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: Objective: Local governments (LGs) often own or manage sport and recreation facilities and can promote health in these settings by implementing healthy food policies. The primary aim of this study was to assess the policies, attitudes and practices of Australian LGs relating to obesity prevention and the provision of healthy food in this setting. Methods: In July 2020, all 539 Australian LGs were invited to complete a survey. We assessed LG priorities to obesity prevention, promoting healthy eating and public health as well as the presence of healthy food policies in sporting facilities. Results: 203 (38%) LGs completed the survey. Improving public health was a high priority, while obesity prevention and promoting healthy eating were a medium priority. 22% of LGs reported that the priority given to promoting healthy food had increased over the previous year and stayed the same at 65%. Ten per cent of LGs had a healthy food and drink policy in sporting facilities, with 32% reporting having made changes without a policy. LGs located in major cities, with larger populations and with more facilities reported having made more healthy changes at their facilities. Conclusion: Promoting health is a priority for LGs across Australia, but very few have policies relating to the food environments in their sporting facilities. Implications for public health: Ongoing monitoring is important to assess changes over time and identify LGs where greater support is required., The food we eat is strongly influenced by our environment.[sup.1] Sport and recreation facilities are a key setting for children and adults seeking to improve their health through physical activity, [...]

Bold and comprehensive action is needed to prevent diet-related diseases in rural areas, which includes improving food environments to enable healthier dietary practices. Rural health services are integral to the health of rural populations, yet their role in community disease prevention is not swell understood. This study sought to understand health service, local government, and food outlet stakeholders' perspectives on (1) the drivers of unhealthy retail environments in a rural setting; (2) the role of rural health services in supporting changes in local food environments; and to (3) identify characteristics of potential interventions. Two Group Model Building workshops were held with health service and local government leaders (n = 9), and interviews were conducted with local food outlet participants (n = 13). Key themes included 'enablers to healthier food environments', 'barriers to healthier food environments', 'Rural health services are a leading broker of knowledge for healthy food environments', and 'characteristics of desirable healthy food environment interventions.'. Rural health services can play a key role in addressing the current barriers to healthy food environments in rural areas. Effective promotion of healthier diets in rural populations will require consideration of key stakeholder perspectives and the development of further evidence on the role that rural health services can play in improving the healthiness of food environments. [ABSTRACT FROM AUTHOR]

School nutrition policies that aim to address unhealthy diets have been introduced in many countries. This systematic review aimed to synthesize the international literature to determine the impact (overall and by socioeconomic position [SEP]) of primary school nutrition policies on the availability of foods and beverages in schools. Seven databases were searched using keywords and medical subject headings related to nutrition policies and schools. Studies that reported on the impact of implemented school nutrition policies on food and beverage availability within primary schools were included. Eighteen studies (reported across 20 papers) were included. Fifteen of the included studies reported some positive impacts of policies, including increased availability of healthier foods and decreased availability of less healthy foods. Five studies focused specifically on schools in low-income communities and a further three specifically compared schools by SEP, with mixed findings. Two studies reported on factors influencing policy implementation, reporting a lack of financial resources as a barrier to schools offering a wider selection of healthy foods and additional school resources as increasing the likelihood of offering healthy foods. School nutrition policies appear to be effective at improving the healthiness of foods and beverages available at schools. Furthermore, the results suggest that well-implemented school nutrition policies that improve the healthiness of foods available are unlikely to exacerbate the socioeconomic gradient of poor nutrition. However, the number of studies that reported results by SEP limits drawing strong conclusions regarding equity impacts and we strongly recommend further studies analyze their findings according to SEP. [ABSTRACT FROM AUTHOR]

Background: The potential role of the food and beverage industry in addressing diet-related disease is much debated, particularly amidst evidence of the targeted strategies, including voluntary self-regulation, used by the industry to influence policy in their favour. At the same time, the need for more comprehensive action to address unhealthy diets has led to a focus on increasing the accountability of different stakeholders. However, there has been limited evaluation of the impact of accountability initiatives on food and beverage company policies and practices. This study evaluated the impact of the BIA-Obesity (Business Impact Assessment -- Obesity and population nutrition) Australia Initiative that benchmarked major Australian food and beverage companies on their nutrition-related policies. Methods: Evaluation was conducted against the pre-specified logic model for BIA-Obesity and established frameworks for analysing organisational change and corporate political activity. Outcomes evaluated included company engagement with the Initiative, level of media coverage, and impact of the Initiative on company policies and practices based on the perspectives of company representatives. A mixed methods design was employed, including surveys and in-depth interviews with company representatives, and media reports. Results: Approximately half of invited companies participated in the evaluation of the BIA-Obesity Australia Initiative. A number of company representatives indicated that the Initiative had influenced their company's nutrition policies, strategies, and disclosure practices, and had raised their company's awareness of the importance of addressing nutrition issues. Conclusion: Company representatives perceive benchmarking and accountability initiatives as helpful for provoking improvements in nutrition-related policies and practices in their companies. However, the benefits of these initiatives need to be assessed in the context of the broader political and economic environment. Whilst the focus of accountability initiatives, such as BIA-Obesity, are on industry self-regulation efforts, they can also play an important role in drawing attention to the need for increased government regulation. [ABSTRACT FROM AUTHOR]

Context Globally, the use of labels or signage targeting SSBs remains in its infancy and there is limited evidence available regarding its ability to decrease purchase and consumption of SSBs. Objective This systematic review aimed to synthesize the evidence on the effect of sugar- or health-related sugar-sweetened beverage (SSB) warning labels or signage on knowledge, attitudes, and beliefs, and SSB purchase and consumption. Data sources Nine databases – Ovid Medline, Emerald Insight, Scopus, Informit, Business Source Complete, CINAHL, Global Health, PsychINFO, and SocIndex – were searched along with grey literature from inception to December 2019. The PRISMA guidelines were applied for reporting this systematic review. Study Selection Studies examining the impact of front of pack (FOP) labels and/or point of sale (POS) signage highlighting added sugar content or its health risks were included. Data extraction Two authors independently extracted data on items, including study details, study design, population characteristics, intervention label details (type, duration, and settings), and outcomes measures. The Effective Public Health Practice Project tool was used to assess the study quality. Data analysis Findings were synthesized narratively. Results Twenty-one studies published between 1992 and 2019 were included. Of these, 16 studies examined the impact of FOP labels and 5 studies examined the impact of POS signage. Both FOP labels and POS signage were associated with improved health knowledge, attitudes, and beliefs regarding SSBs and reduced SSB purchases. Warning labels with diet-related health consequences were found to be particularly effective. Overall quality of studies was assessed as mixed. Conclusion Health- or sugar-related FOP labels and POS signage for SSBs are promising public health measures and may improve consumers' health behaviors toward reduced SSB purchase and consumption. [ABSTRACT FROM AUTHOR]

Objectives: 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.Design: 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.Setting: 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.Participants: Interviews were conducted with council managers and those involved in implementation (September 2016-October 2017). Customers were surveyed (September-October 2017).Results: 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.Conclusions: 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. [ABSTRACT FROM AUTHOR]

This study aimed to pilot the feasibility, acceptability and effectiveness of three co-developed healthy food and beverage pricing interventions in a community retail setting. Aquatic and recreation centres in Victoria, Australia were recruited to co-develop and pilot pricing interventions within their onsite cafés, for 15 weeks from January 2019. A mixed method intervention evaluation was conducted. Interviews were conducted with food retail managers to understand the factors perceived to influence implementation, maintenance and effectiveness. Customer surveys assessed support for, and awareness of, interventions. Interrupted time series analysis estimated the impact of pricing interventions on food and beverage sales. Three centres each implemented a unique intervention: (i) discounted healthy bundles ('healthy combination deals'), (ii) offering deals at specific times of the day ('healthy happy hours') and (iii) increasing the prices of selected unhealthy options and reducing the prices of selected healthier options ('everyday pricing changes'). Café team leaders did not identify any significant challenges to implementation or maintenance of interventions, though low staff engagement was identified as potentially influencing the null effect on sales for healthy combination deals and healthy happy hours interventions. Customers reported low levels of awareness and high levels of support for interventions. Everyday pricing changes resulted in a significant decrease in sales of unhealthy items during the intervention period, though also resulted in a decrease in café revenue. Co-developed healthy food and beverage pricing interventions can be readily implemented with broad customer support. Everyday pricing changes have demonstrated potential effectiveness at reducing unhealthy purchases. [ABSTRACT FROM AUTHOR]