BackgroundChildren of low socioeconomic position (SEP) generally have poorer diets than children of high SEP. However there is no consensus on which SEP variable is most indicative of SEP differences in children’s diets. This study investigated associations between diet and various SEP indicators among children aged 9–13 years.MethodFamilies (n = 625) were recruited from 27 Adelaide primary schools in 2010. Children completed semi-quantitative food frequency questionnaires providing intake scores for fruit, vegetables, non-core foods, sweetened drinks, and healthy and unhealthy eating behaviours. Parents reported demographic information by telephone interview. Differences in dietary intake scores were compared across parental education, income, occupation, employment status and home postcode.ResultsAcross most SEP indicators, lower SEP was associated with poorer dietary outcomes, including higher intake of non-core foods and sweetened drinks, and more unhealthy behaviours; and lower intake of fruit and vegetables, and fewer healthy behaviours. The number and type of significant SEP-diet associations differed across SEP indicators and dietary outcomes. Mother’s education appeared most frequently as a predictor of children’s dietary intake, and postcode was the least frequent predictor of children’s dietary intake.ConclusionSocioeconomic gradients in children’s dietary intake varied according to the SEP indicator used, suggesting indicator-specific pathways of influence on children’s dietary intake. Researchers should consider multiple indicators when defining SEP in relation to children’s eating.

Both rural men and rural women report more barriers to help seeking for mental health issues than physical health issues across a range of domains. There is a need to educate the current and future rural health and mental health workforce about these barriers and to encourage them to test evidence-based strategies to address them, in particular to facilitate more widespread mental health help-seeking in rural Australia.

Purpose This research describes and evaluates the co-creation of a programme called “A Healthy Choice”. Underpinned by design thinking (DT), this study aims to improve the healthfulness of food choices in supermarkets among consumers to promote their well-being. Design/methodology/approach The research features two studies. Study 1 included five co-design workshops with consumers and staff (n = 32) to develop a consumer-centred programme. The findings supported the design and implementation of a programme evaluated in Study 2 (an ecological trial). The programme modified a supermarket environment to increase the prominence of healthier products (shelf-talkers and no discount), ran positive food experiences (cooking and label reading workshops) and was supported by a community-wide information campaign in social and local print media. Findings A total of 15 new strategies were developed by consumers and staff to support health and well-being in supermarkets. Feasibility discussions and staff voting contributed to the development and storewide implementation of the programme. Evaluation showed that the programme was effective in increasing consumer knowledge of healthier food choices (measured via public survey). Sales analysis showed mixed results; sales increased for promoted products in some categories, but there was no effect in others. Research limitations/implications Given the real-world setting in which this programme and its evaluation were conducted, there were several innate limitations. The co-design process generated many more ideas than could be implemented, thus creating a healthy “pipe line” for the next iterations of the programme. Practical implications The key contribution of this work to supermarket intervention literature is the recommendation to change the paradigm of engagement between the key stakeholders who are typically involved in supermarket programs. Using the co-design and DT frameworks, the authors offer an example of stakeholders working together in close partnership to co-design and collaboratively implement a programme that promotes healthier choices. Originality/value This project contributes to the emerging body of empirical work using DT principles in the area of healthy food choices in supermarkets. A rigorously designed evaluation of a co-designed supermarket programme contributes to scholarly evidence on food well-being programs in supermarkets.

ObjectiveThe purpose of the current study was to examine associations of individual and aggregated screen-based behaviours, and total sitting time, with healthy and unhealthy dietary intakes among adolescents.DesignCross-sectional study of adolescents. Participants self-reported durations of television viewing, computer use, playing electronic games (e-games), total sitting time, daily servings of fruits and vegetables, and frequency of consumption of sugar-sweetened beverages (SSB), diet beverages, fast foods and discretionary snacks. Logistic regression models were conducted to identify associations of screen-based behaviours, total screen time and total sitting time with dietary intakes.SettingVictoria, Australia.SubjectsAdolescents (n 939) in School Year 11 (mean age 16·8 years).ResultsThe results showed that watching television (≥2 h/d) was positively associated with consuming SSB and diet beverages each week and consuming discretionary snacks at least once daily, whereas computer use (≥2 h/d) was inversely associated with daily fruit and vegetable intake and positively associated with weekly fast-food consumption. Playing e-games (any) was inversely associated with daily vegetable intake and positively associated with weekly SSB consumption. Total screen (≥2 h/d) and sitting (h/d) times were inversely associated with daily fruit and vegetable consumption, with total screen time also positively associated with daily discretionary snack consumption and weekly consumption of SSB and fast foods.ConclusionsIndividual and aggregated screen-based behaviours, as well as total sitting time, are associated with a number of indicators of healthy and unhealthy dietary intake. Future research should explore whether reducing recreational screen time improves adolescents’ diets.

Purpose: People affected by cancer who live in rural Australia experience inferior survival compared to their urban counterparts. This study determines whether self-reported physical and mental health, as well as health-promoting behaviours, also differ between rural and urban Australian adults with a history of cancer. Methods: Weighted, representative population data were collected via the South Australian Monitoring and Surveillance System between 1 January 2010 and 1 June 2015. Data for participants with a history of cancer (n= 4,295) were analysed with adjustment for survey year, gender, age-group, education, income, family structure, work status, country of birth and arealevel relative socioeconomic disadvantage (SEIFA). Results: Cancer risk factors and co-morbid physical and mental health issues were prevalent among cancer survivors regardless of residential location. In unadjusted analyses, rural survivors were more likely than urban survivors to be obese and be physically inactive. They were equally likely to experience other comorbidities (diabetes, chronic obstructive pulmonary disease, cardiovascular disease, arthritis or osteoporosis). With adjustment for SEIFA, rural/urban differences in obesity and physical activity disappeared. Rural survivors were more likely to have trust in their communities, less likely to report high/very high distress, but equally likely to report a mental health condition, both with and without adjustment for SEIFA. Conclusions: There is a need for deeper understanding of the impact of relative socioeconomic disadvantage on health (particularly physical activity and obesity) in rural settings and the development of accessible and culturally appropriate interventions to address rural cancer survivors' specific needs and risk factors.