Rebecca Anne Perry

Issue Addressed: Research has trialled many initiatives to support caregivers to shape young children's health behaviours. However, translating evidence to public health practice and policy is a challenge, in part due to access to such evidence. We aimed to co‐design a child health evidence dashboard, and to understand the expected enablers and barriers to use of the dashboard with next‐users (e.g., Australian child service managers, program planners). Methods: Using an integrated knowledge translation approach, we conducted a mixed‐methods study involving five online co‐design workshops. Next‐users were invited to participate in the workshops and completed pre‐ and post‐workshop surveys. Pragmatic data analysis occurred after each workshop to identify next‐user requirements and inform iterative dashboard development alongside workshops. Results: 15 next‐users participated in the workshop series (median of 9 per workshop). Next‐user preferences were categorised into desired uses, content, features and functionality, and design for the dashboard. Key enablers to use of the dashboard included relevance, promotion and credibility of the dashboard, positive user experience, time and resources to support use of the dashboard. Conclusions: We identified what and how next‐users want evidence on child health initiatives to inform policy and practice. Findings enabled development of an initial evidence dashboard prototype informed by next‐user preferences. Understanding the enablers and barriers to using and engaging with the dashboard will inform ongoing development and implementation.

Summary: Background: The PEACH™ randomized controlled trial measured changes to children's food and activity behaviours following participation in a weight management programme. We have previously reported a 10% reduction in body mass index z‐score at intervention end (6‐month post‐baseline) that was maintained to 24 months with no further intervention for the full study sample.Objectives: The objective of the study is to report changes in food and activity outcomes in the full sample at (i) the end of the 6‐month intervention and (ii) 24‐month post‐baseline (18‐month post‐intervention).Methods: Changes in dietary and activity outcomes were assessed over time (baseline: n = 169, 8.1 ± 1.2 years, body mass index z‐score 2.72 ± 0.62). Dietary intake was assessed using the Child Dietary Questionnaire, and times spent active and sedentary were assessed using a study‐specific questionnaire. Linear mixed models were used.Results: There were significant time effects for all Child Dietary Questionnaire scores and activity and sedentary behaviours in the expected direction. Significant sex effects were observed for fruit and vegetable and sweetened beverages scores and for time spent in small screen‐based activity.Conclusions: This is one of few child weight management studies to report short‐term and long‐term behaviour outcomes. It demonstrates that an intervention promoting food and activity behaviours consistent with guidelines can achieve modest changes, mediating improvements in relative weight.

Internationally, childhood obesity is a major public health concern. Given the established difficulties in treating obesity, designing and evaluating effective obesity prevention interventions are research priorities. As parents play a crucial role in establishing positive health behaviours in children, they are a key target for child obesity prevention programs. However, recruiting and engaging parents in such interventions can be a considerable challenge for researchers and practitioners. Members of the ‘Parenting, Child Behaviour and Well-being’ stream of the Australasian Child and Adolescent Obesity Research Network (ACAORN) have considerable and varied expertise in conducting such interventions and can provide insights into addressing these challenges. This paper aims to highlight considerations regarding the design, implementation, and evaluation of obesity prevention interventions with families and provide practical insights and recommendations for researchers and practitioners conducting family-based research in this area. Case studies of three family-based interventions conducted by ACAORN members are highlighted to provide examples and contextualise the recommendations proposed.

Food neophobia, the rejection of unknown or novel foods, may result in poor dietary patterns. This study investigates the cross-sectional relationship between neophobia in children aged 24 months and variety of fruit and vegetable consumption, intake of discretionary foods and weight. Secondary analysis of data from 330 parents of children enrolled in the NOURISH RCT (control group only) and SAIDI studies was performed using data collected at child age 24 months. Neophobia was measured at 24 months using the Child Food Neophobia Scale (CFNS). The cross-sectional associations between total CFNS score and fruit and vegetable variety, discretionary food intake and BMI (Body Mass Index) Z-score were examined via multiple regression models; adjusting for significant covariates. At 24 months, more neophobic children were found to have lower variety of fruits (β = −0.16, p = 0.003) and vegetables (β = −0.29, p < 0.001) but have a greater proportion of daily energy from discretionary foods (β = 0.11, p = 0.04). There was no significant association between BMI Z-score and CFNS score. Neophobia is associated with poorer dietary quality. Results highlight the need for interventions to (1) begin early to expose children to a wide variety of nutritious foods before neophobia peaks and (2) enable health professionals to educate parents on strategies to overcome neophobia.