Stakeholder Generated Ideas for Alternative School Food Provision Models in Australia Using the Nominal Group Technique

The use of virtual nominal groups in healthcare research: An extended scoping review

INTRODUCTION

The Nominal Group Technique (NGT) is a consensus group method used to synthesize expert opinions. Given the global shift to virtual meetings, the extent to which researchers leveraged virtual platforms is unclear. This scoping review explores the use of the vNGT in healthcare research during the COVID-19 pandemic.

METHODS

Following the Arksey and O'Malley's framework, eight cross-disciplinary databases were searched (January 2020-July 2022). Research articles that reported all four vNGT stages (idea generation, round robin sharing, clarification, voting) were included. Media Synchronicity Theory informed analysis. Corresponding authors were surveyed for additional information.

RESULTS

Of 2,589 citations, 32 references were included. Articles covered healthcare (27/32) and healthcare education (4/32). Platforms used most were Zoom, MS Teams and GoTo but was not reported in 44% of studies. Only 22% commented on the benefits/challenges of moving the NGT virtually. Among authors who responded to our survey (16/32), 80% felt that the vNGT was comparable or superior.

CONCLUSIONS

The vNGT provides several advantages such as the inclusion of geographically dispersed participants, scheduling flexibility and cost savings. It is a promising alternative to the traditional in-person meeting, but researchers should carefully describe modifications, potential limitations, and impact on results.

Identifying the top 10 research priorities for the school food system in the UK: a priority setting exercise

INTRODUCTION

The school food system varies widely between schools and across the UK. There is a need to understand evidence gaps in school food research to allow the development, implementation and evaluation of policies and interventions to support children's healthy eating at school. This study aimed to conduct a priority setting exercise to co-produce research priorities in relation to the UK school food system.

METHODS

The James Lind Alliance process informed this priority setting exercise; all key steps engaged a wide range of UK school food stakeholders (including teachers, parents, principals, school governors, policymakers, caterers). An initial online stakeholder survey identified perceived research priorities. In a second survey, stakeholders were asked to rank these priorities. Lastly, an online priority setting workshop with stakeholders elicited the most important research priorities.

RESULTS

In 2021, school food stakeholders (n=1280) completed the first survey, from which 136 research priorities were identified. In the second survey, participants (n=107) ranked these research priorities regarding their importance. Lastly, 30 workshop participants discussed and reached consensus on the research priorities. After final refinement by the research team, 18 priorities resulted, with the top 10 being related to the provision of free school meals (effectiveness of cost-effectiveness of different levels of eligibility, including universal provision), implementation of policy (including improving uptake) and food standards, issues around procurement, leadership, inequalities, social norms, the eating environment, food culture throughout the school setting and healthy eating.

CONCLUSION

The top 10 research priorities were elicited through a rigorous approach, including a wide range of stakeholders across the UK. These should be considered by policymakers, researchers and others to inform research, evidence-based policy development and, ultimately, improve the UK school food system.

Exploring Australian children's perceptions of a school-provided lunch model using a story completion method

Children in Australia currently bring a packed lunch to school from home. Many children are not consuming a healthy diet at school. There is interest from key stakeholders (e.g. education and the non-government sector, food service and parents/caregivers) to transform the Australian system to a school-provided model to improve children's diets, reduce parental burden and address food insecurity. To facilitate a successful transition to this system, it is important to consider the views of the children. We aimed to explore Australian primary school children's perceptions of a hypothetical school-provided lunch model. To achieve this aim, we undertook a qualitative study using the story completion method. Twenty-one grade-five children, from one public primary school in South Australia, participated in a once-off data collection session. Children were given a brief story stem and asked to complete a story about a hypothetical school-provided lunch scenario. The story data were analysed using thematic analysis. Four main themes were generated: the eating environment, the food provided, processes of the mealtime and time. The desire for choice was an additional overarching theme that cut across all themes. Our study provides the first exploration of South Australian children's perceptions of hypothetical school-provided meals. These insights can be used to co-design an acceptable school food system with children to create a positive eating environment that supports healthy eating habits they can carry forward into adulthood.

Creation of a risk of harms informed consent form for dry needling: A nominal group technique

BACKGROUND

When consenting patients to dry needling treatment, it is necessary to inform patients of potential risks of harms.

OBJECTIVES

The aim of this study was to identify elements and framework for an Informed Consent (IC) risk of harm statement to improve patient decision-making.

DESIGN

A virtual Nominal Group Technique (vNGT) methodology was used to achieve consensus among participants to identify what needs to be on a consent form, how it should be framed, and what it should state so patients understand the true risks.

METHODS

Eligible participants were identified as one of four groups: legal expert, policy expert, dry needling expert, or patient. The vNGT session consisted of 5 rounds of idea generation and final consensus voting which lasted for 2 h.

RESULTS

Five individuals consented to participate. Of the 27 original ideas, 22 reached consensus including ones specifically related to a risk of harms statement: identifying risks and discomforts, identify different sensations, and using a classification to order risks by severity. Consensus was achieved with percent agreement of ≥ 80%. The constructed risk of harm statement had a reading level of grade 7 and provided a list of stratified risks associated with dry needling.

CONCLUSION

The generated risk of harm statement can be incorporated on IC forms that require disclosure of risks in both the clinical and research setting. Additionally, further elements were identified by panel participants about defining the framework for an IC form outside of the risk of harm statement.

CLINICALTRIALS

GOV REGISTRATION

NCT05560100 (29/09/22).

Protocol for an extended scoping review on the use of virtual nominal group technique in research

INTRODUCTION

Consensus group methods such as the Nominal Group Technique (NGT) and Delphi method are commonly used in research to elicit and synthesize expert opinions when evidence is lacking. Traditionally, the NGT involves a face-to-face interaction. However, due to the COVID-19 pandemic, many in-person meetings have moved to online settings. It is unclear to what extent the NGT has been undertaken in virtual settings. The overarching aim of this scoping review is to explore the use of the virtual NGT in research. Our specific objectives are to answer the following questions: To what extent has the NGT been used virtually? What modifications were made to accommodate this online format? What advantages and disadvantages were noted by authors in comparison with the face-to-face mode of the technique?

MATERIALS AND METHODS

This scoping review will follow the steps outlined by Arksey and O'Malley and the PRISMA-ScR guidelines. Several pilot searches were completed to refine inclusion and exclusion criteria. Media Synchronicity Theory will provide a conceptual framework to inform the research, including data extraction and summarizing results. As an additional extension to the literature review, online interviews with corresponding authors will be conducted to gather further information.

The food and nutrient intake of 5- to 12-year-old Australian children during school hours: a secondary analysis of the 2011-2012 National Nutrition and Physical Activity Survey

OBJECTIVE

School food intake of Australian children is not comprehensively described in literature, with limited temporal, nationally representative data. Greater understanding of intake at school can inform school-based nutrition promotion. This study aimed to describe the dietary intake of primary-aged children during school hours and its contribution to daily intake.

DESIGN

This secondary analysis used nationally representative, cross-sectional data from the 2011 to 2012 National Nutrition and Physical Activity Survey. Dietary intake was assessed using validated 24-h dietary recalls on school days. Descriptive statistics were undertaken to determine energy, nutrients, food groups and food products consumed during school hours, as well as their contributions to total daily intake. Associations between school food intake and socio-demographic characteristics were explored.

SETTING

Australia.

PARTICIPANTS

Seven hundred and ninety-five children aged 5-12 years.

RESULTS

Children consumed 37 % of their daily energy and 31-43 % of select nutrient intake during school hours, with discretionary choices contributing 44 % of school energy intake. Most children consumed less than one serve of vegetables, meat and alternatives or milk and alternatives during school hours. Commonly consumed products were discretionary choices (34 %, including biscuits, processed meat), bread (17 %) and fruit (12 %). There were limited associations with socio-economic position variables, apart from child age.

CONCLUSIONS

Children's diets were not aligned with national recommendations, with school food characterised by high intake of discretionary choices. These findings are consistent with previous Australian evidence and support transformation of the Australian school food system to better align school food consumption with recommendations.

Research on Mediating Mechanisms and the Impact on Food Provision Services in Poor Areas from the Perspective of Stakeholders

Exploring and analyzing the common demands and behavioral responses of different stakeholders is important for revealing the mediating mechanisms of ecosystem service (ES) and realizing the management and sustainable supply of ES. This study took Mizhi County, a poverty-stricken area on the Loess Plateau in China, as an example. First, the main stakeholders, common demands, and behavioral responses in the food provision services were identified. Second, the relationship among stakeholders was analyzed. Finally, this study summarized three types of mediating mechanisms of food provision services and analyzed the influence of the different types of mediating mechanisms. The main conclusions are as follows: (1) Five main stakeholders in the study area were identified: government, farmers, enterprises, cooperatives, and middlemen. (2) Increasing farmers’ income is the common demand of most stakeholders in the study area, and this common demand has different effects on the behavioral responses of different stakeholders. (3) There are three types of mediating mechanisms in the study area: government + farmers mediating corn and mutton, government + enterprises mediating millet, and government + cooperatives mediating apples. On this basis, the effects of the different types of mediating mechanisms on variations in food yield, and trade-offs and synergies in typical townships, were analyzed.