Vanessa M. Lynskey

Orders Of Healthier Children’s Items Remain High More Than Two Years After Menu Changes At A Regional Restaurant Chain

In a previous study we showed that customers ordered healthier food following the April 2012 implementation of a healthier childrens menu at Silver Diner, a regional restaurant chain. In this study we used newly available data to assess orders of childrens menu items both one and two years after our last assessment. Previous assessments took place in September 2011-March 2012 and in September 2012-March 2013, before and after implementation of the new menu, respectively. Orders were abstracted from the restaurants central database. We found that the overarching changes from the previous study were sustained during the two follow-up periods, with some small fluctuations (for example, the prevalence of healthy side dish orders changed from 38 percent of childrens meals ordered to 74 percent, then 76 percent, and then 75 percent in the successive study periods). Ordering patterns at follow-up remained healthier than before the menu change and in some cases continued to improve. Similar interventions have the potential to promote sustainable healthier ordering patterns and inform policy.

Children's perceptions of weight, obesity, nutrition, physical activity and related health and socio-behavioural factors

OBJECTIVE Approximately one-third of children in the USA are either overweight or obese. Understanding the perceptions of children is an important factor in reversing this trend. DESIGN An online survey was conducted with children to capture their perceptions of weight, overweight, nutrition, physical activity and related socio-behavioural factors. SETTING Within the USA. SUBJECTS US children (n 1224) aged 8-18 years. RESULTS Twenty-seven per cent of children reported being overweight; 47·1% of children overestimated the rate of overweight/obesity among US children. A higher percentage of self-classified overweight children (81·9%) worried about weight than did self-classified under/normal weight children (31·1%). Most children (91·1%) felt that it was important to not be overweight, for both health-related and social-related reasons. The majority of children believed that if someone their age is overweight they will likely be overweight in adulthood (93·1%); get an illness such as diabetes or heart disease in adulthood (90·2%); not be able to play sports well (84·5%); and be teased or made fun of in school (87·8%). Children focused more on food/drink than physical activity as reasons for overweight at their age. Self-classified overweight children were more likely to have spoken with someone about their weight over the last year than self-classified under/normal weight children. CONCLUSIONS Children demonstrated good understanding of issues regarding weight, overweight, nutrition, physical activity and related socio-behavioural factors. Their perceptions are important and can be helpful in crafting solutions that will resonate with children.

Designing an Agent-Based Model for Childhood Obesity Interventions: A Case Study of ChildObesity180.

Complex systems modeling can provide useful insights when designing and anticipating the impact of public health interventions. We developed an agent-based, or individual-based, computation model (ABM) to aid in evaluating and refining implementation of behavior change interventions designed to increase physical activity and healthy eating and reduce unnecessary weight gain among school-aged children. The potential benefits of applying an ABM approach include estimating outcomes despite data gaps, anticipating impact among different populations or scenarios, and exploring how to expand or modify an intervention. The practical challenges inherent in implementing such an approach include data resources, data availability, and the skills and knowledge of ABM among the public health obesity intervention community. The aim of this article was to provide a step-by-step guide on how to develop an ABM to evaluate multifaceted interventions on childhood obesity prevention in multiple settings. We used data from 2 obesity prevention initiatives and public-use resources. The details and goals of the interventions, overview of the model design process, and generalizability of this approach for future interventions is discussed.