Annabelle Wilson

Reliability and relative validity of a child nutrition questionnaire to simultaneously assess dietary patterns associated with positive energy balance and food behaviours, attitudes, knowledge and environments associated with healthy eating

BackgroundFood behaviours, attitudes, environments and knowledge are relevant to professionals in childhood obesity prevention, as are dietary patterns which promote positive energy balance. There is a lack of valid and reliable tools to measure these parameters. The aim of this study was to determine the reliability and relative validity of a child nutrition questionnaire assessing all of these parameters, used in the evaluation of a community-based childhood obesity prevention project.MethodsThe development of the 14-item questionnaire was informed by the aims of the obesity prevention project. A sub-sample of children aged 10–12 years from primary schools involved in the intervention was recruited at the projects baseline data collection (Test 1). Questionnaires were readministered (Test 2) following which students completed a 7-day food diary designed to reflect the questionnaire. Twelve scores were derived to assess consumption of fruit, vegetables, water, noncore foods and sweetened beverages plus food knowledge, behaviours, attitudes and environments. Reliability was assessed using (a) the intra class correlation coefficient (ICC) and 95% confidence intervals to compare scores from Tests 1 and 2 (test-retest reliability) and (b) Cronbachs alpha (internal consistency). Validity was assessed with Spearman correlations, bias and limits of agreement between scores from Test 1 and the 7-day diaries. The Wilcoxon signed rank test checked for significant differences between mean scores.ResultsOne hundred and forty one students consented to the study. Test 2 (n = 134) occurred between eight and 36 days after Test 1. For 10/12 scores ICCs ranged from 0.47–0.66 (p < 0.001) while for two scores ICCs were < 0.4 (p < 0.05). Spearman correlations ranged from 0.34–0.48 (p < 0.01) and Cronbachs alpha 0.50–0.80. Three scores were modified based on this analysis. The Wilcoxon signed rank test found no evidence of a difference between means (p > 0.05) for 10/12 (test-retest reliability) and 3/7 (validity) scores.ConclusionThis child nutrition questionnaire is a valid and reliable tool to simultaneously assess dietary patterns associated with positive energy balance, and food behaviours, attitudes and environments in Australian school children aged 10–12 years. Thus it can be used to monitor secular changes in these parameters and measure the effectiveness of this and other obesity prevention projects with similar aims.

Trust makers, breakers and brokers: building trust in the Australian food system.

BackgroundThe importance of consumer trust in the food supply has previously been identified, and dimensions of consumer trust in food—who they trust and the type of trust that they exhibit—has been explored. However, there is a lack of research about the mechanisms through which consumer trust in the food supply is developed, maintained, broken and repaired. This study seeks to address this gap by exploring if, and how, consumer trust in the food supply is considered by the media, food industry and governments when responding to food scares. The aim of the research is to develop models of trust building that can be implemented following food scares.MethodsSemi-structured interviews will be undertaken with media, public relations officials and policy makers in Australia, New Zealand and the United Kingdom. Participants will be recruited through purposive sampling and will be asked to discuss a hypothetical case study outlining a food incident, and any experiences of specific food scares. Models of trust development, maintenance and repair will be developed from interview data. Comment on these models will be sought from experts in food-related organizations through a Delphi study, where participants will be asked to consider the usefulness of the models. Participants’ comments will be used to revise the models until consensus is reached on the suitability and usability of the models.DiscussionThis study will contribute to the literature about systems-based trust, and explore trust as a social and regulatory process. The protocol and results will be of interest and use to the food industry, food regulators, consumer advocate groups, media seeking to report food-related issues and policy makers concerned with public health and consumer health and well-being. This research represents an important contribution to the translation of the theoretical conceptualizations of trust into practical use in the context of food.

The challenges of quantitative evaluation of a multi-setting, multi-strategy community-based childhood obesity prevention programme: lessons learnt from the eat well be active Community Programs in South Australia

OBJECTIVE To describe the rationale, development and implementation of the quantitative component of evaluation of a multi-setting, multi-strategy, community-based childhood obesity prevention project (the eat well be active (ewba) Community Programs) and the challenges associated with this process and some potential solutions. DESIGN ewba has a quasi-experimental design with intervention and comparison communities. Baseline data were collected in 2006 and post-intervention measures will be taken from a non-matched cohort in 2009. Schoolchildren aged 10-12 years were chosen as one litmus group for evaluation purposes. SETTING Thirty-nine primary schools in two metropolitan and two rural communities in South Australia. SUBJECTS A total of 1732 10-12-year-old school students completed a nutrition and/or a physical activity questionnaire and 1637 had anthropometric measures taken; 983 parents, 286 teachers, thirty-six principals, twenty-six canteen and thirteen out-of-school-hours care (OSHC) workers completed Program-specific questionnaires developed for each of these target groups. RESULTS The overall child response rate for the study was 49 %. Sixty-five per cent, 43 %, 90 %, 90 % and 68 % of parent, teachers, principals, canteen and OSHC workers respectively, completed and returned questionnaires. A number of practical, logistical and methodological challenges were experienced when undertaking this data collection. CONCLUSIONS Learnings from the process of quantitative baseline data collection for the ewba Community Programs can provide insights for other researchers planning similar studies with similar methods, particularly those evaluating multi-strategy programmes across multiple settings.

Trust in and through labelling – a systematic review and critique

Purpose – Distrust of conventional food supply systems impacts consumer food choice. This in turn has implications for consumer nutrition outcomes and acceptance of expert advice regarding food and health. The research exploring consumer trust is found across a broad range of research streams, and is not cohesive in topic or approach. The purpose of this paper is to synthesise the disparate literature exploring the interaction between food labelling and consumer trust to determine what is known, and gaps in knowledge regarding food labelling and consumer trust. Design/methodology/approach – A systematic search of trust and food labelling literature was conducted, with study results synthesised and integrated. Studies were then critically analysed for the conceptualisation of the consumer, the label, and their interaction with a framework developed using social theories of trust. Findings – In total, 27 studies were identified. It was found that not only is the current literature predominantly atheoretical...

Consumer trust in the Australian food system - The everyday erosive impact of food labelling.

Consumer trust in food system actors is foundational for ensuring consumer confidence in food safety. As food labelling is a direct communication between consumers and food system actors, it may influence consumer perceptions of actor trustworthiness. This study explores the judgements formed about the trustworthiness of the food system and its actors through labelling, and the expectations these judgements are based on. In-depth, semi-structured interviews with 24 Australian consumers were conducted. Theoretical sampling focussed on shopping location, dietary requirements, rurality, gender, age and educational background. The methodological approach used (adaptive theory) enabled emerging data to be examined through the lens of a set of guiding theoretical concepts, and theory reconsidered in light of emerging data. Food labelling acted as a surrogate for personal interaction with industry and government for participants. Judgements about the trustworthiness of these actors and the broader food system were formed through interaction with food labelling and were based on expectations of both competence and goodwill. Interaction with labelling primarily reduced trust in actors within the food system, undermining trust in the system as a whole. Labelling has a role as an access point to the food system. Access points are points of vulnerability for systems, where trust can be developed, reinforced or broken down. For the participants in this study, in general labelling demonstrates food system actors lack goodwill and violate their fiduciary responsibility. This paper provides crucial insights for industry and policy actors to use this access point to build, rather than undermine, trust in food systems.

The role of the media in construction and presentation of food risks

In this article we examine how and why the media construct food risks, from the perspective of ‘media actors’ (people involved in different types of media) using data from 30 interviews conducted in 2013 with media actors from Australia and the United Kingdom. In modern society, many risks are invisible and are brought to the attention of the public through representations in the mass media. This is particularly relevant for food safety, where the widening gap between producers and consumers in the developed world has increased the need for consumer trust in the food supply. We show the importance of newsworthiness in construction of media stories about food risk using Beck’s ideas on cosmopolitan risk to interpret the data. We note the ways in which the strategies that media actors use to construct stories about food risk amplify the risk posed potentially creating consumer anxiety about the safety of the food system. It is important for food regulators and public health professionals to be aware of this anxiety when presenting information about a food incident so that they can target their message accordingly to decrease anxiety.

Reliability of questionnaires to assess the healthy eating and activity environment of a child's home and school.

Childhood overweight and obesity are a growing concern globally, and environments, including the home and school, can contribute to this epidemic. This paper assesses the reliability of two questionnaires (parent and teacher) used in the evaluation of a community-based childhood obesity prevention intervention, the eat well be active (ewba) Community Programs. Parents and teachers were recruited from two primary schools and they completed the same questionnaire twice in 2008 and 2009. Data from both questionnaires were classified into outcomes relevant to healthy eating and activity, and target outcomes, based on the goals of the ewba Community Programs, were identified. Fourteen and 12 outcomes were developed from the parent and teacher questionnaires, respectively. Sixty parents and 28 teachers participated in the reliability study. Intraclass correlation coefficients for outcomes ranged from 0.37 to 0.92 (parent) (P < 0.05) and from 0.42 to 0.86 (teacher) (P < 0.05). Internal consistency, measured by Cronbachs alpha, of teacher scores ranged from 0.11 to 0.91 and 0.13 to 0.78 for scores from the parent questionnaire. The parent and teacher questionnaires are moderately reliable tools for simultaneously assessing child intakes, environments, attitudes, and knowledge associated with healthy eating and physical activity in the home and school and may be useful for evaluation of similar programs.

Changes in Primary School Children's Behaviour, Knowledge, Attitudes, and Environments Related to Nutrition and Physical Activity

Rigorous evaluation of large-scale community-based obesity interventions can provide important guidance to policy and decision makers. The eat well be active (ewba) Community Programs, a five-year multilevel, multistrategy community-based obesity intervention targeting children in a range of settings, was delivered in two communities. A comprehensive mixed-methods evaluation using a quasiexperimental design with nonmatched comparison communities was undertaken. This paper describes the changes in primary school childrens attitudes, behaviours, knowledge, and environments associated with healthy eating and physical activity, based on data from six questionnaires completed pre- and postintervention by students, parents, and school representatives. As self-reported by students in years from five to seven there were few significant improvements over time in healthy eating and physical activity behaviours, attitudes, knowledge, and perceived environments, and there were few changes in the home environment (parent report). Overall there were considerably more improvements in intervention compared with comparison schools affecting all environmental areas, namely, policy, physical, financial, and sociocultural, in addition to improvements in teacher skill and knowledge. These improvements in childrens learning environments are important and likely to be sustainable as they reflect a change of school culture. More sensitive evaluation tools may detect behaviour changes.

How food regulators communicate with consumers about food safety

Purpose – The purpose of this paper is to report how food regulators communicate with consumers about food safety and how they believe consumers understand their role in relation to food safety. The implications of this on the role of food regulators are considered. Design/methodology/approach – In total, 42 food regulators from Australia, New Zealand and the UK participated in a semi-structured interview about their response to food incidents and issues of food regulation more generally. Data were analysed thematically. Findings – Food regulators have a key role in communicating information to consumers about food safety and food incidents. This is done in two main ways: proactive and reactive communication. The majority of regulators said that consumers do not have a good understanding of what food regulation involves and there were varied views on whether or not this is important. Practical implications – Both reactive and proactive communication with consumers are important, however there are clear be...

The role of social media in communication about food risks: Views of journalists, food regulators and the food industry

Purpose The purpose of this paper is to explore the views of journalists, food regulators and the food industry representatives on the impact of social media on communication about food risk. The authors identify how journalists/media actors use social media in identifying and creating news stories arguing that food regulators need to maintain a social media presence to ensure that accurate information about food safety is disseminated via social media. Design/methodology/approach Data were collected through 105 semi-structured interviews. Findings While food regulators and representatives of the food industry identify advantages of social media including two-way communication and speed of transmission of information, they maintain concerns about information provided via social media fearing the potential for loss of control of the information and sensationalism. There is evidence, however, that media actors use social media to identify food stories, to find sources, gauge public opinion and to provide a human interest angle. Practical implications While there are commonalities between the three groups, concerns with social media reflect professional roles. Food regulators need to be aware of how media actors use social media and maintain a social media presence. Further, they need to monitor other sources to maintain consumer trust. Originality/value This paper adds to public debate through comparing the perspectives of the three groups of respondents each that have their own agendas which impact how they interact with and use social media.