School-based obesity prevention interventions: practicalities and considerations.

Pediatric obesity continues to be a major public health concern. Once established it is difficult to treat, therefore well-designed and evaluated prevention interventions are vitally important. Schools have an important role in the prevention of childhood obesity, however, their involvement can be limited by a number of constraints and barriers, which need to be considered when designing interventions.

Benchmarking government action for obesity prevention--an innovative advocacy strategy.

Background: Successful obesity prevention will require a leading role for governments, but internationally they have been slow to act. League tables of benchmark indicators of action can be a valuable advocacy and evaluation tool.

Objective: To develop a benchmarking tool for government action on obesity prevention, implement it across Australian jurisdictions and to publicly award the best and worst performers.

Large reductions in child overweight and obesity in intervention and comparison communities 3 years after a community project.

What Is Already Known About This Subject: Childhood obesity has been increasing over decades and scalable, population-wide solutions are urgently needed to reverse this trend. Evidence is emerging that community-based approaches can reduce unhealthy weight gain in children. In some countries, such as Australia, the prevalence of childhood obesity appears to be flattening, suggesting that some population-wide changes may be underway.

Biopsychosocial correlates of weight status perception in Australian adolescents.

This study examined the utility of the biopsychosocial model to predict accuracy of weight status perception among Australian adolescents. The factors included in this framework were: age, gender, and BMI-z (biological factors); satisfaction with body weight and shape (psychological factors); socioeconomic status, peer weight (social factors). Cross-sectional data, including measured height and weight, and self-reported weight status, was obtained from 2954 adolescents (mean age=14.

Inconsistent associations between sweet drink intake and 2-year change in BMI among Victorian children and adolescents.

Objective: The aim of this study was to examine whether baseline (T1) or 2-year change in sweet drink intake in children and adolescents was associated with age- and gender-standardized body mass index (BMIz) at time two (T2), 2 years later.

Methods: Data on 1465 children and adolescents from the comparison groups of two quasi-experimental intervention studies from Victoria, Australia were analysed. At two time points between 2003 and 2008 (mean interval: 2.

The cost-effectiveness of a successful community-based obesity prevention program: the be active eat well program.

Objective: To examine the cost-effectiveness of Be Active Eat Well (BAEW), a large, multifaceted, community-based capacity-building demonstration program that promoted healthy eating and physical activity for Australian children aged 4-12 years between 2003 and 2006.

Design And Methods: A quasi-experimental, longitudinal design was used with anthropometric data collected at baseline (1001 children-intervention; 1183-comparator) and follow-up. A societal perspective was employed, with intervention resource use measured retrospectively based on process evaluation reports, school newsletters, reports, and key stakeholder interviews, and valued in 2006 Australian dollars (AUD).

The importance of family functioning, mental health and social and emotional well-being on child oral health.

Objective: To examine the strength of associations between child oral health and aspects of the home environment (child behaviour, parental psychological distress and family functioning) in a large sample of 1- to 12-year-old Australian children.

Methods: The current study used data from the 2006 Victorian Child Health and Wellbeing Study. Data were obtained on 4590 primary carers.

A socio-ecological perspective on behavioural interventions to influence food choice in schools: alternative, complementary or synergistic?

Objective: An increasing focus on legislation, policy and guidance on the nutritional content of school food has in part been in response to the limited impact of more behavioural or educational approaches. However, there is a risk that a sole focus on policy-level action may lead to neglect of the important contribution that more behavioural approaches can make as components of effective, coordinated, multilevel action to improve the dietary intake of schoolchildren. The current paper aims to highlight the potential importance of viewing alternative approaches as complementary or synergistic, rather than competing.

Parental self-efficacy and oral health-related knowledge are associated with parent and child oral health behaviors and self-reported oral health status.

Objectives: This study sought to advance understanding of the influence of psychosocial factors on oral health by examining how parental self-efficacy (with regard to acting on their child's oral health needs) and oral health knowledge relate to parental and child oral health behaviors and self-rated oral health.

Methods: Parents of children in grades 0/1 and 5/6 (n = 804) and children in grades 5/6 (n = 377, mean age 11.5 ± 1.

Consumption patterns of sweet drinks in a population of Australian children and adolescents (2003-2008).

Background: Intake of sweet drinks has previously been associated with the development of overweight and obesity among children and adolescents. The present study aimed to assess the consumption pattern of sweet drinks in a population of children and adolescents in Victoria, Australia.

Methods: Data on 1,604 children and adolescents (4-18 years) from the comparison groups of two quasi-experimental intervention studies from Victoria, Australia were analysed.

A systematic review of risk factors during first year of life for early childhood caries.

Background: Early childhood caries (ECC) describes dental caries affecting children aged 0-71 months. Current research suggests ECC has important aetiological bases during the first year of life. Gaps in knowledge about disease progression prevent the effective and early identification of 'at risk' children.

The appropriateness of opt-out consent for monitoring childhood obesity in Australia.

Childhood obesity monitoring is a fundamental component of obesity prevention but is poorly done in Australia. Monitoring obesity prevalence in children provides important population health data that can be used to track trends over time, identify areas at greatest risk of obesity, determine the effectiveness of interventions and policies, raise awareness and stimulate action. High participation rates are essential for effective monitoring because these provide more representative data.

Process and impact evaluation of the Romp & Chomp obesity prevention intervention in early childhood settings: lessons learned from implementation in preschools and long day care settings.

Background: The Romp & Chomp controlled trial, which aimed to prevent obesity in preschool Australian children, was recently found to reduce the prevalence of childhood overweight and obesity and improve children's dietary patterns. The intervention focused on capacity building and policy implementation within various early childhood settings. This paper reports on the process and impact evaluation of this trial and the lessons learned from this complex community intervention.

Multilevel analysis of the Be Active Eat Well intervention: environmental and behavioural influences on reductions in child obesity risk.

Background: The Be Active Eat Well (BAEW) community-based child obesity prevention intervention was successful in modestly reducing unhealthy weight gain in primary school children using a multi-strategy and multi-setting approach.

Objective: To (1) examine the relationship between changes in obesity-related individual, household and school factors and changes in standardised child body mass index (zBMI), and (2) determine if the BAEW intervention moderated these effects.

Methods: The longitudinal relationships between changes in individual, household and school variables and changes in zBMI were explored using multilevel modelling, with measurement time (baseline and follow-up) at level 1, individual (behaviours, n = 1812) at level 2 and households (n = 1318) and schools (n = 18) as higher levels (environments).

Interventions for preventing obesity in children.

Background: Prevention of childhood obesity is an international public health priority given the significant impact of obesity on acute and chronic diseases, general health, development and well-being. The international evidence base for strategies that governments, communities and families can implement to prevent obesity, and promote health, has been accumulating but remains unclear.

Objectives: This review primarily aims to update the previous Cochrane review of childhood obesity prevention research and determine the effectiveness of evaluated interventions intended to prevent obesity in children, assessed by change in Body Mass Index (BMI).

Reduction in overweight and obesity from a 3-year community-based intervention in Australia: the 'It's Your Move!' project.

'It's Your Move!' was a 3-year intervention study implemented in secondary schools in Australia as part of the Pacific Obesity Prevention In Communities Project. This paper reports the outcome results of anthropometric indices and relevant obesity-related behaviours. The interventions focused on building the capacity of families, schools and communities to promote healthy eating and physical activity.

A prospective study of diet quality and mental health in adolescents.

Objectives: A number of cross-sectional and prospective studies have now been published demonstrating inverse relationships between diet quality and the common mental disorders in adults. However, there are no existing prospective studies of this association in adolescents, the onset period of most disorders, limiting inferences regarding possible causal relationships.

Methods: In this study, 3040 Australian adolescents, aged 11-18 years at baseline, were measured in 2005-6 and 2007-8.

Screen time and physical activity behaviours are associated with health-related quality of life in Australian adolescents.

Purpose: To explore the cross-sectional relationships between health-related quality of life (HRQoL) and physical activity (PA) behaviours and screen-based media (SBM) use among a sample of Australian adolescents.

Methods: Data came from baseline measures collected for the It's Your Move! community-based obesity prevention intervention. Questionnaire data on sociodemographics, PA, SBM and HRQoL were collected from 3,040 students (56% boys) aged 11-18 years in grade levels 7-11 in 12 secondary schools.

Splash!: a prospective birth cohort study of the impact of environmental, social and family-level influences on child oral health and obesity related risk factors and outcomes.

Background: Dental caries (decay) is the most prevalent disease of childhood. It is often left untreated and can impact negatively on general health, and physical, developmental, social and learning outcomes. Similar to other health issues, the greatest burden of dental caries is seen in those of low socio-economic position.

Associations between activity-related behaviours and standardized BMI among Australian adolescents.

Objectives: To examine the relationships between physical activity, sedentary behaviour and body mass index (BMI) among a sample of Australian adolescents.

Methods: Anthropometric, demographic and behavioural data were collected from students (n=3040 mean age 14.6, 44% female) from 12 secondary schools in South West Victoria, Australia (response rate=48.

Government food service policies and guidelines do not create healthy school canteens.

Objective: In 2006, the Victorian Government adopted the School Canteens and other school Food Services (SCFS) Policy that bans the sale of sweet drinks and confectionary and recommends the proportions of menu items based on a traffic light system of food classification. This study aims to determine whether compliance with the policy improves the nutritional profile of the menus.

Methods: Items from food service menus were assessed for compliance with the SCFS policy and categorised as 'everyday' ('green'), 'select carefully' ('amber') or 'occasionally' ('red') (n=106).

Decreasing trends in overweight and obesity among an Australian population of preschool children.

Background: After several decades of increasing prevalence, recent evidence suggests a levelling of obesity rates in some groups, although little is known about trends in children under 5 years of age.

Aim: To investigate the prevalence, trends and sociodemographic correlates of overweight and obesity in Australian preschool children between 1999 and 2007.

Methods: Child anthropometric and demographic data were extracted from records of routine maternal and child health consultations for children aged 2 and 3.