Associate Professor Nicole Nathan
MRFF Investigator Fellow
School of Medicine and Public Health
- Email:nicole.nathan@newcastle.edu.au
- Phone:(02) 4924 6257
Health economies of scale
How can we make positive change on a state-wide or even national scale? Dr Nicole Nathan is working on improving the health of our nation.
When we roll out health programs across multiple institutions and communities, each one with its unique set of challenges, how can we ensure that the positive consequences of all that hard work actually reaches everyone it needs to reach?
Dr Nicole Nathan specialises in implementation science in health policy. Having worked across multiple Hunter New England (HNE) health programs and projects, she knows just how policy workers and researchers can ensure that they don’t fall short on making real and measurable changes within the community.
Like many of us, Nicole was nudged in the direction of her field by a supportive and enthusiastic teacher. Following in her mentor’s footsteps, Nicole originally trained as a PE teacher – but like many teachers, she struggled to find a permanent position close to home. Looking outside of the box, she applied for a position with Hunter New England Population Health, recognising that her expertise in the field of health and fitness would likely make her a suitable candidate.
“Before I started, my idea of health promotion was making pamphlets and doing speeches in schools. Then I started working on a state wide physical activity project, and saw that that’s exactly what health promotion is not!” reveals Nicole. “If you want to make a difference at a population level, you need to be working at scale. That project took me down the path of, 'I need to know how to do this better' – so I did my Masters in Public Health at UON.”
From a statewide issue to a national program
In 2005, the Global Obesity Summit shifted the way public health programs were funded across the state. Prior to the summit, funding was divided between local health districts. The government then realised that for improvement to occur in childhood obesity, significant investment was required. HNE Health put up a tender and were successfully granted the project funds for Australia’s largest childhood obesity prevention program, ‘Good for Kids, Good for Life’.
“The program was whole of community, however I was brought on to manage the school stream component as that was my area of expertise,” explains Nicole. Not long after the project started, she started her PhD in implementation science, working on the Crunch and Sip fruit and veg break program.
“I feel like my whole career had mapped to that point. I started off as a PE teacher, improving health for children - then I developed my research skills, and now I'm doing that same thing but at a wider level.”
When Nicole first made the shift from the classroom to public health research, she missed having that direct impact on the children and communities she worked with. But as she moved forward with her Crunch and Sip project, she began to realise the impact of her research was just as significant – but even wider reaching.
“Even by a conservative estimate, we know there are 100,000 children in the HNE region having a piece of vegetable or fruit every day because of our program. So that for me was the face that I needed.”
“I love it when I drive past a school and they’ve got their Crunch and Sip sign up. I love it because it's just part of school culture now – we’ll go into schools that don’t even know we’re responsible for it all, and they tell us they’ll have to stop for a Crunch and Sip. Parents just expect it now.”
So, what does it take to roll out a successful evidence-based state-wide public health project?
“If you want a school to adopt a policy or program, then you've got to know what the barriers are and then support them to overcome these barriers. “One of the most common barriers for schools is time – teachers ask, ‘how can we possibly make time for this?’ – they’ve already got a crowded curriculum. So our job is to then support teachers overcome such barriers by helping them to embed the policies or programs into their usual practices or routines.
Implementation science asks: when is it necessary to use this ‘bells and whistles’ approach (as Nicole affectionately calls it), and when is it possible to scale back the intervention and still see a significant effect?
“There’s got to be that initial training and consistent support, but sometimes doing that by email or text message can be just as effective – and that’s obviously more scalable than repeatedly driving out to every institution.
“We've got 430 schools in the region - we're a health service and our remit is to provide support to all 430 of those schools.
“What I'm providing in Newcastle needs to be able to be provided to a school in Moree or Boggabilla. We shouldn't be delivering something that can't be scaled - so all of our programs need to keep an eye on that. We need to make sure there's equity and that we're supporting everyone.”
What’s next on the horizon? Nicole has recently received three fellowships: an NHMRC Translating Research Into Practice (TRIP) Fellowship, Hunter New England Clinical Research Fellowship and a Sir Winston Churchill Fellowship, which will aim to assess the effectiveness of a multi-component intervention to support schools implement a mandatory state-wide physical activity policy.
“This is a really exciting opportunity as this will be the first randomised controlled trial to examine the impact of an implementation strategy for a physical activity policy in schools, Nicole says.
Health economies of scale
How can we make positive change on a state-wide or even national scale? Dr Nicole Nathan is working on improving the health of our nation.
Career Summary
Qualifications
- Doctor of Philosophy, University of Newcastle
- Master of Health Science, University of Newcastle
Keywords
- Child obesity prevention
- Implementation Science
- Physical Activity
- Population Health
- School-based interventions
Fields of Research
Code | Description | Percentage |
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420603 | Health promotion | 100 |
Professional Experience
UON Appointment
Title | Organisation / Department |
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MRFF Investigator Fellow | University of Newcastle College of Health, Medicine and Wellbeing Australia |
Professional appointment
Dates | Title | Organisation / Department |
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9/1/2017 - | Clinical Research Fellow | Hunter New England Health Hunter New England Population Health Australia |
9/1/2006 - | Health Promotion Program Manager | Hunter New England Area Health Service Hunter New England Population Health Australia |
7/1/2002 - 31/12/2005 | Health Promotion Project Officer | Hunter New England Area Health Service Hunter New England Population Health Australia |
Awards
Award
Year | Award |
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2016 |
Sir Winston Churchill Fellowship Sir Winston Churchill Memorial Trust |
2015 |
Excellence in Obesity Prevention Award for ‘Good for Kids. Good for Life’ World Health Organization (WHO) Collaboration of Community-based Obesity Prevention Sites (CO-OPS) |
2013 |
Healthy Living project of the year for ‘Good for Kids. Good for Life.’ Child Obesity Prevention Project. NSW Health Innovation Award |
Prize
Year | Award |
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2013 |
National Preventive Health Agency Research Translation Award National Preventative Health Agency |
Publications
For publications that are currently unpublished or in-press, details are shown in italics.
Journal article (145 outputs)
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2024 |
Ryan M, Ricardo LIC, Nathan N, Hofmann R, van Sluijs E, 'Are school uniforms associated with gender inequalities in physical activity? A pooled analysis of population-level data from 135 countries/regions.', J Sport Health Sci, (2024) [C1]
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2024 |
Crane M, Lee K, Bohn-Goldbaum E, Nathan N, Bauman A, 'Sustaining health obesity prevention programs: Lessons from real-world population settings.', Eval Program Plann, 103 102404 (2024) [C1]
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2024 |
Wolfenden L, Shoesmith A, Hall A, Bauman A, Nathan N, 'An initial typology of approaches used by policy and practice agencies to achieve sustained implementation of interventions to improve health.', Implement Sci Commun, 5 21 (2024) [C1]
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2023 |
Hall A, Wolfenden L, Gardner C, McEvoy B, Lane C, Shelton RC, et al., 'A bibliographic review of sustainability research output and investment in 10 leading public health journals across three time periods', Public Health in Practice, 6 100444-100444 (2023) [C1]
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2023 |
Chu G, Silva C, Adams K, Chacko B, Attia J, Nathan N, Wilson R, 'Exploring the factors affecting home dialysis patients' participation in telehealth-assisted home visits: A mixed-methods study.', J Ren Care, (2023) [C1]
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2023 |
Laur C, Ladak Z, Hall A, Solbak NM, Nathan N, Buzuayne S, et al., 'Sustainability, spread, and scale in trials using audit and feedback: a theory-informed, secondary analysis of a systematic review.', Implement Sci, 18 54 (2023) [C1]
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2023 |
Hulteen RM, Lubans DR, Rhodes RE, Faulkner G, Liu Y, Naylor P-J, et al., 'Evaluation of the peer leadership for physical literacy intervention: A cluster randomized controlled trial.', PLoS One, 18 e0280261 (2023) [C1]
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2023 |
Brown A, Nathan N, Janssen L, Chooi A, Lecathelinais C, Hudson N, et al., 'New models to support parents to pack healthy lunchboxes: Parents acceptability, feasibility, appropriateness, and adoption of the SWAP IT m-Health program.', Australian and New Zealand journal of public health, 47 100043 (2023) [C1]
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2023 |
Hall A, Lane C, Wolfenden L, Wiggers J, Sutherland R, McCarthy N, et al., 'Evaluating the scaling up of an effective implementation intervention (PACE) to increase the delivery of a mandatory physical activity policy in primary schools.', Int J Behav Nutr Phys Act, 20 106 (2023) [C1]
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2022 |
Wolfenden L, Mooney K, Gonzalez S, Hall A, Hodder R, Nathan N, et al., 'Increased use of knowledge translation strategies is associated with greater research impact on public health policy and practice: an analysis of trials of nutrition, physical activity, sexual health, tobacco, alcohol and substance use interventions', HEALTH RESEARCH POLICY AND SYSTEMS, 20 (2022) [C1]
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2022 |
Sutherland R, Ying Ooi J, Finch M, Yoong SL, Nathan N, Wrigley J, et al., 'A cluster randomised controlled trial of a secondary school intervention to reduce intake of sugar-sweetened beverages: Mid-intervention impact of switchURsip environmental strategies', HEALTH PROMOTION JOURNAL OF AUSTRALIA, 33 176-186 (2022) [C1]
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2022 |
Nathan N, Hall A, McCarthy N, Sutherland R, Wiggers J, Bauman AE, et al., 'Multi-strategy intervention increases school implementation and maintenance of a mandatory physical activity policy: outcomes of a cluster randomised controlled trial.', Br J Sports Med, 56 385-393 (2022) [C1]
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2022 |
Koorts H, Bauman A, Edwards N, Bellew W, Brown WJ, Duncan MJ, et al., 'Tensions and Paradoxes of Scaling Up: A Critical Reflection on Physical Activity Promotion.', International journal of environmental research and public health, 19 14284 (2022) [C1]
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2022 |
Wolfenden L, McCrabb S, Barnes C, O'Brien KM, Ng KW, Nathan NK, et al., 'Strategies for enhancing the implementation of school-based policies or practices targeting diet, physical activity, obesity, tobacco or alcohol use.', The Cochrane database of systematic reviews, 8 CD011677 (2022) [C1]
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2022 |
Lane C, Naylor P-J, Shoesmith A, Wolfenden L, Hall A, Sutherland R, Nathan N, 'Identifying essential implementation strategies: a mixed methods process evaluation of a multi-strategy policy implementation intervention for schools.', The international journal of behavioral nutrition and physical activity, 19 44 (2022) [C1]
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2022 |
Lane C, Nathan N, Reeves P, Sutherland R, Wolfenden L, Shoesmith A, Hall A, 'Economic evaluation of a multi-strategy intervention that improves school-based physical activity policy implementation.', Implementation science : IS, 17 40 (2022) [C1]
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2022 |
Hall A, Shoesmith A, Doherty E, McEvoy B, Mettert K, Lewis CC, et al., 'Evaluation of measures of sustainability and sustainability determinants for use in community, public health, and clinical settings: a systematic review.', Implementation science : IS, 17 81 (2022) [C1]
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2022 |
Nathan N, Powell BJ, Shelton RC, Laur CV, Wolfenden L, Hailemariam M, et al., 'Do the Expert Recommendations for Implementing Change (ERIC) strategies adequately address sustainment?', Frontiers in health services, 2 905909 (2022) [C1]
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2022 |
Lane C, Wolfenden L, Hall A, Sutherland R, Naylor P-J, Oldmeadow C, et al., 'Optimising a multi-strategy implementation intervention to improve the delivery of a school physical activity policy at scale: findings from a randomised noninferiority trial', INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY, 19 (2022) [C1]
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2022 |
Crane M, Nathan N, McKay H, Lee K, Wiggers J, Bauman A, 'Understanding the sustainment of population health programmes from a whole-of-system approach', Health Research Policy and Systems, 20 (2022) [C1] Background: Population health prevention programmes are needed to reduce the prevalence of chronic diseases. Nevertheless, sustaining programmes at a population level is challengi... [more] Background: Population health prevention programmes are needed to reduce the prevalence of chronic diseases. Nevertheless, sustaining programmes at a population level is challenging. Population health is highly influenced by social, economic and political environments and is vulnerable to these system-level changes. The aim of this research was to examine the factors and mechanisms contributing to the sustainment of population prevention programmes taking a systems thinking approach. Methods: We conducted a qualitative study through interviews with population health experts working within Australian government and non-government agencies experienced in sustaining public health programs at the local, state or national level (n = 13). We used a deductive thematic approach, grounded in systems thinking to analyse data. Results: We identified four key barriers affecting program sustainment: 1) short term political and funding cycles; 2) competing interests; 3) silo thinking within health service delivery; and 4) the fit of a program to population needs. To overcome these barriers various approaches have centred on the importance of long-range planning and resourcing, flexible program design and management, leadership and partnerships, evidence generation, and system support structures. Conclusion: This study provides key insights for overcoming challenges to the sustainment of population health programmes amidst complex system-wide changes.
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2022 |
Murawski B, Reilly KL, Hope K, Hall AE, Sutherland RL, Trost SG, et al., 'Exploring the effect of a school-based cluster-randomised controlled trial to increase the scheduling of physical activity for primary school students on teachers' physical activity.', Health Promot J Austr, 33 373-378 (2022) [C1]
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2022 |
Shoesmith A, Hall A, Wolfenden L, Shelton RC, Yoong S, Crane M, et al., 'School-level factors associated with the sustainment of weekly physical activity scheduled in Australian elementary schools: an observational study', BMC PUBLIC HEALTH, 22 (2022) [C1]
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2022 |
Wade L, Leahy AA, Babic MJ, Beauchamp MR, Smith JJ, Kennedy SG, et al., 'A systematic review and meta-analysis of the benefits of school-based, peer-led interventions for leaders', Scientific Reports, 12 (2022) [C1] The aim of our systematic review and meta-analysis was to quantitatively synthesise the effects of school-based peer-led interventions on leaders¿ academic, psychosocial, behaviou... [more] The aim of our systematic review and meta-analysis was to quantitatively synthesise the effects of school-based peer-led interventions on leaders¿ academic, psychosocial, behavioural, and physical outcomes. Eligible studies were those that: (i) evaluated a school-based peer-led intervention using an experimental or quasi-experimental study design, (ii) included an age-matched control or comparison group, and (iii) evaluated the impact of the intervention on one or more leader outcomes. Medline, Sportdiscus, Psychinfo, Embase, and Scopus online databases were searched on the 24th of October, 2022 which yielded 13,572 results, with 31 included in the narrative synthesis and 12 in the meta-analysis. We found large positive effects for leaders¿ attitudes toward bullying (d = 1.02), small-to-medium positive effects for leaders¿ literacy (d = 0.39), and small positive effects for leaders¿ self-esteem (d = 0.18). There were mixed findings for behavioural outcomes and null effects for physical outcomes. Notable limitations of this research are the inclusion of a relatively small number of studies, and high heterogeneity in those included. Our findings have the potential to inform educational practice, but also highlight the need for further research examining the mechanisms that might account for the observed effects. Our systematic review was prospectively registered with PROSPERO (CRD42021273129).
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2022 |
Sutherland RL, Jackson JK, Lane C, McCrabb S, Nathan NK, Yoong SL, et al., 'A systematic review of adaptations and effectiveness of scaled-up nutrition interventions.', Nutr Rev, 80 962-979 (2022) [C1]
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2022 |
Hall A, Wolfenden L, Shoesmith A, McCarthy N, Wiggers J, Bauman AE, et al., 'The impact of an implementation intervention that increased school's delivery of a mandatory physical activity policy on student outcomes: A cluster-randomised controlled trial', Journal of Science and Medicine in Sport, 25 321-326 (2022) [C1] Objectives: Assess the impact of an implementation intervention on student's physical activity, health-related quality of life (HRQoL) and on-task behaviour. Design: A cluste... [more] Objectives: Assess the impact of an implementation intervention on student's physical activity, health-related quality of life (HRQoL) and on-task behaviour. Design: A cluster-randomised controlled trial. Methods: Following baseline 61 eligible schools were randomised to a 12-month, implementation intervention to increase teacher scheduling of physical activity, or a waitlist control. Whole school-day and class-time physical activity of students from grades 2 and 3 (~ages 7 to 9) were measured via wrist-worn accelerometers and included: moderate-to-vigorous physical activity, light physical activity, sedentary behaviour and activity counts per minute. Children's health related quality of life (HRQoL) and out-of-school-hours physical activity was measured via parent-proxy surveys. Class level on-task behaviour was measured via teacher self-report surveys. Student and teacher obtained outcomes were measured at baseline and 12-month follow-up. Parent reported outcomes were measured at 12-month follow-up. Linear mixed models compared between group differences in outcomes. Differential effects by sex were explored for student and parent reported outcomes. Results: Data from 2485 students, 1220 parents and >500 teachers were analysed. There was no statistically significant between group differences in any of the outcomes, including accelerometer measured physical activity, out-of-school-hours physical activity, HRQoL, and on-task behaviour. A statistically significant differential effect by sex was found for sedentary behaviour across the whole school day (3.16 min, 95% CI: 0.19, 6.13; p = 0.028), with females illustrating a greater difference between groups than males. Conclusions: Only negligible effects on student physical activity were found. Additional strategies including improving the quality of teacher's delivery of physical activity may be required to enhance effects.
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2021 |
Sutherland R, Brown A, Nathan N, Yoong S, Janssen L, Chooi A, et al., 'A multicomponent mHealth-based intervention (SWAP IT) to decrease the consumption of discretionary foods packed in school lunchboxes: Type I effectiveness-implementation hybrid cluster randomized controlled trial', Journal of Medical Internet Research, 23 (2021) [C1] Background: There is significant opportunity to improve the nutritional quality of foods packed in children's school lunchboxes. Interventions that are effective and scalable... [more] Background: There is significant opportunity to improve the nutritional quality of foods packed in children's school lunchboxes. Interventions that are effective and scalable targeting the school and home environment are therefore warranted. Objective: This study aimed to assess the effectiveness of a multicomponent, mobile health-based intervention, SWAP IT, in reducing the energy contribution of discretionary (ie, less healthy) foods and drinks packed for children to consume at school. Methods: A type I effectiveness-implementation hybrid cluster randomized controlled trial was conducted in 32 primary schools located across 3 local health districts in New South Wales, Australia, to compare the effects of a 6-month intervention targeting foods packed in children's lunchboxes with those of a usual care control. Primary schools were eligible if they were not participating in other nutrition studies and used the required school communication app. The Behaviour Change Wheel was used to co-design the multicomponent SWAP IT intervention, which consisted of the following: school lunchbox nutrition guidelines, curriculum lessons, information pushed to parents digitally via an existing school communication app, and additional parent resources to address common barriers to packing healthy lunchboxes. The primary outcome, mean energy (kilojoules) content of discretionary lunchbox foods and drinks packed in lunchboxes, was measured via observation using a validated school food checklist at baseline (May 2019) and at 6-month follow-up (October 2019). Additional secondary outcomes included mean lunchbox energy from discretionary foods consumed, mean total lunchbox energy packed and consumed, mean energy content of core lunchbox foods packed and consumed, and percentage of lunchbox energy from discretionary and core foods, all of which were also measured via observation using a validated school food checklist. Measures of school engagement, consumption of discretionary foods outside of school hours, and lunchbox cost were also collected at baseline and at 6-month follow-up. Data were analyzed via hierarchical linear regression models, with controlling for clustering, socioeconomic status, and remoteness. Results: A total of 3022 (3022/7212, 41.90%) students consented to participate in the evaluation (mean age 7.8 years; 1487/3022, 49.22% girls). There were significant reductions between the intervention and control groups in the primary trial outcome, mean energy (kilojoules) content of discretionary foods packed in lunchboxes (-117.26 kJ; 95% CI -195.59 to -39.83; P=.003). Relative to the control, the intervention also significantly reduced secondary outcomes regarding the mean total lunchbox energy (kilojoules) packed (-88.38 kJ; 95% CI -172.84 to -3.92; P=.04) and consumed (-117.17 kJ; 95% CI -233.72 to -0.62; P=.05). There was no significant difference between groups in measures of student engagement, consumption of discretionary foods outside of school hours, or cost of foods packed in children's lunchboxes. Conclusions: The SWAP IT intervention was effective in reducing the energy content of foods packed for and consumed by primary school-aged children at school. Dissemination of the SWAP IT program at a population level has the potential to influence a significant proportion of primary school-aged children, impacting weight status and associated health care costs.
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2021 |
Brown A, Sutherland R, Janssen L, Hudson N, Chooi A, Reynolds R, et al., 'Enhancing the potential effects of text messages delivered via an m-health intervention to improve packing of healthy school lunchboxes', Public Health Nutrition, 24 2867-2876 (2021) [C1] Abstract Objective: The aim of the study was to assess the impact of different lunchbox messages on parents' intention to pack a healthy lunchbox. Design: This study employed... [more] Abstract Objective: The aim of the study was to assess the impact of different lunchbox messages on parents' intention to pack a healthy lunchbox. Design: This study employed an experimental design. Setting: A series of messages were developed to align with the six constructs of the Health Belief Model. Messages were also developed that were (and were not) personalised and varied based on the source of the information provided (university, school, dietitian and health promotion service). During a telephone survey, participants were read the content of each message and asked about their intention to pack a healthy lunchbox. Participants: Parents of primary school-aged children were randomised to receive different messages to encourage the packing of healthy lunchboxes. Results: The study was completed by 511 parents. Linear mixed regression analyses identified significant differences (P < 0·05) in intention scores between variant messages targeting the same behavioural constructs for 'susceptibility', 'severity', 'benefits' and 'barriers' but not 'cues to action' or 'self-efficacy'. The highest mean behavioural intention score was for 'benefits', whilst the lowest mean score was for 'barriers'. There were no significant differences in intention scores of parents receiving messages from a dietitian, university, health promotion team or school (P = 0·37). Intention scores did not differ in which messages were personalised based on child's name (P = 0·84) or grade level (P = 0·54). Conclusions: The findings suggest that messages that focus on the benefits of packing healthy lunchboxes may be particularly useful in improving intentions of parents to pack healthy foods for their children to consume at school.
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2021 |
Sutherland R, Campbell E, McLaughlin M, Nathan N, Wolfenden L, Lubans DR, et al., 'Scale-up of the Physical Activity 4 Everyone (PA4E1) intervention in secondary schools: 24-month implementation and cost outcomes from a cluster randomised controlled trial', International Journal of Behavioral Nutrition and Physical Activity, 18 (2021) [C1] Background: Physical Activity 4 Everyone (PA4E1) is an evidence-based program effective at increasing adolescent physical activity (PA) and improving weight status. This study aim... [more] Background: Physical Activity 4 Everyone (PA4E1) is an evidence-based program effective at increasing adolescent physical activity (PA) and improving weight status. This study aimed to determine a) the effectiveness of an adapted implementation intervention to scale-up PA4E1 at 24-month follow-up, b) fidelity and reach, and c) the cost and cost-effectiveness of the implementation support intervention. Methods: A cluster randomised controlled trial using a type III hybrid implementation-effectiveness design in 49 lower socio-economic secondary schools, randomised to a program (n = 24) or control group (n = 25). An adapted implementation intervention consisting of seven strategies was developed to support schools to implement PA4E1 over 24-months. The primary outcome was the proportion of schools implementing at least four of the 7 PA practices, assessed via computer assisted telephone interviews (CATI) with Head Physical Education Teachers. Secondary outcomes included the mean number of PA practices implemented, fidelity and reach, cost and cost-effectiveness. Logistic regression models assessed program effects. Results: At baseline, no schools implemented four of the 7 PA practices. At 24-months, significantly more schools in the program group (16/23, 69.6%) implemented at least four of the 7 PA practices than the control group (0/25, 0%) (p < 0.001). At 24-months, program schools were implementing an average of 3.6 more practices than control schools (4.1 (1.7) vs. 0.5 (0.8), respectively) (P < 0.001). Fidelity and reach of the implementation intervention were high (> 75%). The total cost of the program was $415,112 AUD (2018) ($17,296 per school; $117.30 per student). Conclusions: The adapted implementation intervention provides policy makers and researchers with an effective and potentially cost-effective model for scaling-up the delivery of PA4E1 in secondary schools. Further assessment of sustainability is warranted. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12617000681358 prospectively registered 12th May 2017.
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2021 |
McCarthy N, Hall A, Shoesmith A, Sutherland R, Hodder R, Campbell E, Nathan N, 'Australian children are not meeting recommended physical activity levels at school: Analysis of objectively measured physical activity data from a cross sectional study', PREVENTIVE MEDICINE REPORTS, 23 (2021) [C1]
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2021 |
Hall A, Shoesmith A, Shelton RC, Lane C, Wolfenden L, Nathan N, 'Adaptation and validation of the program sustainability assessment tool (Psat) for use in the elementary school setting', International Journal of Environmental Research and Public Health, 18 (2021) [C1] There is a lack of valid and reliable measures of determinants of sustainability specific to public health interventions in the elementary school setting. This study aimed to adap... [more] There is a lack of valid and reliable measures of determinants of sustainability specific to public health interventions in the elementary school setting. This study aimed to adapt and evaluate the Program Sustainability Assessment Tool (PSAT) for use in this setting. An expert reference group adapted the PSAT to ensure face validity. Elementary school teachers participating in a multi-component implementation intervention to increase their scheduling of physical activity completed the adapted PSAT. Structural validity was assessed via confirmatory factor analysis. Convergent validity was assessed using linear mixed regression evaluating the associations between scheduling of physical activity and adapted PSAT scores. Cronbach¿s alpha was used to evaluate internal consistency and intracluster correlation coefficients for interrater reliability. Floor and ceiling effects were also evaluated. Following adaptation and psychometric evaluation, the final measure contained 26 items. Domain Cronbach¿s alpha ranged from 0.77 to 0.92. Only one domain illustrated acceptable interrater reliability. Evidence for structural validity was mixed and was lacking for convergent validity. There were no floor and ceiling effects. Efforts to adapt and validate the PSAT for the elementary school setting were mixed. Future work to develop and improve measures specific to public health program sustainment that are relevant and psychometrically robust for elementary school settings are needed.
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2021 |
Barnes C, Hall A, Nathan N, Sutherland R, McCarthy N, Pettet M, et al., 'Efficacy of a school-based physical activity and nutrition intervention on child weight status: Findings from a cluster randomized controlled trial', PREVENTIVE MEDICINE, 153 (2021) [C1]
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2021 |
Yoong SL, Hall A, Stacey F, Nathan N, Reilly K, Delaney T, et al., 'An exploratory analysis to identify behavior change techniques of implementation interventions associated with the implementation of healthy canteen policies', Translational Behavioral Medicine, 11 1606-1616 (2021) [C1] Empirical studies to disentangle the effects of multicomponent implementation interventions are needed to inform the development of future interventions. This study aims to examin... [more] Empirical studies to disentangle the effects of multicomponent implementation interventions are needed to inform the development of future interventions. This study aims to examine which behavior change techniques (BCTs) primarily targeting canteen manager are associated with school's healthy canteen policy implementation. This is a secondary data analysis from three randomized controlled trials assessing the impact of a "high,""medium,"and "low"intensity intervention primarily targeting canteen managers on school's implementation of a healthy canteen policy. The policy required primary schools to remove all "red"(less healthy items) or "banned"(sugar sweetened beverages) items from regular sale and ensure that "green"(healthier items) dominated the menu (>50%). The delivery of BCTs were retrospectively coded. We undertook an elastic net regularized logistic regression with all BCTs in a single model. Five k-fold cross-validation elastic net models were conducted. The percentage of times each strategy remained across 1,000 replications was calculated. For no "red"or "banned"items (n = 162), the strongest BCTs were: problem solving, goal setting (behavior), and review behavior goals. These BCTs were identified in 100% of replications as a strong predictor in the cross-validation elastic net models. For the outcome relating to >50% "green"items, the BCTs problem solving, instruction on how to perform behavior and demonstration of behavior were the strongest predictors. Two strategies were identified in 100% of replications as a strong (i.e., problem solving) or weak predictor (i.e., feedback on behavior). This study identified unique BCTs associated with the implementation of a healthy canteen policy.
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2021 |
Ooi JY, Wolfenden L, Sutherland R, Nathan N, Oldmeadow C, Mclaughlin M, et al., 'A Systematic Review of the Recent Consumption Levels of Sugar-Sweetened Beverages in Children and Adolescents From the World Health Organization Regions With High Dietary-Related Burden of Disease', ASIA-PACIFIC JOURNAL OF PUBLIC HEALTH, 34 11-24 (2021) [C1]
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2021 |
Barnes C, Yoong SL, Nathan N, Wolfenden L, Wedesweiler T, Kerr J, et al., 'Feasibility of a Web-Based Implementation Intervention to Improve Child Dietary Intake in Early Childhood Education and Care: Pilot Randomized Controlled Trial', JOURNAL OF MEDICAL INTERNET RESEARCH, 23 (2021) [C1]
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2021 |
Brown A, Sutherland R, Reeves P, Nathan N, Wolfenden L, 'Cost and Cost Effectiveness of a Pilot m-Health Intervention Targeting Parents of School-Aged Children to Improve the Nutritional Quality of Foods Packed in the Lunchbox', NUTRIENTS, 13 (2021) [C1]
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2021 |
Barnes C, Yoong SL, Wolfenden L, Nathan N, Wedesweiler T, Kerr J, et al., 'The association between australian childcare centre healthy eating practices and children s healthy eating behaviours: A cross-sectional study within lunchbox centres', Nutrients, 13 (2021) [C1] The association between healthy eating practices and child dietary intake in childcare centres where parents pack foods from home has received little attention. This study aimed t... [more] The association between healthy eating practices and child dietary intake in childcare centres where parents pack foods from home has received little attention. This study aimed to: (1) Describe the nutritional content of foods and beverages consumed by children in care; and (2) Assess the association between centre healthy eating practices and child intake of fruit and vegetable servings, added sugar(grams), saturated fat(grams) and sodium(milligrams) in care. A cross-sectional study amongst 448 children attending 22 childcare centres in New South Wales, Australia, was conducted. Child dietary intake was measured via weighed lunchbox measurements, photographs and researcher observation, and centre healthy eating practices were assessed via researcher observation of centre nutrition environments. Children attending lunchbox centres consumed, on average 0.80 servings (standard deviation 0.69) of fruit and 0.27 servings (standard deviation 0.51) of vegetables in care. The availability of foods within children¿s lunchboxes was associated with intake of such foods (p < 0.01). Centre provision of intentional healthy eating learning experiences (estimate -0.56; p = 0.01) and the use of feeding practices that support children¿s healthy eating (estimate -2.02; p = 0.04) were significantly associated with reduced child intake of saturated fat. Interventions to improve child nutrition in centres should focus on a range of healthy eating practices, including the availability of foods packed within lunchboxes.
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2021 |
Ooi JY, Wolfenden L, Yoong SL, Janssen LM, Reilly K, Nathan N, Sutherland R, 'A trial of a six-month sugar-sweetened beverage intervention in secondary schools from a socio-economically disadvantaged region in Australia', Australian and New Zealand Journal of Public Health, 45 599-607 (2021) [C1] Objective: This study assessed the effectiveness of a school-based intervention in reducing adolescents¿ sugar-sweetened beverage (SSB) consumption and percentage of energy from S... [more] Objective: This study assessed the effectiveness of a school-based intervention in reducing adolescents¿ sugar-sweetened beverage (SSB) consumption and percentage of energy from SSBs. Secondary outcomes were SSB consumption within school, average daily energy intake, and body mass index z-scores. Methods: Six secondary schools located in New South Wales, Australia were recruited to participate in a six-month pilot randomised controlled trial (1:1). The intervention included components targeting the school nutrition environment, curricula and community. Outcomes were collected via online surveys, observations, anthropometric measurements and project records. Between-group differences were assessed via linear mixed models. Results: At the six-month intervention endpoint (n=862) there were no statistically significant differences between students in intervention or control schools for mean daily intake of SSBs (8.55mL; CI -26.77, 43.87; p=0.63), percentage daily energy from SSBs (0.12% kJ; CI -0.55, 0.80; p=0.72), or for secondary outcomes. Acceptability of the school-based strategies were high, however intervention fidelity varied across schools. Conclusion: While acceptable, improving fidelity of implementation and increasing the duration or intensity of the intervention may be required to reduce SSB intake. Implications for public health: Engaging parents and education stakeholders in the development phase to co-design interventions may prove beneficial in improving intervention fidelity and enhance behavioural outcomes.
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2021 |
Shoesmith A, Hall A, Wolfenden L, Shelton RC, Powell BJ, Brown H, et al., 'Barriers and facilitators influencing the sustainment of health behaviour interventions in schools and childcare services: a systematic review', IMPLEMENTATION SCIENCE, 16 (2021) [C1]
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2021 |
Wyse R, Delaney T, Stacey F, Lecathelinais C, Ball K, Zoetemeyer R, et al., 'Long-term Effectiveness of a Multistrategy Behavioral Intervention to Increase the Nutritional Quality of Primary School Students' Online Lunch Orders: 18-Month Follow-up of the Click & Crunch Cluster Randomized Controlled Trial', JOURNAL OF MEDICAL INTERNET RESEARCH, 23 (2021) [C1]
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2021 |
Pearson N, Wolfenden L, Finch M, Yoong SL, Kingsland M, Nathan N, et al., 'A cross-sectional study of packed lunchbox foods and their consumption by children in early childhood education and care services', Nutrition and Dietetics, 78 397-405 (2021) [C1] Aim: To (a) describe lunchbox foods packed and consumed by children attending early childhood education and care services; (b) compare the serves of foods packed and consumed with... [more] Aim: To (a) describe lunchbox foods packed and consumed by children attending early childhood education and care services; (b) compare the serves of foods packed and consumed with nutrition guideline recommendations; and (c) explore associations between parent characteristics and serves of food groups packed in lunchboxes. Methods: A cross sectional study was conducted on a sample of early childhood education and care services where parents provide food in the Hunter New England region of NSW, Australia. Lunchbox contents were assessed using photography and pre- and post-meal weights. Descriptive statistics were used to describe packing and consumption of core food groups and discretionary foods. Results: Data on food packed and consumed were collected for 355 children's lunchboxes from 17 services (preschools n¿=¿14, long day care services n¿=¿3). Less than half (44%) of lunchboxes contained vegetables, and 54% contained at least one serve of discretionary foods. Less than 1% of lunchboxes met all setting-specific nutrition guidelines. On average, children consumed 68% of lunchbox contents, with the lowest consumption rate being for vegetables. An association was found between parent education level and packing of discretionary foods (-0.36, P¿= <.01) but not for packing of fruit or vegetables. Conclusions: Lunchboxes contained an over-representation of discretionary foods and under-representation of vegetables, and children had a low preference for consuming vegetables compared with other food groups. Interventions to support parent packing of lunchboxes in line with nutrition guidelines and strategies to expand child preference for foods such as vegetables are warranted.
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2021 |
Kennedy SG, Smith JJ, Estabrooks PA, Nathan N, Noetel M, Morgan PJ, et al., 'Evaluating the reach, effectiveness, adoption, implementation and maintenance of the Resistance Training for Teens program', International Journal of Behavioral Nutrition and Physical Activity, 18 (2021) [C1] Background: Physical activity guidelines recommend young people engage in regular muscle-strengthening activities (e.g., resistance training [RT]). However, few school-based physi... [more] Background: Physical activity guidelines recommend young people engage in regular muscle-strengthening activities (e.g., resistance training [RT]). However, few school-based physical activity interventions have been delivered at-scale or promoted RT. The aim of this study was to evaluate the¿reach, effectiveness, adoption, implementation and maintenance of the Resistance Training for Teens (RT for Teens) program. Methods: Data were collected between August 2015 and October 2020. RE-AIM was operationalized as: (i) Reach: number and characteristics of students estimated to be exposed to the program; (ii) Effectiveness: impact of the program on student-level outcomes measured in a subsample of 750 students from 17 schools; (iii) Adoption: number and representativeness of schools with one or more teachers trained to deliver the program; (iv) Implementation: extent to which the program was delivered as intended; and (v) Maintenance: extent to which the program was sustained¿in schools. Results: The estimated program reach was ~ 10,000 students, out of a total student population of ~ 200,000 (~ 5%). Students were from diverse socioeconomic and ethnic backgrounds. Improvements in muscular fitness, RT self-efficacy, perceived cardiorespiratory fitness and flexibility, and participation in muscle-strengthening physical activities were documented. A total of 30 workshops were delivered, involving 468 teachers from 249 schools from diverse geographical regions. Implementation varied considerably, with teachers adapting the program to suit the¿context of their school and student cohorts. However, RT skill development and the promotion of muscular fitness were the session components delivered most during sessions. Teachers¿ adherence to the SAAFE (Supportive, Active, Autonomous, Fair and Enjoyable) teaching principles was high. Approximately 30% of teachers (144/476) registered to use the RT for Teens app. At the school-level, 37% (93/249) of schools had at least one registered user (teacher and/or student). A total of 2,336 workouts and 3,116 fitness tests were completed by registered users. Of the 249 schools represented, 51 (20.5%) sent an additional (previously untrained) teacher to a second workshop. Conclusions: The RT for Teens program had broad reach and adoption. However, intervention delivery varied considerably across schools and additional support strategies are required to optimize intervention implementation and maintain program delivery over time. Future studies will benefit from the utilization of accepted frameworks, recommendations and guidelines for implementation research. Trial registration: Australian New Zealand Clinical Trials Registry (ACTRN12621000352808), retrospectively registered 1st February 2021.
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2021 |
Wolfenden L, Foy R, Presseau J, Grimshaw JM, Ivers NM, Powell BJ, et al., 'Designing and undertaking randomised implementation trials: guide for researchers', BMJ-BRITISH MEDICAL JOURNAL, 372 (2021) [C1]
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2021 |
Wyse R, Delaney T, Stacey F, Zoetemeyer R, Lecathelinais C, Lamont H, et al., 'Effectiveness of a Multistrategy Behavioral Intervention to Increase the Nutritional Quality of Primary School Students' Web-Based Canteen Lunch Orders (Click & Crunch): Cluster Randomized Controlled Trial', JOURNAL OF MEDICAL INTERNET RESEARCH, 23 (2021) [C1]
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2021 |
Barnes C, McCrabb S, Stacey F, Nathan N, Yoong SL, Grady A, et al., 'Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review', TRANSLATIONAL BEHAVIORAL MEDICINE, 11 1365-1410 (2021) [C1]
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2021 |
Lane C, McCrabb S, Nathan N, Naylor P-J, Bauman A, Milat A, et al., 'How effective are physical activity interventions when they are scaled-up: a systematic review', INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY, 18 (2021) [C1]
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2021 |
Nathan N, McCarthy N, Hope K, Sutherland R, Lecathelinais C, Hall A, et al., 'The impact of school uniforms on primary school student's physical activity at school: outcomes of a cluster randomized controlled trial', INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY, 18 (2021) [C1]
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2020 |
McCarthy N, Hope K, Sutherland R, Campbell E, Hodder R, Wolfenden L, Nathan N, 'Australian primary school principals', teachers', and parents' attitudes and barriers to changing school uniform policies from traditional uniforms to sports uniforms', Journal of Physical Activity and Health, 17 1019-1024 (2020) [C1] Background: To determine Australian primary school principals', teachers', and parents' attitudes to changing school uniform policies to allow students to wear spor... [more] Background: To determine Australian primary school principals', teachers', and parents' attitudes to changing school uniform policies to allow students to wear sports uniforms every day and to assess associations between participant characteristics and their attitudes. A secondary aim was to identify principals' and teachers' perceived barriers to uniform changes. Methods: Cross-sectional surveys of principals, teachers, and parents of children in grades 2 to 3 (age 7-10 y) from 62 Australian primary schools (Oct 2017-Mar 2018) were undertaken. Mixed logistic regression analyses assessed the associations between participant characteristics and attitudes toward uniform changes. Results: In total, 73% of the principals (38/52) who responded reported that their school only allowed children to wear a sports uniform on sports days. Overall, 38% of the principals (18/47), 63% of the teachers (334/579), and 78% of the parents (965/1231) reported they would support a policy that allowed children to wear daily sports uniforms. The most commonly reported barrier was the perception that sports uniforms were not appropriate for formal occasions. Conclusions: Although the majority of the principals were not supportive of a change to a daily sports uniform, the majority of the teachers and parents were. Strategies to improve principal support may be required if broader adoption of physical activity-supporting uniforms is to be achieved.
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2020 |
Barnes C, Grady A, Nathan N, Wolfenden L, Pond N, McFayden T, et al., 'A pilot randomised controlled trial of a web-based implementation intervention to increase child intake of fruit and vegetables within childcare centres', Pilot and Feasibility Studies, 6 (2020) [C1] Background: As dietary behaviours developed during early childhood are known to track into adulthood, interventions that aim to improve child nutrition at a population level are r... [more] Background: As dietary behaviours developed during early childhood are known to track into adulthood, interventions that aim to improve child nutrition at a population level are recommended. Whilst early childhood education and care (ECEC) is a promising setting for interventions targeting children¿s nutrition behaviours, previous interventions have largely used high intensity, face-to-face approaches, limiting their reach, implementation and potential impact at a population level. Web-based modalities represent a promising means of supporting the delivery of childcare-based interventions whilst overcoming challenges of previous approaches; however, the feasibility of using such modalities to support implementation is largely unknown. As such, this study sought to collect feasibility and pilot data to inform the design of a web-based intervention together with health promotion officer support within childcare centres. Child dietary intake will also be assessed to provide an estimate of the impact of the implementation intervention. Methods: A superiority cluster randomised controlled trial with repeat cross-sectional data collection employing an effectiveness-implementation type-II hybrid design will be conducted with childcare centres within the Hunter New England region of New South Wales, Australia. Type-II hybrid designs provide the opportunity to assess intervention efficacy whilst piloting the feasibility of the implementation strategies. Centres allocated to the intervention group will receive access to a web-based program together with health promotion officer support to implement targeted healthy eating practices to improve child diet in care. A number of outcomes will be assessed to inform the feasibility to conduct a larger trial, including childcare centre and parent recruitment and consent rates for each component of data collection, uptake of the implementation strategies, acceptability of the intervention and implementation strategies, appropriateness of the implementation strategies and the contextual factors influencing implementation. Discussion: This study will provide high-quality evidence regarding the potential feasibility of a web-based intervention and the impact of healthy eating practices on child diet in care. Web-based modalities provide a promising approach for population-wide implementation support to childcare centres given their potential reach and consistency with existing infrastructure. Trial registration: Prospectively registered with Australian New Zealand Clinical Trial Registry (ACTRN12619001158156).
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2020 |
Nathan NK, Sutherland RL, Hope K, McCarthy NJ, Pettett M, Elton B, et al., 'Implementation of a school physical activity policy improves student physical activity levels: Outcomes of a cluster-randomized controlled trial', Journal of Physical Activity and Health, 17 1009-1018 (2020) [C1] Aim: To assess the impact of a multistrategy intervention designed to improve teachers' implementation of a school physical activity (PA) policy on student PA levels. Methods... [more] Aim: To assess the impact of a multistrategy intervention designed to improve teachers' implementation of a school physical activity (PA) policy on student PA levels. Methods: A cluster-randomized controlled trial was conducted in 12 elementary schools. Policy implementation required schools to deliver 150 minutes of organized PA for students each week via physical education, sport, or class-based activities such as energizers. Schools received implementation support designed using the theoretical domains framework to help them implement the current policy. Results: A total of 1,502 children in kindergarten to grade 6 participated. At follow-up compared with control, students attending intervention schools had, measured via accelerometer, significantly greater increases in school day counts per minute (97.5; 95% confidence interval [CI], 64.5 to 130.4; P <.001) and moderate to vigorous physical activity (MVPA) (3.0; 95% CI, 2.2-3.8, P <.001) and a greater decrease in sedentary time (-2.1; 95% CI, -3.9 to -0.4, P =.02) per school day. Teachers in intervention schools delivered significantly more minutes (36.6 min) of PA to their students at follow-up (95% CI, 2.7-70.5, P =.04). Conclusions: Supporting teachers to implement a PA policy improves student PA. Additional strategies may be needed to support teachers to implement activities that result in larger gains in student MVPA.
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2020 |
Shelton RC, Lee M, Brotzman LE, Wolfenden L, Nathan N, Wainberg ML, 'What Is Dissemination and Implementation Science?: An Introduction and Opportunities to Advance Behavioral Medicine and Public Health Globally', International Journal of Behavioral Medicine, 27 3-20 (2020) [C1] There has been a well-documented gap between research (e.g., evidence-based programs, interventions, practices, policies, guidelines) and practice (e.g., what is routinely deliver... [more] There has been a well-documented gap between research (e.g., evidence-based programs, interventions, practices, policies, guidelines) and practice (e.g., what is routinely delivered in real-world community and clinical settings). Dissemination and implementation (D&I) science has emerged to address this research-to-practice gap and accelerate the speed with which translation and real-world uptake and impact occur. In recent years, there has been tremendous development in the field and a growing global interest, but much of the introductory literature has been U.S.-centric. This piece provides an introduction to D&I science and summarizes key concepts and progress of the field for a global audience, provides two case studies that highlight examples of D&I research globally, and identifies opportunities and innovations for advancing the field of D&I research globally.
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2020 |
Nathan N, Murawski B, Hope K, Young S, Sutherland R, Hodder R, et al., 'The efficacy of workplace interventions on improving the dietary, physical activity and sleep behaviours of school and childcare staff: A systematic review', International Journal of Environmental Research and Public Health, 17 1-24 (2020) [C1] There is a need for effective interventions that improve the health and wellbeing of school and childcare staff. This review examined the efficacy of workplace interventions to im... [more] There is a need for effective interventions that improve the health and wellbeing of school and childcare staff. This review examined the efficacy of workplace interventions to improve the dietary, physical activity and/or sleep behaviours of school and childcare staff. A secondary aim of the review was to assess changes in staff physical/mental health, productivity, and students¿ health behaviours. Nine databases were searched for controlled trials including randomised and non-randomised controlled trials and quasi-experimental trials published in English up to October 2019. PRISMA guidelines informed screening and study selection procedures. Data were not suitable for quantitative pooling. Of 12,396 records screened, seven articles (based on six studies) were included. Most studies used multi-component interventions including educational resources, work-based wellness committees and planned group practice (e.g., walking groups). Multiple outcomes were assessed, findings were mixed and on average, there was moderate risk of bias. Between-group differences in dietary and physical activity behaviours (i.e., fruit/vegetable intake, leisure-time physical activity) favoured intervention groups, but were statistically non-significant for most outcomes. Some of the studies also showed differences favouring controls (i.e., nutrient intake, fatty food consumption). Additional robust studies testing the efficacy of workplace interventions to improve the health of educational staff are needed.
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2020 |
Brown A, Barnes C, Byaruhanga J, McLaughlin M, Hodder RK, Booth D, et al., 'Effectiveness of technology-enabled knowledge translation strategies in improving the use of research in public health: Systematic review', Journal of Medical Internet Research, 22 (2020) [C1]
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2020 |
Yoong SL, Bolsewicz K, Grady A, Wyse R, Sutherland R, Hodder RK, et al., 'Adaptation of public health initiatives: expert views on current guidance and opportunities to advance their application and benefit', Health education research, 35 243-257 (2020) [C1]
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2020 |
Sutherland R, Campbell E, McLaughlin M, Nathan N, Wolfenden L, Lubans DR, et al., 'Scale-up of the Physical Activity 4 Everyone (PA4E1) intervention in secondary schools: 12-month implementation outcomes from a cluster randomized controlled trial.', Int J Behav Nutr Phys Act, 17 100 (2020) [C1]
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2020 |
Shoesmith A, Hall A, Hope K, Sutherland R, Hodder RK, Trost SG, et al., 'Associations between in-school-hours physical activity and child health-related quality of life: A cross-sectional study in a sample of Australian primary school children', Preventive Medicine Reports, 20 (2020) [C1]
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2020 |
Sutherland R, Nathan N, Brown A, Yoong S, Reynolds R, Walton A, et al., 'A cross-sectional study to determine the energy density and nutritional quality of primary-school children's lunchboxes', Public Health Nutrition, 23 1108-1116 (2020) [C1] Objective: The present study describes the energy content of primary-school children's lunchboxes and the proportion of lunchbox foods considered discretionary. Subgroup anal... [more] Objective: The present study describes the energy content of primary-school children's lunchboxes and the proportion of lunchbox foods considered discretionary. Subgroup analyses by sex, socio-economic status, age and weight status were undertaken.Design: A cross-sectional study was conducted. Mean kilojoule content, number of items and categorisation of foods and drinks in lunchboxes as 'everyday' (healthy) or discretionary (sometimes) foods were assessed via a valid and reliable lunchbox observational audit.Setting: Twelve Catholic primary schools (Kindergarten-Grade 6) located in the Hunter region of New South Wales, Australia.Participants: Kindergarten to Grade 6 primary-school students.Results: In total, 2143 children (57 %) had parental consent to have their lunchboxes observed. School lunchboxes contained a mean of 2748 kJ, of which 61·2 % of energy was from foods consistent with the Australian Dietary Guidelines and 38·8 % of energy was discretionary foods. The proportion of lunchboxes containing only healthy foods was 12 %. Children in Kindergarten-Grade 2 packed more servings of 'everyday' foods (3·32 v. 2·98, P < 0·01) compared with children in Grades 3-6. Children in Grades 3-6 had a higher percentage of energy from discretionary foods (39·1 v. 33·8 %, P < 0·01) compared with children in Kindergarten-Grade 2 and children from the most socio-economically disadvantaged areas had significantly higher total kilojoules in the school lunchbox compared with the least disadvantaged students (2842 v. 2544 kJ, P = 0·03).Conclusions: Foods packed within school lunchboxes may contribute to energy imbalance. The development of school policies and population-based strategies to support parents overcome barriers to packing healthy lunchboxes are warranted.
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2020 |
Yoong SL, Hall A, Stacey F, Grady A, Sutherland R, Wyse R, et al., 'Nudge strategies to improve healthcare providers' implementation of evidence-based guidelines, policies and practices: a systematic review of trials included within Cochrane systematic reviews', IMPLEMENTATION SCIENCE, 15 (2020) [C1]
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2020 |
Ahmadi MN, Nathan N, Sutherland R, Wolfenden L, Trost SG, 'Non-wear or sleep? Evaluation of five non-wear detection algorithms for raw accelerometer data', Journal of Sports Sciences, 38 399-404 (2020) [C1] Detection of non-wear periods is an important step in accelerometer data processing. This study evaluated five non-wear detection algorithms for wrist accelerometer data and two r... [more] Detection of non-wear periods is an important step in accelerometer data processing. This study evaluated five non-wear detection algorithms for wrist accelerometer data and two rules for non-wear detection when non-wear and sleep algorithms are implemented in parallel. Non-wear algorithms were based on the standard deviation (SD), the high-pass filtered acceleration, or tilt angle. Rules for differentiating sleep from non-wear consisted of an override rule in which any overlap between non-wear and sleep was deemed non-wear; and a 75% rule in which non-wear periods were deemed sleep if the duration was < 75% of the sleep period. Non-wear algorithms were evaluated in 47 children who wore an ActiGraph GT3X+ accelerometer during school hours for 5¿days. Rules for differentiating sleep from non-wear were evaluated in 15 adults who wore a GeneActiv Original accelerometer continuously for 24¿hours. Classification accuracy for the non-wear algorithms ranged between 0.86¿0.95, with the SD of the vector magnitude providing the best performance. The override rule misclassified 37.1¿minutes of sleep as non-wear, while the 75% rule resulted in no misclassification. Non-wear algorithms based on the SD of the acceleration signal can effectively detect non-wear periods, while application of the 75% rule can effectively differentiate sleep from non-wear when examined concurrently.
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2019 |
Nathan N, Janssen L, Sutherland R, Hodder RK, Evans CEL, Booth D, et al., 'The effectiveness of lunchbox interventions on improving the foods and beverages packed and consumed by children at centre-based care or school: a systematic review and meta-analysis', INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY, 16 (2019) [C1]
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2019 |
Reynolds R, Sutherland R, Nathan N, Janssen L, Lecathelinais C, Reilly K, et al., 'Feasibility and principal acceptability of school-based mobile communication applications to disseminate healthy lunchbox messages to parents', Health Promotion Journal of Australia, 30 108-113 (2019) [C1] Issue addressed: This study aimed to assess the feasibility and acceptability of using an existing school-based mobile communication application to deliver messages to parents on ... [more] Issue addressed: This study aimed to assess the feasibility and acceptability of using an existing school-based mobile communication application to deliver messages to parents on how to pack a healthy lunchbox. Methods: A telephone survey was conducted with 196 primary school principals within the Hunter New England region of New South Wales, Australia, in 2016. Results: Almost two thirds of primary schools (59%) currently use a school-based mobile communication application to communicate with parents. Most principals (91%) agreed school lunchboxes need improving, of which 80% agree it is a school's role to provide information and guidelines to parents. However, only 50% of principals reported currently providing such information. The provision of lunchbox messages to parents by a third party appeared an acceptable model of delivery by principals. Larger schools and schools in urban and lower socio-economic localities were more likely to have used a school-based mobile communication application. Conclusion: The majority of principals recognise student lunchboxes need improving. The use of school-based mobile communication applications appears to be feasible and acceptable by principals as a method of communicating lunchbox messages to parents. So what?: Use of school-based mobile communication applications may be an effective method for delivering health information at a population level. Future research should assess the potential efficacy of disseminating health interventions via this modality.
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2019 |
Yoong SL, Grady A, Stacey F, Polimeni M, Clayton O, Jones J, et al., 'A pilot randomized controlled trial examining the impact of a sleep intervention targeting home routines on young children's (3-6 years) physical activity.', Pediatric obesity, 14 e12481 (2019) [C1]
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2019 |
Sutherland R, Nathan N, Brown A, Yoong S, Finch M, Lecathelinais C, et al., 'A randomized controlled trial to assess the potential efficacy, feasibility and acceptability of an m-health intervention targeting parents of school aged children to improve the nutritional quality of foods packed in the lunchbox 'SWAP IT'', International Journal of Behavioral Nutrition and Physical Activity, 16 1-13 (2019) [C1]
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2019 |
Reilly K, Nathan N, Grady A, Wu JHY, Wiggers J, Yoong SL, Wolfenden L, 'Barriers to implementation of a healthy canteen policy: A survey using the theoretical domains framework', Health Promotion Journal of Australia, 30 9-14 (2019) [C1] Issue addressed: Improving implementation of school healthy canteen policies requires a comprehensive understanding of implementation barriers. Therefore, the aim of this study wa... [more] Issue addressed: Improving implementation of school healthy canteen policies requires a comprehensive understanding of implementation barriers. Therefore, the aim of this study was to assess a range of barriers, as reported by canteen managers, using a quantitative survey instrument developed based on a theoretical framework. Methods: A cross sectional survey of primary school canteen managers from the Hunter New England region of New South Wales was conducted of eligible schools in the study region identified as having an operational canteen. Survey items assessed canteen manager employment status, canteen characteristics and potential barriers to healthy canteen policy implementation, aligned to the 14 domains of the theoretical domains framework via a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). The mean domain scores of canteen managers were calculated, less than four indicating the canteen manager considered the domain was a barrier. Canteen managers were also asked to provide the current canteen menu for audit by a dietitian. Results: Of the 184 participants, 20% (n¿=¿36) were assessed as having menus compliant with the state policy. The five most common domains identified as potential barriers to policy implementation were behavioural regulation (n¿=¿117, 65%), skills (n¿=¿105, 57%), beliefs about capabilities (n¿=¿100, 55%), reinforcement (n¿=¿95, 52%) and goals (n¿=¿95, 52%). Canteen managers who reported optimism as a barrier had significantly lower odds of having a menu compliant with the state policy (OR¿=¿0.39; 95% CI 0.16-0.95, P¿=¿0.038). Conclusions: This study provides further evidence of perceived and actual barriers that canteen managers face when attempting to implement a healthy canteen policy, and highlights the need to address differences in canteen characteristics when planning implementation support. So what?: For public health benefits of nutrition policies within schools to be realised, the barriers to implementation need to be identified and used to help guide implementation support strategies.
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2019 |
Wolfenden L, Nathan N, Reilly K, Delaney T, Janssen LM, Reynolds R, et al., 'Two-year follow-up of a randomised controlled trial to assess the sustainability of a school intervention to improve the implementation of a school-based nutrition policy', Health Promotion Journal of Australia, 30 26-33 (2019) [C1] Issue addressed: School-based nutrition policies can have a positive effect on the school food environment. The primary aim of this study was to assess the primary school adherenc... [more] Issue addressed: School-based nutrition policies can have a positive effect on the school food environment. The primary aim of this study was to assess the primary school adherence to a mandatory state-wide healthy canteen policy 12¿months after an effective multi-strategic implementation intervention concluded. Methods: Primary schools were randomised to (a) a 12-14¿months multi-strategic intervention or (b) no-intervention (control). The intervention aimed to improve implementation of a state-wide canteen policy by encouraging schools to remove unhealthy food and beverages (classified as ¿¿red¿¿ or ¿¿banned¿¿) from canteen menus and replace with healthy items (classified as ¿¿green¿¿). No implementation support was provided to either group by the research team between the 12 and 24¿months data collection period. Results: Seventy schools participated, of which 56 schools were assessed at 24-month follow-up. Intervention schools were less likely to have a menu which contained ¿¿red/banned¿¿ items at 24-month follow-up (RR¿=¿2.28; 95% CI: 1.18-4.40; P¿=¿0.01). Intervention schools, however, were not more likely than controls to have a menu which contained >50% ¿¿green¿¿ items at 24-month follow-up (RR¿=¿1.29; 95% CI: 0.98-1.70; P¿=¿0.10). Intervention schools were more likely to adhere to both policy components (no red/banned items and >50% green items on the menu) than control schools (RR¿=¿2.61; 95% CI: 1.29-5.29; P¿=¿0.006). Among intervention schools that were fully adherent to the policy following implementation support (12-month post baseline), all were also adherent at the 24-month follow-up. Conclusion: The intervention was effective in achieving long-term school adherence to a state-wide canteen policy at 24-month follow-up. So what?: The findings suggest that sustained improvements in implementation of school nutrition policies is possible following a period (12¿months) of comprehensive implementation support.
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2019 |
Wolfenden L, Reilly K, Kingsland M, Grady A, Williams CM, Nathan N, et al., 'Identifying opportunities to develop the science of implementation for community-based non-communicable disease prevention: A review of implementation trials', Preventive Medicine, 118 279-285 (2019) [C1] Implementation of interventions in community organisations such as schools, childcare centres, and sporting clubs are recommended to target a range of modifiable risks of non-comm... [more] Implementation of interventions in community organisations such as schools, childcare centres, and sporting clubs are recommended to target a range of modifiable risks of non-communicable diseases. Poor implementation, however, is common and has contributed to the failure of non-communicable disease interventions globally. This study aimed to characterise experimental research regarding strategies to improve implementation of chronic disease prevention programs in community settings. The review used data collected in three comprehensive systematic reviews undertaken between August 2015 and July 2017. Randomised controlled trials, including cluster design, and non-randomised trials with a parallel control group were included. The data were extracted to describe trial characteristics, implementation strategies employed, implementation outcomes and study quality. Of the 40 implementation trials included in the study, unhealthy diet was the most common risk factor targeted (n = 20). The most commonly reported implementation strategies were educational meetings (n = 38, 95%), educational materials (n = 36, 90%) and educational outreach visits (n = 29, 73%). Few trials were conducted ¿at-scale¿ (n = 8, 20%) or reported adverse effects (n = 5, 13%). The reporting of implementation related outcomes; intervention adoption (n = 13, 33%); appropriateness (n = 11, 28%); acceptability (n = 8, 20%); feasibility (n = 8, 20%); cost (n = 3, 8%); and sustainability (n = 2, 5%); was limited. For the majority of trials, risk of bias was high for blinding of study personnel/participants and outcome assessors. Testing of strategies to improve implementation of non-communicable disease prevention strategies in community settings, delivered ¿at-scale¿, utilising implementation frameworks, including a comprehensive range of implementation outcomes should be priority areas for future research in implementation science.
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2019 |
Yoong SL, Nathan N, Reilly K, Sutherland R, Straus S, Barnes C, et al., 'Adapting implementation strategies: a case study of how to support implementation of healthy canteen policies', Public Health, 177 19-25 (2019) [C1] Objectives: Although evidence-based interventions (EBIs) and effective strategies to implement them exist, they cannot be used by policy makers and practitioners if they do not al... [more] Objectives: Although evidence-based interventions (EBIs) and effective strategies to implement them exist, they cannot be used by policy makers and practitioners if they do not align with end users¿ needs. As such, adaptations to EBIs and implementation approaches are likely to occur to increase ¿fit¿ with end users¿ capacity. This article describes an approach undertaken by a population health service delivery unit in one Australian state to develop an adapted implementation strategy to support the implementation of the mandatory healthy canteen policy (EBI) to all schools located in the service delivery region. Study design: This is a case study of adapting an intervention to improve implementation of the healthy canteen policy. Methods and results: This is a six-step pragmatic, empirically driven approach. The steps include (i) adapt, where appropriate, the EBI to facilitate implementation; (ii) identify end users¿ capacity for implementation; (iii) identify opportunities to adapt the implementation interventions while preserving meaningful intervention impact; (iv) undertake program adaptation; (v) develop training and resources to support delivery of implementation strategies and; (vi) evaluate the adapted intervention. This article describes the application of these steps by the authors to develop an adapted support strategy consistent with end users¿ needs. Conclusions: This study provides some guidance on how to adapt implementation support approaches particularly when EBIs cannot be adapted. Future empirical research providing guidance on making practical adaptation decisions are needed.
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2019 |
Wolfenden L, Bolsewicz K, Grady A, McCrabb S, Kingsland M, Wiggers J, et al., 'Optimisation: Defining and exploring a concept to enhance the impact of public health initiatives', Health Research Policy and Systems, 17 (2019) [C1]
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2018 |
Lee H, Hall A, Nathan N, Reilly KL, Seward K, Williams CM, et al., 'Mechanisms of implementing public health interventions: A pooled causal mediation analysis of randomised trials', Implementation Science, 13 1-11 (2018) [C1]
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2018 |
Nathan N, Elton B, Babic M, McCarthy N, Sutherland R, Presseau J, et al., 'Barriers and facilitators to the implementation of physical activity policies in schools: A systematic review', Preventive Medicine, 107 45-53 (2018) [C1]
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2018 |
Hodder RK, O'Brien KM, Stacey FG, Wyse RJ, Clinton-McHarg T, Tzelepis F, et al., 'Interventions for increasing fruit and vegetable consumption in children aged five years and under (Review)', COCHRANE DATABASE OF SYSTEMATIC REVIEWS, (2018) [C1]
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2018 |
Reilly KL, Reeves P, Deeming S, Yoong SL, Wolfenden L, Nathan N, Wiggers J, 'Economic analysis of three interventions of different intensity in improving school implementation of a government healthy canteen policy in Australia: Costs, incremental and relative cost effectiveness', BMC Public Health, 18 1-9 (2018) [C1]
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2018 |
Müller AM, Maher CA, Vandelanotte C, Hingle M, Middelweerd A, Lopez ML, et al., 'Physical Activity, Sedentary Behavior, and Diet-Related eHealth and mHealth Research: Bibliometric Analysis.', Journal of medical Internet research, 20 e122 (2018) [C1]
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2018 |
Clinton-McHarg T, Janssen L, Delaney T, Reilly K, Regan T, Nathan N, et al., 'Availability of food and beverage items on school canteen menus and association with items purchased by children of primary-school age', Public Health Nutrition, 21 2907-2914 (2018) [C1] Objective To (i) describe the proportion of foods and beverages available on school canteen menus classified as having high ('green'), moderate ('amber') or lo... [more] Objective To (i) describe the proportion of foods and beverages available on school canteen menus classified as having high ('green'), moderate ('amber') or low ('red') nutritional value; (ii) describe the proportion of these items purchased by students; and (iii) examine the association between food and beverage availability on school canteen menus and food and beverage purchasing by students.Design A cross-sectional study was conducted as part of a larger randomised controlled trial (RCT).Setting A nested sample of fifty randomly selected government schools from the Hunter New England region of New South Wales, Australia, who had participated in an RCT of an intervention to improve the availability of healthy foods sold from school canteens, was approached to participate.Subjects School principals, canteen managers and students.Results The average proportion of green, amber and red items available on menus was 47·9, 47·4 and 4·7 %, respectively. The average proportion of green, amber and red items purchased by students was 30·1, 61·8 and 8·1 %, respectively. There was a significant positive relationship between the availability and purchasing of green (R 2=0·66), amber (R 2=0·57) and red menu items (R 2=0·61). In each case, a 1 % increase in the availability of items in these categories was associated with a 1·21, 1·35 and 1·67 % increase in purchasing of items of high, moderate and low nutritional value, respectively.Conclusions The findings provide support for school-based policies to improve the relative availability of healthy foods for sale in these settings.
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2018 |
Reilly KL, Nathan N, Wiggers J, Yoong SL, Wolfenden L, 'Scale up of a multi-strategic intervention to increase implementation of a school healthy canteen policy: Findings of an intervention trial', BMC Public Health, 18 (2018) [C1] Background: Implementation interventions delivered in schools to improve food provision have been found to improve student diet and reduce child obesity risk. If the health benefi... [more] Background: Implementation interventions delivered in schools to improve food provision have been found to improve student diet and reduce child obesity risk. If the health benefits of food availability policies are to be realised, interventions that are effective need to be implemented at scale, across an entire population of schools. This study aims to assess the potential effectiveness of an intervention in increasing the implementation, at scale, of a healthy canteen policy by Australian primary schools. Methods: A non-controlled before and after study was conducted in primary schools located in the Hunter New England region of New South Wales, Australia. Schools received a multi-component intervention adapted from a previous efficacious and cost-effective randomised control trial. The primary trial outcome was the proportion of canteen menus compliant with the state healthy canteen policy, assessed via menu audit at baseline and follow-up by dietitians. Secondary outcomes included policy reach and adoption and maintenance policy implementation. Results: Of the 173 schools eligible for inclusion in the trial, 168 provided menus at baseline and 157 menus were collected at follow-up. At follow-up, multiple imputation analysis found 35% (55/157) of schools compared to 17% (29/168) at baseline (OR = 2.8 (1.6-4.7), p = < 0.001) had menus compliant with the state healthy canteen policy. As an assessment of the impact of the intervention on policy reach, canteen manager and principal knowledge of the policy increased from 64% (n = 76) and 38% (n = 44) respectively at baseline to 69% (n = 89) and 60% (n = 70) at follow-up (p = 0.393, p = 0.026). Adoption of the policy increased from 80% (n = 93) at baseline to 90% (n = 104) at follow-up (p = 0.005) for principals, and from 86% (n = 105) to 96% (n = 124) (p = 0.0001) for canteen managers. Multiple imputation analysis showed intervention effects were maintained six-months post intervention (33% of menus compliant OR = 2.6 (1.5-4.5), p = < 0.001 compared to baseline). Conclusions: This study found school canteen compliance with a healthy food policy increased in association with a multi-strategy intervention delivered at scale. The study provides evidence for public health policy makers and practitioners regarding strategies and modes of support required to support improvement in nutrition policy implementation across entire populations of schools.
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2018 |
Reilly K, Nathan N, Wu JHY, Delaney T, Wyse R, Cobcroft M, et al., 'Assessing the potential impact of a front-of-pack nutritional rating system on food availability in school canteens: A randomised controlled trial', Appetite, 121 309-315 (2018) [C1] Background Front-of-pack graphical nutritional rating of products is becoming an important strategy in many countries to improve healthy food purchases by consumers. Evidence of t... [more] Background Front-of-pack graphical nutritional rating of products is becoming an important strategy in many countries to improve healthy food purchases by consumers. Evidence of the effectiveness of such on facilitating healthy food choices by school food service providers has not been reported. The primary aim of the study was to assess the impact of providing front-of-pack nutritional rating information on school canteen managers¿ likely food selections. Secondary outcomes were canteen manager awareness, attitudes and reported barriers to using the front-of-pack information. Methods A randomised controlled trial involving primary school canteen managers was conducted in a single region in New South Wales, Australia. Eligible participants were randomised to an intervention or control group and asked in a telephone interview which of 12 common food products sold in school canteens they would sell. Both groups received product name and brand information. The intervention group also received information regarding the nutritional rating of products. Results Canteen managers in the intervention group were significantly more likely than those in the control group to indicate they would sell three of the six ¿healthier¿ products (p = 0.036, 0.005, 0.009). There was no difference between groups in the likelihood of making available for sale any of the six ¿less healthy¿ products. The majority of canteen managers who had heard of a product nutritional rating system agreed that it was helpful in identifying ¿healthier¿ foods (88%, n = 31). Conclusions The inclusion of product nutritional rating information has the potential to improve the availability of some ¿healthier¿ items on canteen menus and contribute to improving child dietary intake. Further research is required to determine whether the use of product nutritional rating information actually makes a difference to canteen manager choices.
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2017 |
Wolfenden L, Nathan NK, Sutherland R, Yoong SL, Hodder RK, Wyse RJ, et al., 'Strategies for enhancing the implementation of school-based policies or practices targeting risk factors for chronic disease', COCHRANE DATABASE OF SYSTEMATIC REVIEWS, (2017) [C1]
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2017 |
Seward K, Finch M, Yoong SL, Wyse R, Jones J, Grady A, et al., 'Factors that influence the implementation of dietary guidelines regarding food provision in centre based childcare services: A systematic review', Preventive Medicine, 105 197-205 (2017) [C1] Children attending centre based childcare services consume as much as two thirds of their daily dietary requirements while in care. However, such services often fail to provide fo... [more] Children attending centre based childcare services consume as much as two thirds of their daily dietary requirements while in care. However, such services often fail to provide foods that are consistent with guideline recommendations. Developing strategies to improve childcare service adherence to menu dietary guidelines requires a comprehensive understanding of factors that may impede or promote implementation. The primary aim of this systematic review is to describe factors (barriers and facilitators) that may influence the implementation of menu dietary guidelines regarding food provision in centre-based childcare services and to map these factors to a theoretical framework. Over 7000 citations were identified from all sources. Duplicate abstracts were removed and selection criteria applied. Twelve studies (1994¿2015) were included in the review. Dual data extraction was conducted and the reported factors were synthesised using the theoretical domains framework (TDF). Barriers and facilitators identified in qualitative studies were classified into 8 and 10 of the 14 TDF domains. Barriers and facilitators reported in quantitative studies covered 6 and 3 TDF domains respectively. The most common domain of which both barriers and facilitators to the implementation of menu dietary guidelines were identified was ¿environmental context and resources¿. This is the first study that comprehensively assesses literature to identify factors that influence the implementation of menu dietary guidelines in childcare services utilising a theoretical framework. Findings provide guidance to support researchers and policy makers design strategies to improve menu dietary guideline implementation and, as such have the potential to improve food provision in care.
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2017 |
Hodder RK, Stacey FG, Wyse RJ, O'Brien KM, Clinton-McHarg T, Tzelepis F, et al., 'Interventions for increasing fruit and vegetable consumption in children aged five years and under', COCHRANE DATABASE OF SYSTEMATIC REVIEWS, (2017) [C1]
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2017 |
Sutherland RL, Nathan NK, Lubans DR, Cohen K, Davies LJ, Desmet C, et al., 'An RCT to Facilitate Implementation of School Practices Known to Increase Physical Activity.', American journal of preventive medicine, 53 818-828 (2017) [C1]
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2017 |
Hollis JL, Sutherland R, Williams AJ, Campbell E, Nathan N, Wolfenden L, et al., 'A systematic review and meta-analysis of moderate-to-vigorous physical activity levels in secondary school physical education lessons', International Journal of Behavioral Nutrition and Physical Activity, 14 (2017) [C1] Background: Schools play an important role in physical activity promotion for adolescents. The systematic review aimed to determine the proportion of secondary (middle and high) s... [more] Background: Schools play an important role in physical activity promotion for adolescents. The systematic review aimed to determine the proportion of secondary (middle and high) school physical education (PE) lesson time that students spend in moderate to vigorous physical activity (MVPA), and to assess if MVPA was moderated by school level (middle and high school), type of physical activity measurement and type of PE activities. Methods: A systematic search of nine electronic databases was conducted (PROSPERO2014:CRD42014009649). Studies were eligible if they were published between 2005 and 2014; written in English; assessed MVPA in PE lessons of secondary (middle and high) school students; and used a quantitative MVPA measure (i.e., accelerometry, heart rate monitoring, pedometers or observational measures). Two reviewers examined the retrieved articles, assessed risk of bias, and performed data extraction. Random effects meta-analysis was used to calculate a pooled estimate of the percent of PE lesson time spent in MVPA and to assess moderator effects where data allowed. Results: The search yielded 5,132 potentially relevant articles; 28 articles representing 25 studies (7 middle and 18 high school) from seven countries were included. Twelve studies measured MVPA through observational measures, seven used accelerometers, five used heart rate monitors and four used pedometers (including three studies using a mix of measures). Meta-analysis of 15 studies found that overall, students spent a mean (95% CI) of 40.5% (34.8-46.2%) of PE in MVPA. Middle school students spent 48.6% (41.3-55.9%) of the lesson in MVPA (n=5 studies) and high school students 35.9% (28.3-43.6%) (n=10 studies). Studies measuring MVPA using accelerometers (n=5) showed that students spent 34.7% (25.1-44.4%) of the lesson in MVPA, while 44.4% (38.3-50.5%) was found for lessons assessed via observation (n=9), 43.1% (24.3-61.9%) of the lesson for a heart rate based study, and 35.9% (31.0-40.8%) for a pedometer-measured study. Conclusions: The proportion of PE spent in MVPA (40.5%) is below the US Centre for Disease Control and Prevention and the UK Associations for Physical Education recommendation of 50%. Findings differed according to the method of MVPA assessment. Additional strategies and intervention research are needed to build more active lesson time in PE.
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2017 |
Nathan N, Sutherland R, Beauchamp MR, Cohen K, Hulteen RM, Babic M, et al., 'Feasibility and efficacy of the Great Leaders Active StudentS (GLASS) program on children's physical activity and object control skill competency: A non-randomised trial', Journal of Science and Medicine in Sport, 20 1081-1086 (2017) [C1]
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2017 |
Nathan N, Wiggers J, Wyse R, Williams CM, Sutherland R, Yoong SL, et al., 'Factors associated with the implementation of a vegetable and fruit program in a population of Australian elementary schools', Health Education Research, 32 197-205 (2017) [C1]
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2017 |
Wyse R, Yoong SL, Dodds P, Campbell L, Delaney T, Nathan N, et al., 'Online canteens: Awareness, use, barriers to use, and the acceptability of potential online strategies to improve public health nutrition in primary schools', Health Promotion Journal of Australia, 28 67-71 (2017) [C1] Issue addressed: This study of primary school principals assessed the awareness, use, barriers to use and acceptability of online canteens. Methods: A telephone survey of 123 prim... [more] Issue addressed: This study of primary school principals assessed the awareness, use, barriers to use and acceptability of online canteens. Methods: A telephone survey of 123 primary school principals within the Hunter New England Region of New South Wales, Australia was conducted from September 2014 to November 2014. Results: Fifty-six percent of principals were aware of the existence of online canteens, with 8% having implemented such a system, and 38% likely to do so in the future. Medium/large schools were more likely to be aware of or to use online canteens, however there were no differences in awareness or use in relation to school rurality or socioeconomic advantage. Principals cited parent internet access as the most commonly identified perceived barrier to online canteen use, and the majority of principals (71-93%) agreed that it would be acceptable to implement a range of consumer behaviour strategies via an online canteen. Conclusions: Study findings suggest that despite relatively low levels of current use, online canteens have the potential to reach a large proportion of school communities in the future, across geographical and socioeconomic divides, and that the nutrition interventions which they have the capacity to deliver are considered acceptable to school principals. So what? Online canteens may represent an opportunity to deliver nutrition interventions to school communities. Future research should examine the feasibility and potential effectiveness of interventions delivered via this modality.
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2017 |
Borde R, Smith JJ, Sutherland R, Nathan N, Lubans DR, 'Methodological considerations and impact of school-based interventions on objectively measured physical activity in adolescents: a systematic review and meta-analysis', Obesity Reviews, 18 476-490 (2017) [C1] Objective: The aims of this systematic review and meta-analysis are (i) to determine the impact of school-based interventions on objectively measured physical activity among adole... [more] Objective: The aims of this systematic review and meta-analysis are (i) to determine the impact of school-based interventions on objectively measured physical activity among adolescents and (ii) to examine accelerometer methods and decision rule reporting in previous interventions. Methods: A systematic search was performed to identify randomized controlled trials targeting adolescents (age: =10¿years), conducted in the school setting, and reporting objectively measured physical activity. Random effects meta-analyses were conducted to determine the pooled effects of previous interventions on total and moderate-to-vigorous physical activity. Potential moderators of intervention effects were also explored. Results: Thirteen articles met the inclusion criteria, and twelve were included in the meta-analysis. The pooled effects were small and non-significant for both total physical activity (standardized mean difference¿=¿0.02 [95% confidence interval¿=¿-0.13 to 0.18]) and moderate-to-vigorous physical activity (standardized mean difference¿=¿0.24 [95% confidence interval¿=¿-0.08 to 0.56]). Sample age and accelerometer compliance were significant moderators for total physical activity, with a younger sample and higher compliance associated with larger effects. Conclusion: Previous school-based physical activity interventions targeting adolescents have been largely unsuccessful, particularly for older adolescents. There is a need for more high-quality research using objective monitoring in this population. Future interventions should comply with best-practice recommendations regarding physical activity monitoring protocols.
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2017 |
Wolfenden L, Nathan N, Janssen LM, Wiggers J, Reilly K, Delaney T, et al., 'Multi-strategic intervention to enhance implementation of healthy canteen policy: a randomised controlled trial', IMPLEMENTATION SCIENCE, 12 (2017) [C1]
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2016 |
Nathan N, Yoong SL, Sutherland R, Reilly K, Delaney T, Janssen L, et al., 'Effectiveness of a multicomponent intervention to enhance implementation of a healthy canteen policy in Australian primary schools: a randomised controlled trial', INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY, 13 (2016) [C1]
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2016 |
Sutherland RL, Campbell EM, Lubans DR, Morgan PJ, Nathan NK, Wolfenden L, et al., 'The Physical Activity 4 Everyone Cluster Randomized Trial: 2-Year Outcomes of a School Physical Activity Intervention Among Adolescents.', Am J Prev Med, 51 195-205 (2016) [C1]
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2016 |
Yoong SL, Nathan N, Wolfenden L, Wiggers J, Reilly K, Oldmeadow C, et al., 'CAFE: a multicomponent audit and feedback intervention to improve implementation of healthy food policy in primary school canteens: a randomised controlled trial', INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY, 13 (2016) [C1]
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2016 |
Sutherland R, Reeves P, Campbell E, Lubans DR, Morgan PJ, Nathan N, et al., 'Cost effectiveness of a multi-component school-based physical activity intervention targeting adolescents: The 'Physical Activity 4 Everyone' cluster randomized trial', International Journal of Behavioral Nutrition and Physical Activity, 13 (2016) [C1] Background: Few school-based interventions have been successful in reducing physical activity decline and preventing overweight and obesity in adolescent populations. As a result,... [more] Background: Few school-based interventions have been successful in reducing physical activity decline and preventing overweight and obesity in adolescent populations. As a result, few cost effectiveness analyses have been reported. The aim of this paper is to report the cost and cost effectiveness of the Physical Activity 4 Everyone (PA4E1) intervention which was a multi-component intervention implemented in secondary schools located in low-income communities. Cost effectiveness was assessed using both the physical activity and weight status trial outcomes. Methods: Intervention and Study Design: The PA4E1 cluster randomised controlled trial was implemented in 10 Australian secondary schools (5 intervention: 5 control) and consisted of intervention schools receiving seven physical activity promotion strategies and six additional strategies that supported school implementation of the intervention components. Costs associated with physical activity strategies, and intervention implementation strategies within the five intervention schools were estimated and compared to the costs of usual physical activity practices of schools in the control group. The total cost of implementing the intervention was estimated from a societal perspective, based on the number of enrolled students in the target grade at the start of the intervention (Grade 7, n = 837). Economic Outcomes: The economic analysis outcomes were cost and incremental cost effectiveness ratios for the following: minutes of moderate-to-vigorous physical activity (MVPA) per day gained, MET hours gained per person/day; Body Mass Index (BMI) unit avoided; and 10 % reduction in BMI z-score. Results: The intervention cost AUD $329,952 over 24 months, or AUD$394 per student in the intervention group. This resulted in a cost effectiveness ratio of AUD$56 ($35-$147) per additional minute of MVPA, AUD$1 ($0.6-$2.7) per MET hour gained per person per day, AUD$1408 ($788-$6,570) per BMI unit avoided, and AUD$563 ($282-$3,942) per 10 % reduction in BMI z-score. Conclusion: PA4E1 is a cost effective intervention for increasing the physical activity levels and reducing unhealthy weight gain in adolescence, a period in which physical activity typically declines. Additional modelling could explore the potential economic impact of the intervention on morbidity and mortality. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12612000382875.
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2016 |
Vandelanotte C, Müller AM, Short CE, Hingle M, Nathan N, Williams SL, et al., 'Past, Present, and Future of eHealth and mHealth Research to Improve Physical Activity and Dietary Behaviors', Journal of Nutrition Education and Behavior, 48 219-228.e1 (2016) [C1] Because physical inactivity and unhealthy diets are highly prevalent, there is a need for cost-effective interventions that can reach large populations. Electronic health (eHealth... [more] Because physical inactivity and unhealthy diets are highly prevalent, there is a need for cost-effective interventions that can reach large populations. Electronic health (eHealth) and mobile health (mHealth) solutions have shown promising outcomes and have expanded rapidly in the past decade. The purpose of this report is to provide an overview of the state of the evidence for the use of eHealth and mHealth in improving physical activity and nutrition behaviors in general and special populations. The role of theory in eHealth and mHealth interventions is addressed, as are methodological issues. Key recommendations for future research in the field of eHealth and mHealth are provided.
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2016 |
Wolfenden L, Williams CM, Wiggers J, Nathan N, Yoong SL, 'Improving the translation of health promotion interventions using effectiveness-implementation hybrid designs in program evaluations', Health Promotion Journal of Australia, 27 204-207 (2016) [C1] Bridging the gap between research-based evidence and public health policy and practice is a considerable challenge to public health improvement this century, requiring a rethinkin... [more] Bridging the gap between research-based evidence and public health policy and practice is a considerable challenge to public health improvement this century, requiring a rethinking of conventional approaches to health research production and use. Traditionally the process of research translation has been viewed as linear and unidirectional, from epidemiological research to identify health problems and determinants, to efficacy and effectiveness trials and studies of strategies to maximise the implementation and dissemination of evidence-based interventions in practice. A criticism of this approach is the considerable time it takes to achieve translation of health research into practice. Hybrid evaluation designs provide one means of accelerating the research translation process by simultaneously collecting information regarding intervention impacts and implementation and dissemination strategy. However, few health promotion research trials employ such designs and often fail to report information to enable assessment of the feasibility and potential impact of implementation and dissemination strategies. In addition to intervention effects, policy makers and practitioners also want to know the impact of implementation strategies. This commentary will define the three categories of effectiveness-implementation hybrid designs, describe their application in health promotion evaluation, and discuss the potential implications of more systematic use of such designs for the translation of health promotion and evaluation.So what?Greater use of effectiveness-implementation hybrid designs may accelerate research translation by providing more practice- and policy-relevant information to end-users, more quickly.
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2016 |
Hollis JL, Sutherland R, Campbell L, Morgan PJ, Lubans DR, Nathan N, et al., 'Effects of a 'school-based' physical activity intervention on adiposity in adolescents from economically disadvantaged communities: secondary outcomes of the 'Physical Activity 4 Everyone' RCT', INTERNATIONAL JOURNAL OF OBESITY, 40 1486-1493 (2016) [C1]
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2016 |
Hollis JL, Williams AJ, Sutherland R, Campbell E, Nathan N, Wolfenden L, et al., 'A systematic review and meta-analysis of moderate-to-vigorous physical activity levels in elementary school physical education lessons', Preventive Medicine, 86 34-54 (2016) Objective: To examine elementary school students' moderate-to-vigorous physical activity (MVPA) levels during physical education (PE) lessons. Methods: A systematic search of... [more] Objective: To examine elementary school students' moderate-to-vigorous physical activity (MVPA) levels during physical education (PE) lessons. Methods: A systematic search of nine electronic databases was conducted (PROSPERO2014:CRD42014009649). Studies were eligible if they were in English; published between 2005-April 2014; assessed MVPA levels in PE lessons of elementary school children (aged four-12 years); and used an objective MVPA measure. Two reviewers retrieved articles, assessed risk of bias, and performed data extraction. The findings were synthesised using a meta-analysis. Results: The search yielded 5132 articles. Thirteen studies from nine countries met the inclusion criteria. Eight studies measured MVPA through observational measures, five used accelerometry and one used heart rate monitoring. The percentage of PE lesson time spent in MVPA ranged between 11.4-88.5%. Meta-analysis of seven studies (direct observations; 4 accelerometers) found that children spent a mean (95% CI) 44.8 (28.2-61.4)% of PE lesson time in MVPA. When measured using direct observation and accelerometers, children spent 57.6 (47.3-68.2) and 32.6 (5.9-59.3)% of PE lesson time in MVPA, respectively. The review has limitations; the search strategy was restricted to studies in English; theses, dissertations and conference abstracts were excluded; and six studies that provided insufficient data were excluded from the meta-analysis. Conclusion: MVPA levels during elementary school PE lessons do not meet the United States Centre for Disease Control and Prevention and the United Kingdom's Association of Physical Education recommendation (50% of lesson time), but is higher than estimated in the previous review (34.2%). Interventions to increase MVPA in PE lessons are needed.
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2016 |
Yoong SL, Finch M, Nathan N, Wiggers J, Lecathelinais C, Jones J, et al., 'A longitudinal study assessing childcare services' adoption of obesity prevention policies and practices', Journal of Paediatrics and Child Health, 52 765-770 (2016) [C1] Aim: Despite ongoing investments to improve the obesogenic environments of childcare settings, little is known regarding how these services have changed their physical activity an... [more] Aim: Despite ongoing investments to improve the obesogenic environments of childcare settings, little is known regarding how these services have changed their physical activity and nutrition-promoting practices. This study aims to describe changes in the proportion of Australian childcare services that have adopted best-practice healthy eating and physical activity practices between 2006 and 2013 and to assess whether adoption varied by socio-economic status and locality. Methods: A randomly selected sample of nominated supervisors (n = 358) from childcare services located in New South Wales, Australia, participated in a telephone survey in 2006, 2009, 2010 and 2013. Supervisors reported on their service's adoption of six practices: (i) having written nutrition and physical activity policies; (ii) staff trained in physical activity and nutrition in the past year; (iii) scheduled time for fundamental movement skills and (iv) outdoor play; (v) weekly or less screen time opportunities; and (vi) serving only non-sweetened beverages. Results: A significant increase in the prevalence of services adopting all but one practice, between 2006 and 2013 was identified. Ninety one percent of services adopted four or more practices, a significant increase from 38% in 2006. There were no differences in the proportion of services adopting each practice by locality and socio-economic status. Conclusions: Government investment in obesity prevention programmes can equitably improve childcare service's adoption of healthy eating and physical activity promoting practices on a jurisdiction-wide basis. The establishment of a routine system to monitor adoption of a broader range of practices by childcare services is warranted.
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2016 |
Reilly K, Nathan N, Wolfenden L, Wiggers J, Sutherland R, Wyse R, Yoong SL, 'Validity of four measures in assessing school canteen menu compliance with state-based healthy canteen policy', Health Promotion Journal of Australia, 27 215-221 (2016) [C1] Issue addressed In order to assess the impact of healthy school canteen policies on food availability for students, valid methods of measuring compliance are needed that can be ap... [more] Issue addressed In order to assess the impact of healthy school canteen policies on food availability for students, valid methods of measuring compliance are needed that can be applied at scale. The aim of this study is to assess the validity and direct cost of four methods to assess policy compliance: 1) principal and 2) canteen manager self-report via a computer-assisted telephone interview; and 3) comprehensive and 4) quick menu audits by dietitians, compared with observations. Methods A cross-sectional study took place in the Hunter region of NSW, Australia, in a sample of 38 primary schools that had previously participated in a randomised controlled trial to improve healthy canteen policy compliance. Policy compliance was assessed using the four methods specified above. Percentage agreement, kappa, sensitivity and specificity compared with observations was calculated together with the direct time taken and costs of each method. Indirect costs (including set-up costs) for all measures have not been included. Results Agreement with observations was substantial for the quick menu audit (kappa=0.68), and moderate for the comprehensive menu audit (kappa=0.42). Principal and canteen manager self-report resulted in poor agreement and low specificity with the gold standard. The self-reported measures had the lowest cost, followed by the quick menu audit and lastly the comprehensive menu audit. Conclusion The quick menu audit represents a valid and potentially low-cost method of supporting policy implementation at scale. So what? This study demonstrates that a quick menu audit represents a valid measure of undertaking assessment of school canteen policy compliance at a population level.
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2016 |
Sutherland R, Campbell E, Lubans DR, Morgan PJ, Okely AD, Nathan N, et al., 'Physical education in secondary schools located in low-income communities: Physical activity levels, lesson context and teacher interaction', Journal of Science and Medicine in Sport, 19 135-141 (2016) [C1] Objectives: Physical education (PE) plays an important role in contributing to students' physical activity (PA); however, moderate-to-vigorous PA (MVPA) within PE is lower th... [more] Objectives: Physical education (PE) plays an important role in contributing to students' physical activity (PA); however, moderate-to-vigorous PA (MVPA) within PE is lower than recommended. Little is known about the PA levels of students from disadvantaged schools within PE. This study aimed to describe: (i) the PA levels of students from disadvantaged secondary schools during PE lessons, (ii) the lesson context and teacher interactions occurring during PE, and (iii) the associations between teacher, school or PE lesson characteristics with student physical activity levels in PE. Design: Cross-sectional study of 100 Grade 7 PE lessons across 10 secondary schools. Methods: System for observing fitness instruction time (SOFIT) was used to assess student PA, lesson context, and teacher interaction. Teacher and school characteristics were collected via survey. Mean proportion of lesson time was used to describe PA, lesson context and teacher interaction. Associations between each outcome variable and each characteristic were examined using 2-sample t-tests, ANOVAs and linear regression. Results: Thirty-nine percent of PE lesson was spent in MVPA, and less than 10% spent in VA. Lessons in schools in urban areas included significantly more MVPA than rural areas (P = 0.04). Male teachers and more experienced teachers conducted lessons with significantly more VA than female and less experienced teachers (P = 0.04 and 0.02). MVPA was also higher in lessons conducted by more experienced teachers. Conclusions: PA during PE lessons within disadvantaged secondary schools is below international recommendations. Male teachers, more experienced teachers and schools in urban regions teach more active lessons.
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2016 |
Sutherland R, Campbell E, Lubans DR, Morgan PJ, Okely AD, Nathan N, et al., ''Physical activity 4 everyone' school-based intervention to prevent decline in adolescent physical activity levels: 12 month (mid-intervention) report on a cluster randomised trial', British Journal of Sports Medicine, 50 488-495 (2016) [C1] Background: Adolescence is a recognised period of physical activity decline, particularly among low-income communities. We report the 12-month (midpoint) effects of a 2-year multi... [more] Background: Adolescence is a recognised period of physical activity decline, particularly among low-income communities. We report the 12-month (midpoint) effects of a 2-year multicomponent physical activity intervention implemented in disadvantaged secondary schools. Methods: A cluster randomised trial was undertaken in 10 secondary schools located in disadvantaged areas in New South Wales, Australia. Students in Grade 7 were recruited, with follow-up in Grade 8. The intervention was guided by socioecological theory and included seven physical activity strategies, and six implementation adoption strategies. The primary outcome was mean minutes of moderate-to-vigorous physical activity (MVPA) per day assessed using Actigraph GT3X accelerometers. Outcome data were analysed using repeated measures linear mixed models. Results: At baseline, 1150 (93%) students participated in the data collection (mean age 12 years, 48% boys) and 1050 (79%) students participated at 12-month follow-up. By the 12-month follow-up, the six implementation adoption strategies had been used to support schools to deliver four of the seven physical activity elements. There was a significant group-by-time interaction for mean minutes of MVPA per day in favour of the intervention group (adjusted difference between groups at follow-up=3.85 min, 95% CI (0.79 to 6.91), p=0.01), including significantly more vigorous physical activity (2.45 min, p=0.01), equating to 27 min more MVPA per week. Summary: At 12-month follow-up, the intervention had reduced the decline in physical activity among adolescents from disadvantaged schools. The intervention may assist students to meet physical activity guidelines.
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2015 |
Williams CM, Nathan NK, Wyse RJ, Yoong SL, Delaney T, Wiggers J, et al., 'Strategies for enhancing the implementation of school-based policies or practices targeting risk factors for chronic disease', Cochrane Database of Systematic Reviews, 2015 (2015) This is the protocol for a review and there is no abstract. The objectives are as follows: The primary aims of the review are to examine the effectiveness of strategies aiming to ... [more] This is the protocol for a review and there is no abstract. The objectives are as follows: The primary aims of the review are to examine the effectiveness of strategies aiming to improve the implementation of school-based policies, programs or practices that aim to promote healthy or reduce unhealthy behaviours relating to child diet, physical activity, obesity, or tobacco or alcohol use. Secondary objectives of the review are to: examine the effectiveness of implementation strategies on health behavioural (e.g. fruit and vegetable consumption) and anthropometric outcomes (e.g. BMI, weight); describe the impact of such strategies on the knowledge, skills or attitudes of stakeholders involved in implementing health promoting policies, programs or practices; describe the cost or cost effectiveness of such strategies; describe any unintended adverse effects of strategies on schools, school staff or children.
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2015 |
Hills A, Nathan N, Robinson K, Fox D, Wolfenden L, 'Improvement in primary school adherence to the NSW Healthy School Canteen Strategy in 2007 and 2010', Health Promotion Journal of Australia, 26 89-92 (2015) [C1] Issue addressed Since 2005, a government-endorsed strategy guiding food sold in New South Wales school canteens has been in place. This study describes the changes in school cante... [more] Issue addressed Since 2005, a government-endorsed strategy guiding food sold in New South Wales school canteens has been in place. This study describes the changes in school canteen food between 2007 and 2010 and characterises schools most likely to adhere to strategy guidelines. Methods Menus obtained from a cohort of primary and central schools in the Hunter New England region of New South Wales were audited using a traffic light system of classification. Energy dense, nutrient-poor or 'red' items are restricted; 'amber' are to be selected carefully and healthier 'green' items are encouraged. Results In 2007, 7% of schools had no red items on their menu. In 2010, this improved to 22% (P<0.05). In 2010, small schools (OR=1.9, 95% CI=1.25-3.05, P=0.003); lower socioeconomic schools (OR=1.3, 95% CI=1.02-1.78, P=0.03); non-government (OR=1.7, 95% CI=1.22-2.23, P=0.001) and rural schools (OR=1.7, 95% CI=1.30-2.25, P<0.001) had higher odds of having red items on the menu. No significant change occurred in the proportion of green foods listed for sale between 2007 and 2010. Conclusions Proportion of schools adhering to strategy guidelines had increased slightly, however, most continue to list red items for regular sale. So what? For health policies to improve public health they need implementation. Findings suggest more work is required, particularly in small schools, rural schools and non-government schools.
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2015 |
Wolfenden L, Finch M, Nathan N, Weaver N, Wiggers J, Yoong SL, et al., 'Factors associated with early childhood education and care service implementation of healthy eating and physical activity policies and practices in Australia: a cross-sectional study', Translational Behavioral Medicine, 5 327-334 (2015) [C1] Many early childhood education and care (ECEC) services fail to implement recommended policies and practices supportive of healthy eating and physical activity. The purpose of thi... [more] Many early childhood education and care (ECEC) services fail to implement recommended policies and practices supportive of healthy eating and physical activity. The purpose of this study was to assess whether certain theoretically-based factors are associated with implementation of healthy eating and physical activity policies and practices in a sample of ECEC services. A cross-sectional survey was conducted with Service Managers of ECEC services. The survey assessed the operational characteristics, policy, and practice implementation, and 13 factors were suggested by Damschroder¿s Consolidated Framework for Implementation Research to impede or promote implementation. Logistic regression analyses found a significant association between implementation factor score and full implementation (OR 1.38; 95% CI 1.18¿1.61; p = <0.01), indicating that for every one point increase in implementation score, ECEC services were 38¿% more likely to be fully implementing the policies and practices. The findings highlight the opportunities for improving implementation of obesity prevention interventions in this setting by developing interventions that address such factors.
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2015 |
Nathan N, Wolfenden L, Williams CM, Yoong SL, Lecathelinais C, Bell AC, et al., 'Adoption of obesity prevention policies and practices by Australian primary schools: 2006 to 2013', HEALTH EDUCATION RESEARCH, 30 262-271 (2015) [C1]
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2015 |
Yoong SL, Nathan NK, Wyse RJ, Preece SJ, Williams CM, Sutherland RL, et al., 'Assessment of the School Nutrition Environment: A Study in Australian Primary School Canteens', American Journal of Preventive Medicine, 49 215-222 (2015) [C1] Introduction Schools represent a valuable setting for interventions to improve children's diets, as they offer structured opportunities for ongoing intervention. Modification... [more] Introduction Schools represent a valuable setting for interventions to improve children's diets, as they offer structured opportunities for ongoing intervention. Modifications to the school food environment can increase purchasing of healthier foods and improve children's diets. This study examines the availability of healthy food and drinks, implementation of pricing and promotion strategies in Australian primary school canteens, and whether these varied by school characteristics. Methods In 2012 and 2013, canteen managers of primary schools in the Hunter New England region of New South Wales reported via telephone interview the pricing and promotion strategies implemented in their canteens to encourage healthier food and drink purchases. A standardized audit of canteen menus was performed to assess the availability of healthy options. Data were analyzed in 2014. Results Overall, 203 (79%) canteen managers completed the telephone interview and 170 provided menus. Twenty-nine percent of schools had menus that primarily consisted of healthier food and drinks, and 11% did not sell unhealthy foods. Less than half reported including only healthy foods in meal deals (25%), labeling menus (43%), and having a comprehensive canteen policy (22%). A significantly larger proportion of schools in high socioeconomic areas (OR=3.0) and large schools (OR=4.4) had primarily healthy options on their menus. School size and being a Government school were significantly associated with implementation of some pricing and promotion strategies. Conclusions There is a need to monitor canteen environments to inform policy development and research. Future implementation research to improve the food environments of disadvantaged schools in particular is warranted.
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2015 |
Nathan N, Wolfenden L, Rose B, Robertson K, Wiggers J, 'Benefits of policy support of a healthy eating initiative in schools', Australian and New Zealand Journal of Public Health, 39 94-95 (2015) [C3]
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2015 |
Williams CM, Nathan N, Delaney T, Yoong SL, Wiggers J, Preece S, et al., 'CAFÉ: A multicomponent audit and feedback intervention to improve implementation of healthy food policy in primary school canteens: Protocol of a randomised controlled trial', BMJ Open, 5 (2015) [C1] Introduction: A number of jurisdictions internationally have policies requiring schools to implement healthy canteens. However, many schools have not implemented such policies. On... [more] Introduction: A number of jurisdictions internationally have policies requiring schools to implement healthy canteens. However, many schools have not implemented such policies. One reason for this isthat current support interventions cannot feasibly be delivered to large numbers of schools. A promising solution to support population-wide implementation of healthy canteen practices is audit and feedback. The effectiveness of this strategy has, however, not previously been assessed in school canteens. This study aims to assess the effectiveness and cost-effectiveness of an audit and feedback intervention, delivered by telephone and email, in increasing the number of school canteens that have menus complying with a government healthy-canteen policy. Methods and analysis: Seventy-two schools, across the Hunter New England Local Health District in New South Wales Australia, will be randomised to receive the multicomponent audit and feedback implementation intervention or usual support. The intervention will consist of between two and four canteen menu audits over 12 months. Each menu audit will be followed by two modes of feedback: a written feedback report and a verbal feedback/support via telephone. Primary outcomes, assessed by dieticians blind to group status and as recommended by the Fresh Tastes @ School policy, are: (1) the proportion of schools with a canteen menu containing foods or beverages restricted for sale, and; (2) the proportion of schools that have a menu which contains more than 50% of foods classified as healthy canteen items. Secondary outcomes are: the proportion of menu items in each category ('red', 'amber' and 'green'), canteen profitability and cost-effectiveness. Ethics and dissemination: Ethical approval has been obtained by from the Hunter New England Human Research Ethics Committee and the University of Newcastle Human Research Ethics Committee. The findings will be disseminated in usual forums, including peer-reviewed publication and conference presentations.
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2015 |
Yoong SL, Williams CM, Finch M, Wyse R, Jones J, Freund M, et al., 'Childcare service centers' preferences and intentions to use a web-based program to implement healthy eating and physical activity policies and practices:a cross-sectional study', Journal of Medical Internet Research, 17 (2015) [C1] Background: Overweight and obesity is a significant public health problem that impacts a large number of children globally. Supporting childcare centers to deliver healthy eating ... [more] Background: Overweight and obesity is a significant public health problem that impacts a large number of children globally. Supporting childcare centers to deliver healthy eating and physical activity-promoting policies and practices is a recommended strategy for obesity prevention, given that such services provide access to a substantial proportion of children during a key developmental period. Electronic Web-based interventions represent a novel way to support childcare service providers to implement such policies and practices. Objective: This study aimed to assess: (1) childcare centers' current use of technology, (2) factors associated with intention to use electronic Web-based interventions, and (3) Web-based features that managers rated as useful to support staff with implementing healthy eating and physical activity-promoting policies and practices. Methods: A computer-Assisted telephone interview (CATI) was conducted with service managers from long day care centers and preschools. The CATI assessed the following: (1) childcare center characteristics, (2) childcare centers' use of electronic devices, (3) intention to use a hypothetical electronic Web-based program-Assessed using the Technology Acceptance Model (TAM) with ratings between 1 (strongly disagree) and 7 (strongly agree), and (4) features rated as useful to include in a Web-based program. Results: Overall, 214 service centers out of 277 (77.3%) consented to participate. All service centers except 2 reported using computers (212/214, 99.1%), whereas 40.2% (86/214) used portable tablets. A total of 71.9% (151/210) of childcare service managers reported a score of 6 or more for intention to use a hypothetical electronic Web-based program. In a multivariable logistic regression analysis, intention to use the program was significantly associated with perceived ease of use (P=.002, odds ratio [OR] 3.9, 95% CI 1.6-9.2) and perceived usefulness (P<.001, OR 28,95% CI 8.0-95.2). Features reported by service managers as useful or very useful for a Web-based program included decision-support tools to support staff with menu planning (117/129, 90.7%), links to relevant resources (212/212, 100%), updated information on guidelines (208/212, 98.1%), and feedback regarding childcare center performance in relation to other childcare centers (212/212, 100%). Conclusions: Childcare service managers reported high intention to use a Web-based program and identified several useful features to support staff to implement healthy eating and physical activity policies and practices. Further descriptive and intervention research examining the development and use of such a program to support childcare centers with the implementation of healthy eating and physical activity-promoting policies and practices is warranted.
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2015 |
Wolfenden L, Nathan N, Williams CM, 'Computer-tailored interventions to facilitate health behavioural change.', Br J Sports Med, 49 1478-1479 (2015) [C2]
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2014 |
Dodds P, Wyse R, Jones J, Wolfenden L, Lecathelinais C, Williams A, et al., 'Validity of a measure to assess healthy eating and physical activity policies and practices in Australian childcare services', BMC Public Health, 14 (2014) [C1] Childcare services represent a valuable obesity prevention opportunity, providing access to a large portion of children at a vital point in their development. Few rigorously valid... [more] Childcare services represent a valuable obesity prevention opportunity, providing access to a large portion of children at a vital point in their development. Few rigorously validated measures exist to measure healthy eating and physical activity policies and practices in this setting, and no such measures exist that are specific to the childcare setting in Australia. Methods. This was a cross sectional study, comparing two measures (pen and paper survey and observation) of healthy eating and physical activity policies and practices in childcare services. Research assistants attended consenting childcare services (n = 42) across the Hunter region of New South Wales, Australia and observed practices for one day. Nominated Supervisors and Room Leaders of the service also completed a pen and paper survey during the day of observation. Kappa statistics and proportion agreement were calculated for a total of 43 items relating to healthy eating and physical activity policies and practices. Results: Agreement ranged from 38%-100%. Fifty one percent of items showed agreement of greater than or equal to 80%. Items assessing the frequency with which staff joined in active play with children reported the lowest percent agreement, while items assessing availability of beverages such as juice, milk and cordial, as well as the provision of foods such as popcorn, pretzels and sweet biscuits, reported the highest percent agreement. Kappa scores ranged from -0.06 (poor agreement) to 1 (perfect agreement). Of the 43 items assessed, 27 were found to have moderate or greater agreement. Conclusions: The study found that Nominated Supervisors and Room Leaders were able to accurately report on a number of healthy eating and physical activity policies and practices. Items assessing healthy eating practices tended to have higher kappa scores than those assessing physical activity related policies or practices. The tool represents a useful instrument for public health researchers and policy makers working in this setting. © 2014Dodds et al.; licensee BioMed Central Ltd.
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2014 |
Wolfenden L, Nathan N, Williams CM, Delaney T, Reilly KL, Freund M, et al., 'A randomised controlled trial of an intervention to increase the implementation of a healthy canteen policy in Australian primary schools: study protocol.', Implement Sci, 9 147 (2014) [C3]
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2014 |
Williams CM, Nathan N, Wolfenden L, 'Physical activity promotion in primary care has a sustained influence on activity levels of sedentary adults', British Journal of Sports Medicine, 48 1069-1070 (2014) [C3]
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2013 |
Nathan N, Wolfenden L, Morgan PJ, 'Pre-service primary school teachers' experiences of physical education', AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, 37 294-294 (2013) [C3]
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2013 |
Sutherland R, Campbell E, Lubans DR, Morgan PJ, Okely AD, Nathan N, et al., 'A cluster randomised trial of a school-based intervention to prevent decline in adolescent physical activity levels: study protocol for the 'Physical Activity 4 Everyone' trial', BMC PUBLIC HEALTH, 13 (2013) [C3]
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2013 |
Nathan N, Wolfenden L, Morgan PJ, Bell AC, Barker D, Wiggers J, 'Validity of a self-report survey tool measuring the nutrition and physical activity environment of primary schools', INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY, 10 (2013) [C1]
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2012 |
Nathan NK, Wolfenden L, Bell AC, Wyse R, Morgan PJ, Butler MT, et al., 'Effectiveness of a multi-strategy intervention in increasing the implementation of vegetable and fruit breaks by Australian primary schools: A non-randomized controlled trial', BMC Public Health, 12 651 (2012) [C1]
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2011 |
Wyse R, Campbell EM, Nathan NK, Wolfenden L, 'Associations between characteristics of the home food environment and fruit and vegetable intake in preschool children: A cross-sectional study', BMC Public Health, 11 938 (2011) [C1]
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2011 |
Nathan NK, Wolfenden L, Butler M, Bell AC, Wyse R, Campbell EM, et al., 'Vegetable and fruit breaks in Australian primary schools: prevalence, attitudes, barriers and implementation strategies', Health Education Research, 26 722-731 (2011) [C1]
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2010 |
Falkiner M, Wolfenden L, Bell C, Nathan NK, 'Obesity prevention and human service organisations: A survey of managers', Developing Practice: The Child, Youth and Family Work Journal, 21-28 (2010) [C1]
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2010 |
Falkiner M, Wolfenden L, Nathan NK, Francis JL, Rowe S, Bell C, 'Advice on healthy eating and physical activity where it is needed most: Empowering home-visiting human services to provide the right information at the right time to vulnerable families', Developing Practice: The Child, Youth and Family Work Journal, 29-41 (2010) [C1]
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Conference (42 outputs)
Year | Citation | Altmetrics | Link | ||||||||
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2023 |
Imad N, Hall A, Nathan N, Shoesmith A, Pearson N, Lum M, Yoong S, 'Cross-sectional study describing factors of sustainment of physical activity and nutrition interventions in childcare services', IMPLEMENTATION SCIENCE (2023)
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2023 |
Hall A, Doherty E, Nathan N, Wiggers J, Attia J, Tully B, et al., 'Exploring sustained receipt of recommended antenatal care for alcohol consumption, by pregnant women following an effective practice change intervention', IMPLEMENTATION SCIENCE (2023)
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2023 |
Lane C, Nathan N, Hall A, Shoesmith A, Wolfenden L, 'APPLLYING LEARNING HEALTH SYSTEMS PRINCIPLES TO OPTIMISE THE PUBLIC HEALTH IMPACT OF A POLICY IMPLEMENTATION STRATEGY', INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE (2023)
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2021 |
Ooi JY, Yoong SL, Sutherland R, Wrigley J, Lecathelinais C, Reilly K, et al., 'Prevalence of current school-level nutrition policies and practices of secondary schools in NSW, Australia', Health Promotion Journal of Australia (2021) [C1] Issue addressed: Lowering the rates of adolescent overweight and obesity is a public health priority. The implementation of nutrition policies and practices in schools is recommen... [more] Issue addressed: Lowering the rates of adolescent overweight and obesity is a public health priority. The implementation of nutrition policies and practices in schools is recommended by various health organisations, but there is little information on the extent of their implementation. The aim of this study is to describe the prevalence of the implementation of recommended school-level nutrition policies and practices in secondary schools in New South Wales (NSW), Australia, and reported barriers and facilitators to the adoption of such policies and practices in school plans. Methods: A cross-sectional study was undertaken with school principals and canteen managers. All eligible secondary schools in NSW were approached to participate in a telephone survey (n¿=¿440). Descriptive statistics were used to describe prevalence, and associations between school characteristics and implementation were examined using univariate statistics. Results: A total of 137 school principals and 80 canteen managers completed the survey. The implementation of practices on drinking water during class, healthy food and beverage marketing and learning opportunities regarding healthy eating was high (>90% of participating schools). The implementation of practices regarding the restriction of unhealthy drinks in school canteens, healthy school fundraisers and staff training related to healthy eating was reported in under 25% of participating schools. There were no significant differences in implementation by school sector, socio-economic status and geographic location. The main barrier to inclusion of nutrition policies and practices in the school plan was having other priorities and commitments (28.5%), and the main facilitator was support from stakeholders, the staff, students and their parents (37.2%). Conclusions: There is opportunity to improve the implementation of nutrition policies and practices in NSW secondary schools. So What?: Strategies are needed for targeting barriers. These include: gaining support from school staff, students and parents, provision of resources and funding and staff training.
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2015 |
Sutherland RL, Campbell L, Lubans D, Morgan P, Oakley A, Nathan N, et al., 'Mid-intervention findings from the Physical Activity 4 Every1 trial: a cluster RCT in secondary schools located in low-income communities', Edinburgh, UK (2015) [E3]
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2015 |
Wolfenden L, Nathan NR, Yoong S, Rose B, Aikman V, Williams C, et al., 'Improving implementation of NSW healthy canteen policy: Findings from a series of RCTs conducted by the Hunter New England Population Health Research Group', 4th Annual NHMRC Symposium on Research Translation jointly with CIPHER, Sydney, NSW (2015) [E3]
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2014 |
Nathan N, Wolfenden L, Williams CM, Yoong SL, Lecathelinais C, Bell AC, et al., 'Physical Activity Policies and Practices in Australian Primary Schools 2006-2013: How Far Have We Really Come?', JOURNAL OF PHYSICAL ACTIVITY & HEALTH, Toronto, CANADA (2014)
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2014 |
Yoong SL, Wolfenden L, Finch M, Nathan N, Lecathelinais C, Dodds P, et al., 'ASSESSING CHANGES IN THE ADOPTION OF OBESITY PREVENTION PRACTICES IN AUSTRALIAN CHILDCARE SERVICES', INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE, Brainerd, MN (2014)
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2014 |
Wolfenden L, Finch M, Yoong SL, Nathan N, Waever N, Jones J, et al., 'FACTORS ASSOCIATED WITH THE IMPLEMENTATION OF OBESITY PREVENTION PRACTICES IN AUSTRALIAN CHILDCARE SERVICES', INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE, Brainerd, MN (2014)
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2014 |
Wiggers JH, Nathan N, Wolfenden L, Williams CM, Yoong SZ, Lecathelinais C, et al., 'OBESITY PREVENTION POLICIES AND PRACTICES IN AUST RALIAN PRIMARY SCHOOLS 2006-2013: HOW FAR HAVE WE COME?', INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE (2014)
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2014 |
Sutherland R, Campbell E, Lubans DR, Morgan PJ, Okely AD, Nathan N, et al., 'Objectively Measured Sedentary Behavior in Secondary School Physical Education Lessons', JOURNAL OF PHYSICAL ACTIVITY & HEALTH, Toronto, CANADA (2014)
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Preprint (7 outputs)
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2024 |
Viana da Silva P, Kamper SJ, Yamato TP, Wolfenden L, Sutherland R, McCarthy N, et al., 'Effects of a school-based physical activity implementation program to reduce musculoskeletal pain frequency in children aged 9 to 12: a randomised clinical trial (2024)
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2021 |
Wyse R, Delaney T, Stacey F, Lecathelinais C, Ball K, Zoetemeyer R, et al., 'Long-term Effectiveness of a Multistrategy Behavioral Intervention to Increase the Nutritional Quality of Primary School Students Online Lunch Orders: 18-Month Follow-up of the Click & Crunch Cluster Randomized Controlled Trial (Preprint) (2021)
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2020 |
Wyse R, Delaney T, Stacey F, Zoetemeyer R, Lecathelinais C, Lamont H, et al., 'Effectiveness of a Multistrategy Behavioral Intervention to Increase the Nutritional Quality of Primary School Students Web-Based Canteen Lunch Orders (Click & Crunch): Cluster Randomized Controlled Trial (Preprint) (2020)
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Show 4 more preprints |
Grants and Funding
Summary
Number of grants | 45 |
---|---|
Total funding | $17,384,595 |
Click on a grant title below to expand the full details for that specific grant.
20242 grants / $4,969,259
Tools for Change: Informing and Supporting Sustainable Chronic Disease Prevention in Australian Schools$4,869,263
Funding body: NHMRC (National Health & Medical Research Council)
Funding body | NHMRC (National Health & Medical Research Council) |
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Project Team | Associate Professor Nicole Nathan, Doctor Alix Hall, Associate Professor Rachel Sutherland, Associate Professor Narelle Eather, Doctor Jordan Smith, Mr Andrew Milat, Asst Professor Byron Powell, Dr Michelle Jongenelis, Associate Professor Louise Freebairn, Doctor Elaine Toomey |
Scheme | MRFF - Early to Mid-Career Researchers Grant |
Role | Lead |
Funding Start | 2024 |
Funding Finish | 2028 |
GNo | G2300708 |
Type Of Funding | C1300 - Aust Competitive - Medical Research Future Fund |
Category | 1300 |
UON | Y |
LLW@School Optimisation$99,996
Funding body: Health Administration Corporation
Funding body | Health Administration Corporation |
---|---|
Project Team | Associate Professor Rachel Sutherland, Associate Professor Nicole Nathan, Professor Luke Wolfenden |
Scheme | Research Award |
Role | Investigator |
Funding Start | 2024 |
Funding Finish | 2024 |
GNo | G2400066 |
Type Of Funding | C2300 – Aust StateTerritoryLocal – Own Purpose |
Category | 2300 |
UON | Y |
20231 grants / $30,000
HMRI Foundation Research Team Excellence Award $30,000
Funding body: Hunter Medical Research Institute
Funding body | Hunter Medical Research Institute |
---|---|
Project Team | Associate Professor Nicole Nathan, Doctor Alix Hall, Doctor Cassandra Lane, Mrs Nicole McCarthy, Doctor Adam Shoesmith |
Scheme | Research Grant |
Role | Lead |
Funding Start | 2023 |
Funding Finish | 2023 |
GNo | G2300225 |
Type Of Funding | C3300 – Aust Philanthropy |
Category | 3300 |
UON | Y |
20224 grants / $3,102,415
Prevention Research Support Program$1,650,000
Funding body: NSW Ministry of Health
Funding body | NSW Ministry of Health |
---|---|
Project Team | Professor John Wiggers, Conjoint Professor David Durrheim, Doctor Alix Hall, Doctor Rebecca Hodder, Doctor Melanie Kingsland, Peter Massey, Associate Professor Nicole Nathan, Ms Penny Reeves, Associate Professor Rachel Sutherland, Associate Professor Flora Tzelepis, Associate Professor Christopher Williams, Professor Luke Wolfenden, Doctor Serene Yoong |
Scheme | Prevention Research Support Program (PRSP) |
Role | Investigator |
Funding Start | 2022 |
Funding Finish | 2026 |
GNo | G2101299 |
Type Of Funding | C2300 – Aust StateTerritoryLocal – Own Purpose |
Category | 2300 |
UON | Y |
Using existing digital infrastructure for the national scale-up of an effective school nutrition program to reduce population CVD risk$1,029,203
Funding body: Department of Health and Aged Care
Funding body | Department of Health and Aged Care |
---|---|
Project Team | Professor Luke Wolfenden, Associate Professor Rachel Sutherland, Professor Philip Morgan, Doctor Nicole Nathan, Dr Jannah Jones, Andrew Milat, Professor Heather McKay, Professor Heather McKay, Li Kheng Chai, Associate Professor Comeel Vandelanotte, Associate Professor Comeel Vandelanotte, Miss Li Kheng Chai, Ms Jannah Jones, Mr Andrew Milat, Associate Professor Nicole Nathan |
Scheme | MRFF - Cardiovascular Health Mission - Cardiovascular Health |
Role | Investigator |
Funding Start | 2022 |
Funding Finish | 2025 |
GNo | G2101458 |
Type Of Funding | C1300 - Aust Competitive - Medical Research Future Fund |
Category | 1300 |
UON | Y |
Investigating the direct and indirect effects of a student leader program$420,212
Funding body: ARC (Australian Research Council)
Funding body | ARC (Australian Research Council) |
---|---|
Project Team | Professor David Lubans, Dr Nicole Nathan, Doctor Jordan Smith, Professor Mark Beauchamp, Associate Professor Nicole Nathan |
Scheme | Discovery Projects |
Role | Investigator |
Funding Start | 2022 |
Funding Finish | 2024 |
GNo | G2001368 |
Type Of Funding | C1200 - Aust Competitive - ARC |
Category | 1200 |
UON | Y |
Pursue chronic disease prevention research$3,000
Funding body: The Sax Institute
Funding body | The Sax Institute |
---|---|
Project Team | Associate Professor Nicole Nathan, Mr Adam Shoesmith |
Scheme | Australian Prevention Partnership Centre |
Role | Lead |
Funding Start | 2022 |
Funding Finish | 2022 |
GNo | G2201126 |
Type Of Funding | C1100 - Aust Competitive - NHMRC |
Category | 1100 |
UON | Y |
20214 grants / $2,198,536
Sustaining the implementation of evidence-based chronic disease prevention programs in education$1,632,087
Funding body: Department of Health and Aged Care
Funding body | Department of Health and Aged Care |
---|---|
Project Team | Associate Professor Nicole Nathan |
Scheme | MRFF - Investigator |
Role | Lead |
Funding Start | 2021 |
Funding Finish | 2025 |
GNo | G2000053 |
Type Of Funding | C1300 - Aust Competitive - Medical Research Future Fund |
Category | 1300 |
UON | Y |
A multi-site guideline implementation randomised controlled trial to improve physical activity and screen time in Out of School Hours Care$411,385
Funding body: Department of Health and Aged Care
Funding body | Department of Health and Aged Care |
---|---|
Project Team | Dr Carol Maher, Associate Professor Hayley Christian, Professor Adrian Esterman, Associate Professor Nicole Nathan, Professor Richard Rosenkranz, Professor Luke Wolfenden, Associate Professor Lucy Lewis, Dr Dylan Cliff, Dr Rachel Curtis, Dr Rachel Milte |
Scheme | MRFF - PPHRI - Maternal Health and First 2000 Days, Early Childhood, and Exercise and Nutrition |
Role | Lead |
Funding Start | 2021 |
Funding Finish | 2023 |
GNo | G2100918 |
Type Of Funding | C1300 - Aust Competitive - Medical Research Future Fund |
Category | 1300 |
UON | Y |
Transformational leadership program for children: The ‘Learning to Lead’ cluster randomised controlled trial$135,064
Funding body: NSW Department of Education
Funding body | NSW Department of Education |
---|---|
Project Team | Professor David Lubans, Associate Professor Nicole Nathan, Doctor Jordan Smith, Doctor Mark Babic, Miss Sarah Kennedy, Doctor Angus Leahy, Professor Mark Beauchamp, Mr Ran Bao |
Scheme | Prequalification Scheme: Performance and Management Services |
Role | Investigator |
Funding Start | 2021 |
Funding Finish | 2022 |
GNo | G2100687 |
Type Of Funding | C2400 – Aust StateTerritoryLocal – Other |
Category | 2400 |
UON | Y |
HMRI Early Career Research Award$20,000
Funding body: Hunter Medical Research Institute
Funding body | Hunter Medical Research Institute |
---|---|
Project Team | Associate Professor Nicole Nathan |
Scheme | Research Grant |
Role | Lead |
Funding Start | 2021 |
Funding Finish | 2021 |
GNo | G2101359 |
Type Of Funding | C3300 – Aust Philanthropy |
Category | 3300 |
UON | Y |
20203 grants / $2,096,224
A randomised trial of an intervention to sustain schools’ implementation of a state-wide physical activity policy$1,071,348
Funding body: NHMRC (National Health & Medical Research Council)
Funding body | NHMRC (National Health & Medical Research Council) |
---|---|
Project Team | Associate Professor Nicole Nathan, Professor Luke Wolfenden, Professor John Wiggers, Associate Professor Rachel Sutherland, Adrian Bauman, Chris Rissel, Patti-Jean Naylor, Professor Patti-Jean Naylor, Mr Edward Riley-Gibson |
Scheme | Partnership Projects |
Role | Lead |
Funding Start | 2020 |
Funding Finish | 2026 |
GNo | G1900842 |
Type Of Funding | C1100 - Aust Competitive - NHMRC |
Category | 1100 |
UON | Y |
A randomised trial of an intervention to sustain schools’ implementation of a state-wide physical activity policy$1,020,959
Funding body: Hunter New England Population Health
Funding body | Hunter New England Population Health |
---|---|
Project Team | Associate Professor Nicole Nathan, Professor Luke Wolfenden, Professor John Wiggers, Associate Professor Rachel Sutherland, Professor Adrian Bauman, Professor Patti-Jean Naylor, Professor Chris Rissel, Ms Carly Gardner |
Scheme | Partnership Projects Partner Funding |
Role | Lead |
Funding Start | 2020 |
Funding Finish | 2024 |
GNo | G2000223 |
Type Of Funding | C2300 – Aust StateTerritoryLocal – Own Purpose |
Category | 2300 |
UON | Y |
SWAP-IT Healthy lunchbox program$3,917
Funding body: Hunter Medical Research Institute
Funding body | Hunter Medical Research Institute |
---|---|
Project Team | Associate Professor Rachel Sutherland, Associate Professor Rachel Sutherland, Professor Luke Wolfenden, Associate Professor Nicole Nathan |
Scheme | Research Grant |
Role | Investigator |
Funding Start | 2020 |
Funding Finish | 2022 |
GNo | G2001068 |
Type Of Funding | C3300 – Aust Philanthropy |
Category | 3300 |
UON | Y |
20191 grants / $21,208
Disseminating an efficacious healthy eating intervention to primary schools across the Hunter New England region$21,208
Funding body: Hunter Medical Research Institute
Funding body | Hunter Medical Research Institute |
---|---|
Project Team | Doctor Rebecca Wyse, Doctor Rebecca Hodder, Associate Professor Rachel Sutherland, Associate Professor Nicole Nathan |
Scheme | Research Grant |
Role | Investigator |
Funding Start | 2019 |
Funding Finish | 2022 |
GNo | G1901537 |
Type Of Funding | C3300 – Aust Philanthropy |
Category | 3300 |
UON | Y |
20184 grants / $719,200
A technology based solution to support parents to improve their child’s diet ‘Swap What’s Packed in the lunchbox: ‘SWAP-It’$499,500
Funding body: nib Foundation
Funding body | nib Foundation |
---|---|
Project Team | Professor Luke Wolfenden, Associate Professor Rachel Sutherland, Associate Professor Nicole Nathan, Doctor Serene Yoong, Professor John Wiggers |
Scheme | Multi-Year Partnerships |
Role | Investigator |
Funding Start | 2018 |
Funding Finish | 2021 |
GNo | G1700907 |
Type Of Funding | C3200 – Aust Not-for Profit |
Category | 3200 |
UON | Y |
Addressing the health risk behaviours of the education workforce: A program to enhance the wellbeing of primary school teachers$124,700
Funding body: Teachers Health Foundation
Funding body | Teachers Health Foundation |
---|---|
Project Team | Associate Professor Nicole Nathan, Professor Luke Wolfenden, Doctor Serene Yoong, Associate Professor Flora Tzelepis, Associate Professor Rachel Sutherland, Doctor Rebecca Hodder, Doctor Kathryn Reilly, Doctor Elaine Toomey |
Scheme | Research Funding |
Role | Lead |
Funding Start | 2018 |
Funding Finish | 2020 |
GNo | G1800853 |
Type Of Funding | C3200 – Aust Not-for Profit |
Category | 3200 |
UON | Y |
Enhancing Teacher's Health$70,000
Funding body: Hunter New England Population Health
Funding body | Hunter New England Population Health |
---|---|
Project Team | Associate Professor Nicole Nathan, Professor Luke Wolfenden, Doctor Serene Yoong, Associate Professor Flora Tzelepis, Associate Professor Rachel Sutherland, Doctor Rebecca Hodder, Doctor Kathryn Reilly, Doctor Elaine Toomey |
Scheme | Research Project |
Role | Lead |
Funding Start | 2018 |
Funding Finish | 2018 |
GNo | G1800924 |
Type Of Funding | C2400 – Aust StateTerritoryLocal – Other |
Category | 2400 |
UON | Y |
Pilot cluster randomised controlled trial assessing the potential impact of an online intervention to improve child dietary intake in childcare$25,000
Funding body: Hunter Medical Research Institute
Funding body | Hunter Medical Research Institute |
---|---|
Project Team | Doctor Alice Grady, Doctor Serene Yoong, Professor Luke Wolfenden, Associate Professor Nicole Nathan, Miss Courtney Barnes |
Scheme | Project Grant |
Role | Investigator |
Funding Start | 2018 |
Funding Finish | 2018 |
GNo | G1801365 |
Type Of Funding | C3300 – Aust Philanthropy |
Category | 3300 |
UON | Y |
20179 grants / $1,550,390
A randomised trial of an intervention to facilitate the implementation of a state-wide primary school physical activity policy.$594,340
Funding body: NHMRC (National Health & Medical Research Council)
Funding body | NHMRC (National Health & Medical Research Council) |
---|---|
Project Team | Doctor Luke Wolfenden, Professor John Wiggers, Professor Adrian Bauman, Professor Chris Rissel, Dr Nicole Nathan |
Scheme | Partnership Grant |
Role | Investigator |
Funding Start | 2017 |
Funding Finish | 2020 |
GNo | |
Type Of Funding | Aust Competitive - Commonwealth |
Category | 1CS |
UON | N |
A randomized trial of an intervention to facilitate the implementation of a state-wide school physical activity policy$254,400
Funding body: Hunter New England Local Health District
Funding body | Hunter New England Local Health District |
---|---|
Project Team | Dr Nicole Nathan |
Scheme | Clinical Research Fellowship |
Role | Lead |
Funding Start | 2017 |
Funding Finish | 2019 |
GNo | |
Type Of Funding | Other Public Sector - Local |
Category | 2OPL |
UON | N |
Peer Leadership and Physical Literacy Promotion among Elementary School Children$253,219
Funding body: Social Sciences and Humanities Research Council of Canada
Funding body | Social Sciences and Humanities Research Council of Canada |
---|---|
Project Team | Mark Beauchamp, Guy Faulkner, Patti-Jean Naylor, Ryan Rhodes, Yan Liu, David Lubans, Nicole Nathan |
Scheme | Social Sciences and Humanities Research Council of Canada |
Role | Investigator |
Funding Start | 2017 |
Funding Finish | 2020 |
GNo | |
Type Of Funding | International - Competitive |
Category | 3IFA |
UON | N |
A randomised trial of an intervention to facilitate the implementation of a state-wide primary school physical activity policy.$204,000
Funding body: Hunter New England Population Health
Funding body | Hunter New England Population Health |
---|---|
Project Team | Doctor Luke Wolfenden, Professor John Wiggers, Professor Adrian Bauman, Professor Chris Rissel, Dr Nicole Nathan |
Scheme | Partnership Projects Partner Funding |
Role | Investigator |
Funding Start | 2017 |
Funding Finish | 2020 |
GNo | |
Type Of Funding | Other Public Sector - Local |
Category | 2OPL |
UON | N |
Increasing the implementation of a mandatory primary school physical activity policy$181,107
Funding body: NHMRC (National Health & Medical Research Council)
Funding body | NHMRC (National Health & Medical Research Council) |
---|---|
Project Team | Associate Professor Nicole Nathan |
Scheme | Translating Research into Practice (TRIP) Fellowships |
Role | Lead |
Funding Start | 2017 |
Funding Finish | 2019 |
GNo | G1600651 |
Type Of Funding | Aust Competitive - Commonwealth |
Category | 1CS |
UON | Y |
A randomised trial of an intervention to facilitate the implementation of a state-wide school physical activity policy$30,000
Funding body: NSW Office of Preventative Health
Funding body | NSW Office of Preventative Health |
---|---|
Project Team | Doctor Luke Wolfenden, Professor John Wiggers, Professor Adrian Bauman, Professor Chris Rissel, Dr Nicole Nathan |
Scheme | Partnership Projects Partner Funding |
Role | Investigator |
Funding Start | 2017 |
Funding Finish | 2020 |
GNo | |
Type Of Funding | Other Public Sector - State |
Category | 2OPS |
UON | N |
A randomised controlled trial to assess the impact of a uniform intervention on girl’s physical activity at school$25,000
Funding body: Hunter Medical Research Institute
Funding body | Hunter Medical Research Institute |
---|---|
Project Team | Associate Professor Nicole Nathan, Professor Luke Wolfenden, Associate Professor Rachel Sutherland, Doctor Serene Yoong, Professor John Wiggers |
Scheme | Project Grant |
Role | Lead |
Funding Start | 2017 |
Funding Finish | 2017 |
GNo | G1701511 |
Type Of Funding | C3300 – Aust Philanthropy |
Category | 3300 |
UON | Y |
Feasibility and Efficacy Of The Active Wear For Everyone (AWE) Project$4,974
Funding body: PRC Health Behaviour
Funding body | PRC Health Behaviour |
---|---|
Project Team | Dr Nicole Nathan, Dr Rachel Sutherland, Dr Lorraine Paras, Mr Mark Babic, Ms Kathryn Reilly |
Scheme | Pilot Grant |
Role | Lead |
Funding Start | 2017 |
Funding Finish | 2017 |
GNo | |
Type Of Funding | Internal |
Category | INTE |
UON | N |
Systematic review to examine the effectiveness of resilience interventions in reducing tobacco, alcohol and illicit substance use in children and adolescents with chronic pain. $3,350
Funding body: PRC Health Behaviour
Funding body | PRC Health Behaviour |
---|---|
Project Team | Hodder RK, Lee H, Nathan N, Kamper S, Williams C |
Scheme | Pilot Grant |
Role | Investigator |
Funding Start | 2017 |
Funding Finish | 2017 |
GNo | |
Type Of Funding | Internal |
Category | INTE |
UON | N |
20165 grants / $1,104,648
Implementation trial of multicomponent school-based physical activity and healthy nutrition $990,779
Funding body: NSW Ministry of Health
Funding body | NSW Ministry of Health |
---|---|
Project Team | Wiggers John, Sutherland Rachel, Campbell Libby, Wolfenden Luke, Oldmeadow Christopher, Searles Andrew, Lubans David, Nathan Nicole, Morgan Phillip |
Scheme | Translational Research Grant Scheme (TRGS) |
Role | Investigator |
Funding Start | 2016 |
Funding Finish | 2019 |
GNo | |
Type Of Funding | Other Public Sector - State |
Category | 2OPS |
UON | N |
Research to gather baseline data regarding operations and provision of healthy food and drinks of licensed school canteens$78,030
Funding body: Health Administration Corporation
Funding body | Health Administration Corporation |
---|---|
Project Team | Doctor Luke Wolfenden, Professor John Wiggers, Doctor Rebecca Wyse, Ms Tessa Delaney, Doctor Serene Yoong, Dr Rachel Sutherland, Dr Nicole Nathan |
Scheme | Research Grant |
Role | Investigator |
Funding Start | 2016 |
Funding Finish | 2016 |
GNo | |
Type Of Funding | Other Public Sector - State |
Category | 2OPS |
UON | N |
Sir Winston Churchill Fellowship$21,479
Funding body: The Winston Churchill Memorial Trust
Funding body | The Winston Churchill Memorial Trust |
---|---|
Project Team | Nicole Nathan |
Scheme | The Northern Districts Education Centre (Sydney) Sir Winston Churchill Fellowship |
Role | Lead |
Funding Start | 2016 |
Funding Finish | 2017 |
GNo | |
Type Of Funding | Aust Competitive - Non Commonwealth |
Category | 1NS |
UON | N |
A systematic review of barriers and facilitators to the implementation of physical activity policies and programs in schools and application to the Theoretical Domains Framework$9,360
Funding body: Hunter Cancer Research Alliance (HCRA)
Funding body | Hunter Cancer Research Alliance (HCRA) |
---|---|
Project Team | Dr Nicole Nathan, Dr Rachel Sutherland, Dr Serene Yoong, Dr Rebecca Hodder, Prof John Wiggers, A/Prof Luke Wolfenden |
Scheme | HCRA Implementation Flagship program |
Role | Lead |
Funding Start | 2016 |
Funding Finish | 2017 |
GNo | |
Type Of Funding | Internal |
Category | INTE |
UON | N |
Teachers Health Program in Schools$5,000
Funding body: Teachers Mutual Bank
Funding body | Teachers Mutual Bank |
---|---|
Project Team | Doctor Luke Wolfenden, Dr Nicole Nathan |
Scheme | Research Project |
Role | Investigator |
Funding Start | 2016 |
Funding Finish | 2016 |
GNo | |
Type Of Funding | External |
Category | EXTE |
UON | N |
20152 grants / $12,950
Interventions to change the behaviour of health care practitioners and organizational practice to promote and improve weight management in children and adolescents.$9,450
Funding body: HCRA Hunter Cancer Research Alliance
Funding body | HCRA Hunter Cancer Research Alliance |
---|---|
Project Team | Sze Lin Yoon, Luke Wolfenden, Christopher WIlliams, Nicole Nathan, John Wiggers |
Scheme | Research Project |
Role | Investigator |
Funding Start | 2015 |
Funding Finish | 2015 |
GNo | |
Type Of Funding | External |
Category | EXTE |
UON | N |
PhD completion grant.$3,500
Funding body: Faculty of Health and Medicine, University of Newcastle
Funding body | Faculty of Health and Medicine, University of Newcastle |
---|---|
Project Team | Nicole Nathan |
Scheme | Faculty Grant |
Role | Lead |
Funding Start | 2015 |
Funding Finish | 2015 |
GNo | |
Type Of Funding | Internal |
Category | INTE |
UON | N |
20135 grants / $581,005
Moving from policy to practice: A randomised trial of an implementation intervention to facilitate the adoption of a statewide healthy canteen policy$416,263
Funding body: ARC (Australian Research Council)
Funding body | ARC (Australian Research Council) |
---|---|
Project Team | Doctor Luke Wolfenden, Professor John Wiggers, Conjoint Associate Professor Andrew Bell, Doctor Megan Freund, Ms Karen Gillham, Doctor Libby Campbell, Ms Rachel Sutherland, Dr Nicole Nathan |
Scheme | Linkage Projects |
Role | Investigator |
Funding Start | 2013 |
Funding Finish | 2015 |
GNo | |
Type Of Funding | Aust Competitive - Commonwealth |
Category | 1CS |
UON | N |
Moving from policy to practice: A randomised trial of an implementation intervention to facilitate the adoption of a statewide healthy canteen policy$127,998
Funding body: Hunter New England Population Health
Funding body | Hunter New England Population Health |
---|---|
Project Team | Doctor Luke Wolfenden, Professor John Wiggers, Conjoint Associate Professor Andrew Bell, Doctor Megan Freund, Ms Karen Gillham, Doctor Libby Campbell, Ms Rachel Sutherland, Dr Nicole Nathan |
Scheme | Linkage Projects Partner Funding |
Role | Investigator |
Funding Start | 2013 |
Funding Finish | 2015 |
GNo | |
Type Of Funding | Other Public Sector - Local |
Category | 2OPL |
UON | N |
Strategies to increase adoption of obesity prevention and public health trials$13,637
Funding body: Priority Research Centre for Health Behaviour (CHB)
Funding body | Priority Research Centre for Health Behaviour (CHB) |
---|---|
Project Team | Finch Meghan, Yoong Serene, Wolfenden Luke, Nathan Nicole, Wiggers John |
Scheme | Pilot Grants |
Role | Investigator |
Funding Start | 2013 |
Funding Finish | 2013 |
GNo | |
Type Of Funding | Internal |
Category | INTE |
UON | N |
A pilot trial of tailored electronic educational material for professional development and self-efficacy of school staff to implement health policies in schools. $13,266
Funding body: PRC Health Behaviour
Funding body | PRC Health Behaviour |
---|---|
Project Team | Christopher Williams, Nicole Nathan, Luke Wolfenden, John Wiggers. |
Scheme | Pilot Grant |
Role | Investigator |
Funding Start | 2013 |
Funding Finish | 2013 |
GNo | |
Type Of Funding | Internal |
Category | INTE |
UON | N |
A pilot trial of an intervention to facilitate the implementation of a state-wide healthy canteen policy$9,841
Funding body: Priority Research Centre for Health Behaviour (CHB)
Funding body | Priority Research Centre for Health Behaviour (CHB) |
---|---|
Project Team | Nathan Nicole, Wiggers John, Freund Megan, Gillham Karen, Sutherland Rachel, Williams Christopher Wolfenden, Luke, White, Jim |
Scheme | Pilot Grants |
Role | Lead |
Funding Start | 2013 |
Funding Finish | 2013 |
GNo | |
Type Of Funding | Internal |
Category | INTE |
UON | N |
20101 grants / $330,820
Physical activity 4 every 1. NSW Health Promotion Demonstration Grant.$330,820
Funding body: NSW Ministry of Health
Funding body | NSW Ministry of Health |
---|---|
Project Team | John Wiggers, Philip Morgan, David Lubans, Libby Campbell, Luke Wolfenden, Karen Gillham, Nicole Nathan. |
Scheme | Health Promotion Demonstration Grant |
Role | Investigator |
Funding Start | 2010 |
Funding Finish | 2013 |
GNo | |
Type Of Funding | Other Public Sector - State |
Category | 2OPS |
UON | N |
20061 grants / $30,750
Follow-Up Survey of Exercise Leaders Trained through the Rural Falls Injury Prevention Program$30,750
Funding body: NSW Ministry of Health
Funding body | NSW Ministry of Health |
---|---|
Project Team | Nicole Nathan |
Scheme | Research Project |
Role | Lead |
Funding Start | 2006 |
Funding Finish | 2006 |
GNo | |
Type Of Funding | Other Public Sector - State |
Category | 2OPS |
UON | N |
20032 grants / $135,190
The Implementation and Evaluation of Forming Lifeball Groups for Veterans Living in 4 Regional and Rural Areas of NSW$73,700
Funding body: NSW Ministry of Health
Funding body | NSW Ministry of Health |
---|---|
Project Team | Deborah Radvan, Nicole Nathan, John Wiggers |
Scheme | Research & Evaluation Grants |
Role | Investigator |
Funding Start | 2003 |
Funding Finish | 2004 |
GNo | |
Type Of Funding | Other Public Sector - State |
Category | 2OPS |
UON | N |
The Implementation and Evaluation of Forming Lifeball Groups for Veterans Living in 4 Regional and Rural Areas of NSW$61,490
Funding body: Department of Veterans` Affairs
Funding body | Department of Veterans` Affairs |
---|---|
Project Team | Deborah Radvan, Nicole Nathan, John Wiggers |
Scheme | Research Project |
Role | Investigator |
Funding Start | 2003 |
Funding Finish | 2003 |
GNo | |
Type Of Funding | Other Public Sector - State |
Category | 2OPS |
UON | N |
20011 grants / $502,000
Needle and Syringe Program Enhancement Funds $502,000
Funding body: NSW Ministry of Health
Funding body | NSW Ministry of Health |
---|---|
Project Team | Robyn Considine, Jenny Knight, Milly Licata, Nicole Nathan, Karen Gillham |
Scheme | Drug and Alcohol Grants Program |
Role | Investigator |
Funding Start | 2001 |
Funding Finish | 2003 |
GNo | |
Type Of Funding | Other Public Sector - State |
Category | 2OPS |
UON | N |
Research Supervision
Number of supervisions
Current Supervision
Commenced | Level of Study | Research Title | Program | Supervisor Type |
---|---|---|---|---|
2023 | PhD | Understanding the Mechanisms of Scale-up to Achieve Population Level Health Outcomes - A Randomised Controlled Trial to Evaluate the Scale-up of a School Nutrition Program to Improve the Dietary Intake of School Children | PhD (Public Health & BehavSci), College of Health, Medicine and Wellbeing, The University of Newcastle | Co-Supervisor |
2023 | PhD | Identifying the Characteristics of Self-Sustaining Evidence Based Public Health Interventions | PhD (Public Health & BehavSci), College of Health, Medicine and Wellbeing, The University of Newcastle | Principal Supervisor |
2023 | PhD | A Randomised Trial of an Intervention to Sustain Schools’ Implementation of a State-Wide Physical Activity Policy | PhD (Public Health & BehavSci), College of Health, Medicine and Wellbeing, The University of Newcastle | Principal Supervisor |
2023 | PhD | Using a Learning Health System to Improve Perinatal Mental Wellbeing with a Text Message Service | PhD (Public Health & BehavSci), College of Health, Medicine and Wellbeing, The University of Newcastle | Co-Supervisor |
2022 | PhD | Evaluating the Effect of a Multicomponent Support Program to Assist Schools in Sustaining Physical Activity Policy Implementation | PhD (Public Health & BehavSci), College of Health, Medicine and Wellbeing, The University of Newcastle | Principal Supervisor |
2018 | PhD | A technology based intervention to improve the nutritional value of primary school children’s lunchboxes: The SWAP-It trial | Public Health, The Faculty of Health, The University of Newcastle | Co-Supervisor |
2017 | PhD | A cluster randomised controlled trial of a sugar-sweetened beverage intervention in secondary schools | Public Health, The University of Newcastle | Co-Supervisor |
2015 | PhD | Improving Population Wide Implementation of Healthy Food Policy in Primary Schools | Public Health, Faculty of Health and Medicine, University of Newcastle | Co-Supervisor |
Past Supervision
Year | Level of Study | Research Title | Program | Supervisor Type |
---|---|---|---|---|
2024 | PhD | Active School Uniforms: a Scalable Intervention to Improve Primary School Students' Physical Activity | PhD (Public Health & BehavSci), College of Health, Medicine and Wellbeing, The University of Newcastle | Principal Supervisor |
2024 | PhD | Investigating Determinants Influencing the Sustainability of Chronic Disease Prevention Interventions in Schools and Early Childhood Education and Care Settings | PhD (Public Health & BehavSci), College of Health, Medicine and Wellbeing, The University of Newcastle | Principal Supervisor |
2023 | PhD | Improving the Nutritional Quality of Australian Primary School Lunchboxes | PhD (Behavioural Science), College of Health, Medicine and Wellbeing, The University of Newcastle | Co-Supervisor |
2022 | PhD | Optimising an Intervention to Improve Schools' Implementation of A Physical Activity Policy at Scale | PhD (Public Health & BehavSci), College of Health, Medicine and Wellbeing, The University of Newcastle | Co-Supervisor |
2021 | PhD | Improving the Dietary Intake of Children Attending Centre-Based Childcare in NSW, Australia | PhD (Behavioural Science), College of Health, Medicine and Wellbeing, The University of Newcastle | Co-Supervisor |
2021 | PhD | Investigating Nutrition in Adolescents and Piloting an Intervention to Reduce Adolescent Sugar-Sweetened Beverage Consumption | PhD (Behavioural Science), College of Health, Medicine and Wellbeing, The University of Newcastle | Co-Supervisor |
2018 | PhD | Improving Population Wide Implementation of a Healthy Food Policy in Primary Schools | PhD (Behavioural Science), College of Health, Medicine and Wellbeing, The University of Newcastle | Co-Supervisor |
2011 | Masters | The impact of the NSW Healthy School canteen strategy and its influence on school food service | Public Health, HETI (Health Education and Training Institute) | Principal Supervisor |
Research Collaborations
The map is a representation of a researchers co-authorship with collaborators across the globe. The map displays the number of publications against a country, where there is at least one co-author based in that country. Data is sourced from the University of Newcastle research publication management system (NURO) and may not fully represent the authors complete body of work.
Country | Count of Publications | |
---|---|---|
Australia | 179 | |
United Kingdom | 51 | |
Canada | 30 | |
United States | 27 | |
Finland | 6 | |
More... |
News
News • 20 Feb 2024
$10.6m MRFF funding boosts researchers’ mission to improve Australia’s health
Seven University of Newcastle teams have secured more than $10.6m in Australian government funding to help solve some of the nation’s most pressing health issues.
News • 12 Oct 2023
University of Newcastle 2023 Alumni Award recipients announced
Recipients of the 2023 University of Newcastle Alumni Excellence Awards were recognised at the annual celebration last night to celebrate their accomplishments in exceptional leadership, innovation, and outstanding community contributions.
News • 11 Nov 2022
2022 HMRI Researchers of the Year announced
University of Newcastle’s Professor Brett Nixon is the 2022 Hunter Medical Research Institute Researcher of the Year.
News • 5 Nov 2021
2021 HMRI Awards for Research Excellence announced
The HMRI Awards are a celebration of the outstanding efforts and achievements of individuals and teams who drive and support the opportunities that health and medical research bring to the wellbeing of our community.
News • 21 May 2020
More than $10 million to support innovations in health service delivery
Six projects led by Hunter researchers have been successful in attracting a combined total of $10.6 million in the latest round of competitive National Health and Medical Research Council (NHMRC) funding.
Associate Professor Nicole Nathan
Position
MRFF Investigator Fellow
School of Medicine and Public Health
College of Health, Medicine and Wellbeing
Contact Details
nicole.nathan@newcastle.edu.au | |
Phone | (02) 4924 6257 |
Fax | (02) 4924 6022 |
Link |
Office
Room | Booth Building Wallsend Health Campus Room 1105 |
---|---|
Building | Booth Building Wallsend Health Campus |
Location | Wallsend , |