Bridget Kelly’s research while affiliated with University of Wollongong and other places

Background Encouraging healthy eating and physical activity in children has long-term benefits for their health and development, however many do not meet the requirements for fruit and vegetable consumption, or physical activity. Experiential learning (EL) has been shown to improve children’s healthy eating and physical activity-related knowledge, attitudes, and behaviour. Children’s museums provide opportunities for hands-on EL activities that can engage families. This study examined stakeholder perspectives on the perceived feasibility, acceptability, fidelity and impact of an EL health-promoting program in a children’s museum. Methods A qualitative case study was conducted at the Early Start Discovery Space, a university-based children’s museum, in Australia. The study involved implementing a 4-week Healthy Living program comprising EL activities related to food and movement for children aged 0–10 years. Perceived feasibility, acceptability, fidelity and impact were assessed through focus groups and observations. Focus groups (23 participants, 17 caregivers and 6 museum staff) were conducted post-implementation. Focus groups were audio-recorded, transcribed verbatim and analysed using thematic analysis. 15 HL sessions were observed throughout implementation. Results Stakeholders perceived that the HL program was feasible and acceptable. As a result of consultation between researchers and museum staff, the HL program was easily implemented in the museum. Stakeholders suggested that children and their carers enjoyed the HL activities and were engaged in the HL activities. Aspects of fidelity were explored and showed that most sessions were delivered as intended, however, the delivery of the key messages was suboptimal. Perceived changes in children’s knowledge, attitudes behaviour relating to healthy eating and physical activity were minimal. Conclusions Key stakeholders (museum staff and caregivers) provided insights regarding perceived feasibility and acceptability of the HL program delivered in the children’s museum. Preliminary findings highlight the potential of children’s museums as a setting for EL health eating and physical activity programs. Further, this study highlights the significance of stakeholder engagement, collaboration, and incorporation of hands-on and enjoyable activities to promote healthy habits in children. Future studies, with larger sample sizes, should be conducted to extend the results from this study.

Food and physical activity environments in family day care can be improved to better support healthy behaviors. A 6-month two-arm parallel randomized controlled trial evaluated the effectiveness of a web-based tool to promote healthier practices through quality improvement planning among Australian service providers and their educators. Service providers were randomized 1:1 into the intervention group (using the tool for a minimum of 1 month alongside regular quality improvement plan processes) and control group (regular quality improvement plan processes). The primary outcome of change in the quality of the improvement plan (in relation to the incorporation of healthy practices) was assessed using a checklist designed specifically for the study. Secondary outcomes were self-ratings of awareness and knowledge of various topics assessed using a 5-point Likert-type scale. Eight service providers and 22 educators participated (four service providers and 10 educators in the intervention group; four service providers and 12 educators in the control group). Intention-to-treat analyses found significant change in quality of the revised improvement plan for the intervention group. The intervention group showed an increase in self-rated awareness and knowledge on healthy practices and National Quality Standards, and confidence in identifying priority areas. This is the first-known web-based tool designed specifically for family day care to promote healthier practices. There are several opportunities for the tool to be embedded in practice, including delivery of the tool as part of support programs or training. This trial is registered with Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12623000369628.

The objective of this study was to examine associations between children’s exposure to food marketing and their liking, purchase and consumption of unhealthy foods in Thailand. A face-to-face cross-sectional survey was conducted with a nationally representative sample of 4,117 Thai children aged 6–18 years. Ordinal logistic regression models were applied to determine the association between marketing exposures and liking, purchase and consumption of unhealthy foods. Of all children, 78.8% reported seeing cartoons on food packaging in the past week, while 72.5% had seen a celebrity or online influencer endorses a product. Most children (84%) reported being exposed to marketing for unhealthy foods through social media in the past week. Exposure to unhealthy food marketing was positively associated with children’s preferences for, and purchases and intakes of, unhealthy foods. Comprehensive regulations are required in Thailand to limit children’s exposure to, and the persuasive power of, unhealthy food marketing.

Issue Addressed Nutrition and physical activity practices in Australian family day care are suboptimal. A web‐based tool was co‐developed with family day care service providers and educators, health promotion staff and the New South Wales Ministry of Health to promote healthier nutrition and physical activity practices through an existing quality improvement process. Methods Formative evaluation was conducted in January–February 2023. An online survey included 13 questions relating to content, language, structure, ease of usage and participant satisfaction. Questions used Likert scales to rate participants' experience from poor to excellent. Tool usage data were extracted from the website to reflect user activity. Service providers ( n = 3) and educators ( n = 9) tested the tool for 4 weeks. Results Survey questions were grouped into measures of perceived convenience, difficulty and helpfulness. All participants chose a rating of ‘good’ or ‘excellent’ across all questions, with a higher proportion of participants rating the questions as ‘excellent’. All participants used the tool at least once. Perceived value of research was the main theme that emerged from the open text feedback. Conclusions Results suggest that the tool was feasible, easy to use and relevant to practice. So What? This is the first known tool designed for family day care to promote healthier nutrition and physical activity practices through an existing quality improvement process to implement change. An efficacy trial will follow to evaluate effectiveness. The tool is predicted to serve as a platform for identifying gaps between policy and practice and for facilitating practice improvements.

Objective To characterize the nature of digital food and beverage advertising in Singapore Setting Food and beverage advertisements within 20 clicks on top 12 non-food websites and all posts on Facebook and Instagram pages of 15 major food companies in Singapore were sampled from January 1 to June 30, 2018. Design Advertised foods were classified as being core (healthier), non-core or mixed-dishes (example burger) using the WHO nutrient profile model and national guidelines. Marketing techniques were assessed using published coding frameworks. Participants: NA Results Advertisements (n=117) on the 12 non-food websites were largely presented as editorial content. Food companies posted twice weekly on average on social media sites (n=1261), with eatery-chains posting most frequently and generating largest amount of likes and shares. Key marketing techniques emphasized non-health attributes for example hedonic or convenience attributes (85% of advertisements). Only a minority of foods and beverages advertised were core foods (non-food website:16.2%; social media: 13.5%). Conclusions Top food and beverage companies in Singapore actively use social media as a platform for promotion with a complex array of marketing techniques. A vast majority of these posts were unhealthy highlighting an urgent need to consider regulating digital food and beverage advertising in Singapore.

Issue Addressed Munch & Move is a New South Wales (NSW) Ministry of Health program offering family day care (FDC) educators training to support children's healthy behaviours. This study examined educators' nutrition, physical activity and screen time practices and relationships between Munch & Move training and professional development (PD) on these practices. Methods NSW FDC educators ( n = 186) completed an online survey from July 2020–June 2021. Differences between groups based on Munch & Move training (trained; not trained) and PD (those who completed PD ≥1 time per year; those who completed PD <1 time per year or never) were tested using bivariate analyses. Results A significantly higher proportion of educators trained in Munch & Move offered information to families regarding food serving sizes, nutrition policies, and children's physical activity and screen time. Over one‐third in both groups did not meet the guideline of no screen time for children under 2 years old. Compared with those who completed PD ≥1 time per year, a significantly higher proportion of educators who completed PD <1 time per year or never did not provide families with nutrition guidelines or resources. Conclusions Educators trained in Munch & Move , and those who completed PD more frequently, demonstrated better nutrition, physical activity and screen time practices in several areas. So What? This study demonstrated benefits of the Munch & Move program, implemented with support from Local Health District health promotion officers, and highlighted key areas for improvement in healthy practices in FDC.