Australian State and Territory Eclectic Approaches to Obesity Prevention in the Early Years: Policy Mapping and Perspectives of Senior Health Officials

Abstract

BackgroundThe international increase in the prevalence of childhood obesity has hastened in recent decades. This rise has coincided with the emergence of comorbidities in childhood—such as type II diabetes, non-alcoholic fatty liver disease, metabolic syndrome, sleep apnoea and hypertension—formerly only described in adulthood. This phenomenon suggests global social and economic trends are impacting on health supportive environments. Obesity prevention is complex and necessitates both long-term and systems approaches. Such an approach considers the determinants of health and how they interrelate to one another. Investment in the early years (from conception to about 5 years of age) is a key life stage to prevent obesity and establish lifelong healthy habits relating to nutrition, physical activity, sedentary behavior and sleep. In Australia, obesity prevention efforts are spread across national and state/territory health departments. It is not known from the literature how, with limited national oversight, state and territory health departments approach obesity prevention in the early years.MethodsWe conducted a qualitative study including policy mapping and interviews with senior officials from each Australian state/territory health department. A series of questions were developed from the literature to guide the policy mapping, drawing on the World Health Organisation Ending Childhood Obesity Report, and adapted to the state/territory context. The policy mapping was iterative. Prior to the interviews initial policy mapping was undertaken. During the interviews, these policies were discussed, and participants were asked to supply any additional policies of relevance to obesity prevention. The semi-structured interviews explored the approaches to obesity prevention taken in each jurisdiction and the barriers and enablers faced for policy implementation. Thematic analysis was used to analyse the data, using NVivo software.ResultsState and territory approaches to obesity prevention are eclectic and while there are numerous similarities between jurisdictions, no two states are the same. The diversity of approaches between jurisdictions is influenced by the policy culture and unique social, geographic, and funding contexts in each jurisdiction. No Australian state/territory had policies against all the guiding questions. However, there are opportunities for sharing and collaborating within and between Australian jurisdictions to establish what works, where, and for whom, across Australia's complex policy landscape.ConclusionsEven within a single country, obesity prevention policy needs to be adaptable to local contexts. Opportunities for jurisdictions within and between countries to share, learn, and adapt their experiences should be supported and sustained funding provided.

Meta-Analysis of the Effect of Nursing Intervention on Children with Type 2 Diabetes

“…Type 2 diabetes is rare in children with diabetes, accounting for about 5% of the incidence rate of diabetes in children [23]. The disease is a chronic disease with serious clinical Computational and Mathematical Methods in Medicine harm, which seriously endangers children's daily life [24,25]. Since there is no complete cure at present, it is very important to take appropriate treatment measures to control blood glucose in the body [26].…”

Factors affecting policy implementation for childhood obesity prevention in New South Wales, Australia: policy mapping and interviews with senior officials

“…Within the NPAPH context the Ministry developed and adopted the Healthy Eating and Active Living (HEAL) Strategy 2013(NSW Ministry of Health 2013. The HEAL Strategy was identified as the key 'framework for action' to retain childhood obesity reduction as a NSW Government priority despite the loss of NPAPH funding in 2014 (Innes-Hughes et al 2019), another external event (Esdaile et al 2022a) (see supportive information file (SIF) 2.5, HEAL Strategy timeline). It was approved by the NSW Cabinet as a whole-of-government obesity prevention strategy and aimed to improve healthy lifestyle behaviours (eating and movement) in the short to medium term, with the ultimate long-term goal of preventing overweight and obesity across the population via four strategic directions (SD) outlined in Fig.…”

“…Government agency websites were searched using embedded search engines and keywords relating to each area in the policy mapping tool. Additional searches were carried out using the advanced search tool function in Google search engine to ensure comprehensiveness of included data, as described in previous studies (Esdaile et al 2019(Esdaile et al , 2022a. Bias was minimised by localising results to Australia, use of the incognito function and clearing user browser history, cookies and cache.…”