% falling into the category that should not be sold. Sugary drinks occupied a third of beverage varieties in outlets and 38% of beverage slots in vending machines. The current university food environment was poorly compliant with the existing benchmark. Specific food policy in the university setting may be needed to make healthier choices more accessible to young adults.
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16
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'Buying Salad Is a Lot More Expensive than Going to McDonalds': Young Adults' Views about What Influences Their Food Choices. Nutrients 2018; 10:nu10080996. [PMID: 30061513 PMCID: PMC6116192 DOI: 10.3390/nu10080996] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 07/21/2018] [Accepted: 07/24/2018] [Indexed: 11/17/2022] Open
Abstract
Young adults (18⁻30 years of age) are an 'at-risk' group for poor dietary behaviours and less healthy food choices. Previous research with young adults has looked at the barriers and enablers driving their food choices, focusing primarily on university and college students. However, there is less research using qualitative methods with young adults as a broader population group. This study aimed to explore the experiences of young adults in two different yet similar settings: Sydney, Australia and Glasgow, Scotland. Eight focus groups of young adult participants, ranging in size from 2⁻6 participants, were held in Sydney, Australia (n = 14) and Glasgow, Scotland (n = 16) to discuss, explore and compare the determinants and influences of their food choices. Focus group transcripts were coded thematically based on a process of narrative analysis. Three major narratives were identified across both locations: value of food; appeal of food; and emotional connections with food. These narratives were underpinned by a broader narrative of 'performing adulthood.' This narrative reflected a belief amongst participants that they should make rational, informed choices about food despite this conflicting with their broader food environment. Future research could examine which environment-level or policy-based interventions are most acceptable to young adults in terms of influencing their food choices and dietary behaviours.
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