Andrea Begley

Adolescent food literacy programmes: A review of the literature

Aim The aim of this study was to explore what is known about food literacy programmes targeting adolescents, including identification of the constituents of food literacy addressed, assessment of programme effectiveness, and description of programme design or delivery specific to adolescents. Methods A review of the peer-reviewed literature surrounding adolescent food literacy was conducted using scholarly electronic databases. Programme reports were identified in the grey literature using online searching and cross-referencing to support the research aim. Programmes from 2000 to 2012 targeting adolescents aged 13–17 years were included. Results A total of 19 peer-reviewed papers and four grey literature programmes met the search criteria. Interventions focused on practical cooking and/or food preparation skills and targeted younger adolescent age groups. Programmes were most commonly held in schools and community settings. The majority of programmes (n = 16/23) did not use a theoretical basis for their development. Programme evaluation encompassed the use of pre- and post-intervention questionnaires and focus groups. Only nine studies included a dietary behaviour-based outcome measure. Although 19 of the 23 studies reviewed reported positive changes related to the intervention, these did not include significant changes in diet quality or cooking frequency at home. Conclusions Few existing adolescent food literacy programmes have demonstrated a positive impact on dietary behaviours to date. Adolescent target groups present unique challenges in programme development and delivery. However, the physical, social and emotional health needs of this age group and potential to influence lifelong behaviours highlight the need to design effective and age-appropriate adolescent food literacy programmes.

Foodbank of Western Australia’s Healthy Food for All

Purpose – In Australia, the Foodbank of Western Australia (Foodbank WA) has a reputation for being at the forefront of health promotion. The purpose of this paper is to describe Foodbank WAs innovative food bank plus approach of incorporating healthy lifestyle initiatives (i.e. nutrition and physical activity education) into its core food bank business, so as to target priority issues such as food insecurity, poor food literacy, overweight, obesity, poor nutrition and physical inactivity. Design/methodology/approach – A case study approach was utilised to explore Foodbank WAs Healthy Food for All® (HFFA) strategy. HFFA is a comprehensive state wide, school and community based strategy, including the School Breakfast Programme, Food Sensations® and Choose to Move initiatives, designed to promote healthy lifestyles to low socioeconomic and vulnerable groups – a major target group of food banks. Findings – Since its inception in 2007, the delivery of food, education and resources has increased across all o...

Aspirational competency expectations for public health nutritionists in Australia: A consensus study

Aim To assess consensus among public health nutrition (PHN) workforce development stakeholders on the competencies required for effective PHN practice in the Australian workforce context. Methods A modified Delphi study involving two iterative survey rounds among an expert panel of 33 Australian PHN workforce development stakeholders. Surveys tested panellist ratings (essential, useful, irrelevant) of a listing of 143 competency elements derived from the literature and existing competency standards, across two survey rounds, with feedback between rounds. An arbitrary consensus cut-off of 67% was applied with <10% change between rounds or 100% agreement interpreted as agreement stability. Results A total of 109 competency elements from the total list of 143 were rated as essential above the consensus cut-off, representing 76% of the original list. Thirty-three (33) elements were rated as essential by 100% of panellists. Approximately 90% or more of the competency elements tested were retained using the 67% cut-off across nutrition science, nutrition communication, professional communication, capacity building and intervention management competency units. Competency elements rated as essential beyond the consensus cut-off concentrated in the practice competency units of nutrition assessment, monitoring and surveillance, capacity building, and intervention management. Conclusions The results provide an empirical basis for future nutrition curriculum renewal and workforce development innovations and challenge the assumption that existing dietetic workforce preparation based on meeting entry-level competencies is adequate for community and PHN practice.

Consensus on the core functions of the public health nutrition workforce in Australia

Aim To assess consensus among public health nutrition workforce development stakeholders on public health nutrition workforce core functions, and the level of competency attainment required to perform each function in different practice jurisdictions. Methods A modified Delphi study involving three iterative survey rounds among a purposively sampled expert panel of 33 public health nutrition workforce development stakeholders. Surveys tested panellist ratings of a listing of 50 function statements derived from the literature, across two survey rounds (rounds 1 and 2), with feedback between rounds. Rounds 2 and 3 assessed panellist ratings of the level of competency attainment required to perform functions across pre-defined district, provincial and national practice jurisdictions. An arbitrary consensus cut-off of >50% was applied with <10% change between rounds interpreted as agreement stability. Results Eighteen of a total list of 50 functions were rated as ‘core’ by a majority (>50%) of panellists, with six categorised as analytical, five as capacity building and eight as intervention management functions. The level of competency attainment required to effectively perform these 19 core functions increased consistently as the jurisdiction of practice increased in population coverage (district < provincial < national). Conclusions Public health nutrition workforce development stakeholders in Australia agree that there are a number of consistent core functions of the public health nutrition workforce that help define the work of public health nutritionists. They also recognise that the competency expectations for practice vary in different practice jurisdictions. The results provide an empirical basis for prioritising and designing future workforce development targeting specific practice jurisdictions.

Gratitude, resignation and the desire for dignity: lived experience of food charity recipients and their recommendations for improvement, Perth, Western Australia

Objective The present study explored recipients’ perceptions of food charity and their suggested improvements in inner-city Perth, Western Australia. Design In-depth interviews were conducted with charitable food service (CFS) recipients. Transcripts were thematically analysed using a phenomenological approach. Setting Interviews were conducted at two CFS in inner-city Perth. Subjects Fourteen adults. Results The recipients’ journeys to a reliance on CFS were varied and multifactorial, with poverty, medical issues and homelessness common. The length of time recipients had relied on food charity ranged from 8 months to over 40 years. Most were ‘grateful yet resigned’, appreciative of any food and resigned to the poor quality, monotony and their unmet individual preferences. They wanted healthier food, more variety and better quality. Accessing services was described as a ‘full-time job’ fraught with unreliable information and transport difficulties. They called for improved information and assistance with transport. ‘Eroded dignity’ resulted from being fed without any choice and queuing for food in public places, often in a volatile environment. ‘Food memories and inclusion’ reflected a desire for commensality. Recipients suggested services offer choice and promote independence, focusing on their needs both physical and social. Conclusions Although grateful, long-term CFS recipients described what constitutes a voluntary failure. Their service improvement recommendations can help meet their nutritional and social needs. A successful CFS provides a food service that prioritises nutritious, good-quality food and individual need, while promoting dignity and social inclusion, challenging in the current Australian context.

Charitable Food Systems’ Capacity to Address Food Insecurity: An Australian Capital City Audit

Australian efforts to address food insecurity are delivered by a charitable food system (CFS) which fails to meet demand. The scope and nature of the CFS is unknown. This study audits the organisational capacity of the CFS within the 10.9 square kilometres of inner-city Perth, Western Australia. A desktop analysis of services and 12 face-to-face interviews with representatives from CFS organisations was conducted. All CFS organisations were not-for–profit and guided by humanitarian or faith-based values. The CFS comprised three indirect services (IS) sourcing, banking and/or distributing food to 15 direct services (DS) providing food to recipients. DS offered 30 different food services at 34 locations feeding over 5670 people/week via 16 models including mobile and seated meals, food parcels, supermarket vouchers, and food pantries. Volunteer to paid staff ratios were 33:1 (DS) and 19:1 (IS). System-wide, food was mainly donated and most funding was philanthropic. Only three organisations received government funds. No organisation had a nutrition policy. The organisational capacity of the CFS was precarious due to unreliable, insufficient and inappropriate financial, human and food resources and structures. System-wide reforms are needed to ensure adequate and appropriate food relief for Australians experiencing food insecurity.

Reported changes in dietary behavior following a first clinical diagnosis of central nervous system demyelination

Background/objectives Although the current evidence is insufficient to recommend a special diet for people with multiple sclerosis (MS), dietary advice for people with MS is prolific online and in the media. This study aimed to describe dietary changes made in the year following a first clinical diagnosis of central nervous system demyelination (FCD), a common precursor to MS. Subjects/methods We used follow-up data from the Ausimmune Study, a multicentre matched case-control study examining the environmental risk factors for a FCD. A total of 244 cases (60 male, 184 female) completed a 1-year follow-up interview, which included a question about dietary changes. We described the number and proportion (%) of participants who reported making dietary changes and the type of change made. We investigated independent predictors of making a dietary change using a multivariable logistic regression model. Results A total of 38% (n = 92) of participants at the 1-year follow-up reported making at least one dietary change over the last year. There were no statistically significant independent associations between any participant characteristic and odds of making a dietary change. Of those who made at least one dietary change, the most common changes were increasing fruit and/or vegetable intake (27%, n = 25) and following a low-fat diet (25%, n = 23). Conclusion A considerable proportion of the study population reported making at least one dietary change in the year following a FCD, with the majority of changes being toward a healthier diet. Further research is warranted to investigate the reasons behind any dietary changes adopted by people with a FCD or with MS, and whether making a dietary change has benefits for the progression of demyelinating diseases, e.g., to a diagnosis of MS, as well as for general health and well-being.

The Rise of Food Inequality in Australia

This chapter describes the factors unique to Australia that both describe and report on the impact on food inequality. The context for food inequality and the measures used to give an insight are briefly described. Australia is often referred to as the ‘lucky country’. In 1964, Donald Horne wrote The Lucky Country, using the term ironically to highlight that Australia was simply lucky rather than clever as it had reaped the benefits of technological, economic, social and political innovations developed in other countries that were clever. The chapter concludes with a discussion about the future challenges of food inequity in Australia. The chapter will address the following issues: (1) The uniqueness of the Australian situation and how this impacts on food inequality. (2) How the issue/problem of food inequality is represented by government in a ‘lucky country’ like Australia. (3) The challenges for food inequality in developed countries like Australia. (4) What would a comprehensive Food and nutrition monitoring systems that report on food inequality look like?

Dietary responses to a multiple sclerosis diagnosis: a qualitative study

Background/objectivesMultiple sclerosis (MS) is an immune-mediated disease with no known cure and insufficient evidence to support a special therapeutic diet to alter symptom management or disease progression. Several studies have reported dietary changes made by people with MS, but there has been limited investigation into experiences surrounding diet in those recently diagnosed. This study explored responses to diet after a recent diagnosis of MS in people living in Western Australia.Subjects/methodsEleven adults with MS (mean time since diagnosis 8 months) participated in semi-structured interviews focusing on responses to diet since MS diagnosis. Interviews were transcribed, coded and analysed using grounded theory principles.ResultsThree theme responses emerged; (1) the perceived incompatibility of lack of/or generalised dietary advice with disease seriousness at the time of diagnosis; (2) extensive personal research and information seeking with difficulty judging credibility, and (3) self-experimentation with diet to either control MS symptoms or to cure MS.ConclusionsGiven the seriousness of the disease, there is a perceived gap in dietary information provided at the time of diagnosis. Healthcare professionals should address concerns with alternative therapeutic diets advertised to treat or cure MS, and clearly convey the reasoning for the general healthy dietary recommendations. This would better align advice with the perceptions about the role of diet in MS, assist people with MS in need of information and minimise dietary self-experimentation. Future research should explore the importance of diet for those who have had MS for a longer period of time.

Iodine‐containing supplement use by pregnant women attending antenatal clinics in Western Australia

Iodine requirements increase during pregnancy and although national recommendations for daily iodine supplementation (150 µg) exist, there is no research related to the uptake of these recommendations by pregnant women in Western Australia.