Evaluation of the 2008 NSW water campaign.

ISSUE ADDRESSED: The consumption of soft and other sweetened drinks is an emerging nutrition issue in Australia. In 2005-6, 63% of NSW children aged between 2 and 15 years consumed sweetened drinks (soft drinks, cordials or sports drinks) weekly, 33% of which consumed at least 6 cups per week. In 2008 NSW Health implemented the 'Water Campaign' to increase the proportion of NSW children up to 15 years of age who consume water in place of sweetened drinks. METHODS: A pre-post survey study design was used to evaluate the Campaign. Two telephone surveys of stratified random samples of 500 respondents each from the primary target audience (parents and carers of children up to 15 years of age) were conducted across NSW. RESULTS: Fifty-three per cent of respondents in the post-survey said that they recalled the mass media Campaign when it was described to them compared to 19% in the pre-survey. There was an increase in parents' knowledge of the high sugar content of sweetened drinks and a decline in the reported consumption of sweetened drinks by boys. CONCLUSIONS: Though modest in size and duration, the campaign was successful in achieving a number of campaign objectives, particularly changes in parent's and carer's knowledge and awareness of water related nutrition and reduced reported consumption of sweetened drinks among boys.

Computer-tailored physical activity behavior change interventions targeting adults: a systematic review.

BACKGROUND: Increasing physical activity is important in the promotion of better health. Computer-tailored behavior change programs have shown promise in changing lifestyle risk factors. PURPOSE: To provide a narrative systematic review describing the range of evidence on 'second' and 'third' generation computer-tailored primary prevention interventions for physical activity, to determine their effectiveness and key characteristics of success. Unlike previous reviews, this review used specific criteria to measure the external validity of studies, was exclusive to primary prevention interventions in which tailoring was generated through an expert system, and excluded first generation computer-tailored interventions. METHODS: Computer-tailored intervention studies published from January 1996-2008 were identified through a search of five databases: Medline; Embase; PsycINFO; CINAHL; and All EBM Reviews and by examining reference lists of relevant articles. RESULTS: Seventeen articles were included, describing the evaluation of 16 interventions, ten of which found significant positive effects of the computer-tailored interventions on physical activity or weight reduction outcomes. CONCLUSION: The evidence of effectiveness for computer-tailored physical activity interventions is inconclusive. They have potential to reach large groups of people however there is uncertainty whether reported effects are generalizable and sustained.

Computer-tailored weight reduction interventions targeting adults: a narrative systematic review.

ISSUE ADDRESSED: Potentially modifiable risk factors such as high body mass, physical inactivity and poor nutrition are, when combined, the largest contributors to the preventable burden of disease in Australia. Computer-tailoring has shown promise in modifying lifestyle risk factors. This paper describes a narrative systematic review examining the evidence for 'second' generation computer-tailored primary prevention weight reduction interventions. METHOD: Studies published from January 1996-2008 were identified through electronic databases and searches of reference lists of relevant articles. Only randomised controlled trials or quasi-experimental designs with pretest and post-test weight reduction outcome data were included. RESULTS: Six articles were identified, three of which reported significant positive effects. The intervention intensity and duration, method of tailoring and theory used differed. The internal validity was good but external validity poor for the majority of studies. CONCLUSIONS: The evidence of effectiveness for computer-tailored primary prevention interventions for weight reduction is limited to a small number of heterogeneous studies. There is uncertainty whether reported effects are generalisable and sustained. The relative success of different components of efficacious interventions and the optimal intervention intensity and tailoring methods are unclear.

Computer-tailored dietary behaviour change interventions: a systematic review.

Improving dietary behaviours such as increasing fruit and vegetable consumption and reducing saturated fat intake are important in the promotion of better health. Computer tailoring has shown promise as a strategy to promote such behaviours. A narrative systematic review was conducted to describe the available evidence on 'second'-generation computer-tailored primary prevention interventions for dietary behaviour change and to determine their effectiveness and key characteristics of success. Systematic literature searches were conducted through five databases: Medline, Embase, PsycINFO, CINAHL and All EBM Reviews and by examining the reference lists of relevant articles to identify studies published in English from January 1996 to 2008. Randomized controlled trials or quasi-experimental designs with pre-test and post-test behavioural outcome data were included. A total of 13 articles were reviewed, describing the evaluation of 12 interventions, seven of which found significant positive effects of the computer-tailored interventions for dietary behaviour outcomes, one also for weight reduction outcomes. Although the evidence of short-term efficacy for computer-tailored dietary behaviour change interventions is fairly strong, the uncertainty lies in whether the reported effects are generalizable and sustained long term. Further research is required to address these limitations of the evidence.

Rapid versus intermediate health impact assessment of foreshore development plans.

OBJECTIVE: To describe the main differences between conducting a rapid health impact assessment (HIA) and an intermediate HIA on foreshore development plans and their feasibility from a health service perspective. METHODS: A rapid HIA and an intermediate HIA were undertaken on two foreshore development plans. RESULTS: The main differences between the two HIAs were in the identification, assessment and decision-making stages of the HIA. CONCLUSION: While the rapid HIA was less resource intensive than the intermediate HIA, there are several factors that affect the feasibility of conducting this type of HIA within a short time period.

A health impact assessment of an environmental management plan: the impacts on physical activity and social cohesion.

ISSUE ADDRESSED: This article describes a prospective health impact assessment (HIA) on a local government environmental management plan, the Shellharbour Foreshore Management Plan (SFM Plan). The health outcomes of interest were physical activity and social cohesion. METHODS: The procedures undertaken include: screening; scoping; assessment of potential health impacts; negotiation; and decision-making. The potential positive and negative health impacts of the SFM Plan were assessed and opportunities to enhance the positive and mitigate the negative were identified. RESULTS: Implementation of the SFM Plan was supported as the HIA showed a potential to benefit the health of local residents and visitors to the Shellharbour Foreshore area by increasing physical activity and social cohesion. CONCLUSION: The HIA provided a useful framework for establishing a collaborative relationship between the local government and health sector. It improved the local government's understanding of the inter-relationship between the environment and physical activity and social cohesion and enabled health authorities to have an impact on a capital works program to maximise health gain.

Food advertising on Australian television: the extent of children's exposure.

The objective of this study was to investigate the extent and nature of food advertising during Australian children's television (TV) viewing hours and programs, and to determine whether confectionery and fast food restaurant advertisements were more likely to be broadcast during children's programs than during adults' programs on Sydney television stations. One week (390 h) of Australian advertising data broadcast during children's TV viewing hours over 15 television stations were analysed to determine the proportion of food advertisements and, in turn, the proportion of those advertisements promoting foods high in fat and/or sugar. One week (346 h) of confectionery and fast food restaurant advertisements broadcast over three Sydney television stations were analysed to determine whether these types of advertisements were more likely to be advertised during children's programs than adults' programs. Half of all food advertisements promoted foods high in fat and/or sugar. 'Confectionery' and 'fast food restaurants' were the most advertised food categories during children's TV viewing hours. Confectionery advertisements were three times as likely, and fast food restaurant advertisements twice as likely, to be broadcast during children's programs than adults' programs. It can be concluded that foods most advertised during children's viewing hours are not those foods that contribute to a healthy diet for children. Confectionery and fast food restaurant advertising appears to target children. Australian children need protection from the targeted promotion of unhealthy foods on television, but currently little exists.