To determine whether the ‘Read for Nutrition’ programme would increase liking and consumption of broccoli (a target vegetable) in preschool children and test acceptability and practicality of the programme.

Pilot pre-post intervention study, where childcare teachers received training and coaching followed by reading the book ‘Monsters Don’t Eat Broccoli’ multiple times with the children during a three-week intervention.

Five classrooms of Educare, Lincoln, Nebraska in 2018.

Sixty-nine (11 to 16 children per classroom) preschool-aged children and sixteen teachers (minimum, three per classroom).

Average total consumption of broccoli increased 35 % (0·14 ounces or 0·05th cup) after the ‘Read for Nutrition’ programme (t = 2·66; P = 0·01; 95 % CIs (0·035, 0·246)) for all children. Proportional consumption increased for children who received ≥ five exposures to the book (t46 = 2·77; P = 0·008). Exposures to the book predicted proportional consumption (β = 0·365; P = 0·002). Liking of broccoli increased (W69 = 2·2, P = 0·03) as well. Teachers rated the programme as acceptable, practical and enjoyable to children and to themselves.

Programmes such as ‘Read for Nutrition’ have the potential to improve children’s vegetable liking and consumption in early care and education settings with only book readings and no exposure to a real vegetable.

To investigate (i) changes in stakeholder commitment and (ii) perceptions of the purpose, challenges and benefits of healthy food and beverage provision in community sports settings during the stepwise implementation of a healthy beverage policy.

Convergent, parallel, mixed-methods design complemented (i) repeat semi-structured interviews with council stakeholders (n 17 interviews, n 6 interviewees), with (ii) repeat quantitative stakeholder surveys measuring Commitment to Organisational Change; (iii) weekly sales data examining health behaviour and revenue effects (15 months pre-intervention; 14 months post-intervention); (iv) customer exit surveys (n 458); and (v) periodic photographic audits of beverage availability. Interviews were analysed inductively. Stakeholder surveys, sales data, customer surveys and audits were analysed descriptively.

Four local government-owned sports and recreation centres in Melbourne, Australia, completed a 3-month trial to increase the availability of healthy beverages and decrease the availability of unhealthy beverages in food outlets.

Interviews were conducted with council managers and those involved in implementation (September 2016–October 2017). Customers were surveyed (September–October 2017).

Interviews and surveys indicated that stakeholders’ commitment to policies varied such that, over time, optimism that changing beverage availability could increase the healthiness of customers’ purchases became more widespread among interviewees. Stakeholder focus generally progressed from anticipatory concern to solutions-focused discussions. Sales, audit and customer survey data supported interview findings.

We found a general increase in optimism regarding policy outcomes over time during the implementation of a healthy beverage policy. Stepwise trials should be further explored as an engagement tool within community retail settings.

To evaluate the impact of a preschool-based nutrition education programme consisting of twelve ‘hands on’ nutrition education lessons delivered during the school year on young children’s willingness to consume fruits and vegetables.

Quasi-experimental, pre-post design including the collection of plate waste evaluation data at the start and end of the 2015–2016 school year within two groups: (1) randomly selected classrooms receiving the intervention and (2) within conveniently sampled preschool classrooms not receiving the intervention serving as a comparison group.

Centre-based preschool programmes serving low-income families in the Denver metro area.

Three- to five-year-old children in preschool classrooms participating in the intervention during the 2015–2016 school year (n 308) and children enrolled in comparison classrooms (n 215).

Repeated-measures logit models assessed whether increases in the odds of consuming small samples of fruits and vegetables between Time 1 (pre-intervention) and Time 2 (post-intervention) were different for children within the intervention group compared with the comparison group. Analyses showed that the change over time in consumption of the three vegetable samples varied by intervention status with greater change occurring among children within the intervention group (edamame: P = 0·001; cauliflower: P ≤ 0·0001 and red pepper: P ≤ 0·0001). Unlike vegetables, the change over time in consumption of the two fruit samples was not different between children within the intervention and comparison groups.

An experiential-learning nutrition education programme can positively influence eating behaviours of low-income preschoolers in a centre-based setting by increasing willingness to consume vegetables.

To identify the features of a nutrition education programme for disadvantaged adults deemed most attractive and useful by participants.

A two-year, multi-method, qualitative evaluation of pre and post data collected from programme participants. Data were imported into NVivo10 for coding to facilitate a thematic analysis.

Western Australia.

Individuals attending the Western Australian FOODcents nutrition education programme that is designed to provide knowledge and skills needed to consume a healthy diet on a budget. Focus groups were conducted several weeks after course completion (five groups, forty-seven participants), observations were conducted during FOODcents sessions (thirty-one observation episodes, 237 participants), and open-ended questions were asked in pre–post hard-copy surveys administered in sessions (n 927) and an online survey administered on average six weeks after course completion (n 114).

The course attributes that were found to be especially important to participants were: (i) user-friendly, practical information that could be immediately translated to their daily lives; (ii) experiential learning that involved direct contact with food products; and (iii) opportunities for social interaction. These aspects of nutrition education were described as being highly influential in the decision to participate in the course, the application of the information in their subsequent food purchase and preparation activities, and their word-of-mouth communications with others about the course.

Incorporating aspects of most importance to participants into nutrition education programme delivery and promotion may increase joining rates, enjoyment, satisfaction with course content and, ultimately, the uptake of recommended behaviours.

To evaluate the effectiveness of an Interprofessional Education (IPE) programme in eating disorders for mental health practitioners using a case-based learning approach.

A total of 25 mental health clinicians were asked to evaluate their IPE programme as part of training for the National Clinical Programme in Eating Disorders. They completed a Readiness for Interprofessional Learning Scale (RIPLS), a learner reaction questionnaire after each session and a final open evaluation at 4 months. Non-parametric statistical analysis was employed to analyse learner attitudes and reactions, and qualitative information was coded.

A total of 23 (92%) clinicians from five disciplines participated. Baseline attitudes towards IPE were positive on all RIPLS subscales, and those with prior IPE experience had most positive views as to its benefits for teamwork and patient care (p=0.036). Learner reactions on content, delivery, outcome and structure indicated that individual learning experience was strongly positively endorsed. Change in clinical practice behaviour was reported in terms of communication, clinical activity, outcome evaluation and confidence. Barriers included other demands on time, organisational support, not having enough patients or co-workers to practice skills, and knowledge differentials between learners.

IPE using a case based learning approach is an effective and acceptable means of developing specialist training across existing service, team and professional boundaries. It has potential for positive impact on knowledge, clinical behaviour and service delivery. Recommendations include the introduction of IPE group guidelines, wider circulation of learning points and content, and the use of self-competency ratings and reflective logs.

For more than 20 years, the FOODcents adult nutrition education programme has been delivered to Western Australians. The aim of the programme is to provide disadvantaged individuals with the knowledge, skills and motivation to buy healthy foods on a limited budget. The present study evaluated whether the FOODcents curriculum and the way it is delivered are effective in improving participants’ nutrition-related knowledge and behaviours.

Evaluation data were collected via in-session pre–post questionnaires and a post-course online questionnaire.

Western Australia.

Data were collected from participants attending just over one-half (54 %) of the FOODcents courses conducted over the two-year evaluation period. In total, 927 course participants provided usable data.

After exposure to the course, respondents demonstrated an improved ability to: (i) categorize foods according to the frequency with which they should be consumed and the proportion of the food budget that should be allocated to them; (ii) correctly interpret nutrition labels on food products; and (iii) appreciate the link between diet/obesity and a range of diseases. Improvements in the latter were especially pronounced among participants of low socio-economic status. In terms of behaviour change, significant improvements in fruit and vegetable consumption were reported, along with reductions in the consumption of fast food. Participants of low socio-economic status reported the greatest changes.

The results indicate that the FOODcents nutrition education programme improves participants’ nutrition-related knowledge and behaviours.

To examine behavioural intention to reduce soda consumption after exposure to the Choose Health LA ‘Sugar Pack’ campaign in Los Angeles County, California, USA.

A cross-sectional street-intercept survey was conducted to assess knowledge, attitudes, health behaviours and behavioural intentions after exposure to the ‘Sugar Pack’ campaign. A multivariable regression analysis was performed to examine the relationships between the amount of soda consumed and self-reported intention to reduce consumption of non-diet soda among adults who saw the campaign.

Three pre-selected Los Angeles County Metro bus shelters and/or rail stops with the highest number of ‘Sugar Pack’ campaign advertisement placements.

Riders of the region’s Metro buses and railways who were the intended audience of the campaign advertisements.

The overall survey response rate was 56 % (resulting n 1041). Almost 60 % of respondents were exposed to the advertisements (619/1041). The multivariable logistic regression analysis suggested that the odds of reporting intention to reduce soda consumption among moderate consumers (1–6 sodas/week) were 1·95 times greater than among heavy consumers (≥1 soda/d), after controlling for clustering and covariates. Respondents with less than a high-school education and who perceived sugary beverage consumption as harmful also had higher odds; in contrast, respondents aged ≥65 years had lower odds.

Results suggest that future campaigns should be tailored differently for moderate v. heavy consumers of soda. Similar tailoring strategies are likely needed for younger groups, for those with less educational attainment and for those who do not perceive consumption of soda as harmful.

To evaluate the impact of the Baby-Friendly Hospital Initiative (BFHI) on breast-feeding initiation and duration overall and according to maternal education.

Quasi-experimental study using data from five states (Alaska, Maine, Nebraska, Ohio, Washington) that participated in the Pregnancy Risk Assessment Monitoring System from 1999 to 2009. Using differences-in-differences models that included year and hospital fixed effects, we compared rates of breast-feeding initiation and duration (any and exclusive breast-feeding for ≥4 weeks) before and after BFHI accreditation between mothers who gave birth in hospitals that were accredited or became accredited and mothers from matched non-BFHI facilities. We stratified analyses into lower and higher education groups.

Thirteen BFHI hospitals and nineteen matched non-BFHI facilities across five states in the USA.

Mothers (n 11 723) who gave birth in BFHI hospitals and mothers (n 13 604) from nineteen matched non-BFHI facilities.

Although we did not find overall differences in breast-feeding initiation between birth facilities that received BFHI accreditation compared with non-Baby-Friendly facilities (adjusted coefficient = 0·024; 95 % CI −0·00, 0·51), breast-feeding initiation increased by 3·8 percentage points among mothers with lower education who delivered in Baby-Friendly facilities (P = 0·05), but not among mothers with higher education (adjusted coefficient = 0·002; 95 % CI −0·04, 0·05). BFHI accreditation also increased exclusive breast-feeding for ≥4 weeks by 4·5 percentage points (P = 0·02) among mothers with lower education who delivered in BFHI facilities.

By increasing breast-feeding initiation and duration among mothers with lower education, the BFHI may reduce socio-economic disparities in breast-feeding.

As part of a larger evaluation of school nutrition programmes (SNP), the present study examined programme coordinators’ perceptions of strengths, weaknesses, opportunities and threats (SWOT) regarding their SNP and public health professionals’ support.

Qualitative interviews were conducted with twenty-two of eighty-one programme coordinators who had completed a programme evaluation survey. Interviews followed a SWOT framework to evaluate programmes and assessed coordinators’ perceptions regarding current and future partnerships with public health professionals.

The study was conducted in a large, urban region within Ontario.

The twenty-two coordinators who participated represented a cross-section of elementary, secondary, Public and Catholic schools.

SNP varied enormously in foods/services offered, how they offered them and perceived needs. Major strengths included universality, the ability to reach needy students and the provision of social opportunities. Major weaknesses included challenges in forming funding partnerships, lack of volunteers, scheduling and timing issues, and coordinator workload. Common threats to effective SNP delivery included lack of sustainable funding, complexity in tracking programme use and food distribution, unreliable help from school staff, and conflicts with school administration. Opportunities for increased public health professionals’ assistance included menu planning, nutrition education, expansion of programme food offerings, and help identifying community partners and sustainable funding.

The present research identified opportunities for improving SNP and strategies for building on strengths. Since programmes were so diverse, tailored strategies are needed. Public health professionals can play a major role through supporting menu planning, food safety training, access to healthy foods, curriculum planning and by building community partnerships.