Dr Nicole Nathan

Dr Nicole Nathan

Postdoctoral Research Fellow

School of Medicine and Public Health

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.

Read more

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
111799 Public Health and Health Services not elsewhere classified 100

Professional Experience

UON Appointment

Title Organisation / Department
Postdoctoral Research Fellow University of Newcastle
School of Medicine and Public Health
Australia

Professional appointment

Dates Title Organisation / Department
9/01/2017 -  Clinical Research Fellow Hunter New England Health
Hunter New England Population Health
Australia
9/01/2006 -  Health Promotion Program Manager Hunter New England Area Health Service
Hunter New England Population Health
Australia
7/01/2002 - 31/12/2005 Health Promotion Project Officer Hunter New England Area Health Service
Hunter New England Population Health
Australia

Awards

Award

Year Award
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
2013 National Preventive Health Agency Research Translation Award
National Preventative Health Agency
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Publications

For publications that are currently unpublished or in-press, details are shown in italics.


Journal article (45 outputs)

Year Citation Altmetrics Link
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]

© 2017 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 pr... [more]

© 2017 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.

DOI 10.1016/j.ypmed.2017.09.024
Co-authors Luke Wolfenden, Serene Yoong, John Wiggers, Rebecca Wyse
2017 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, (2017)
DOI 10.1016/j.ypmed.2017.11.012
Co-authors Luke Wolfenden, Serene Yoong, Rebecca Hodder
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]
DOI 10.1002/14651858.CD008552.pub3
Co-authors Serene Yoong, Flora Tzelepis, Erica James, Rebecca Hodder, Tara Clinton-Mcharg, Kate Bartlem, Luke Wolfenden, Rebecca Wyse
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]
DOI 10.1016/j.amepre.2017.08.009
Co-authors Luke Wolfenden, David Lubans, John Wiggers
2017 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, (2017)
DOI 10.1016/j.appet.2017.11.103
Co-authors Luke Wolfenden, Serene Yoong
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 Syst Rev, 11 CD011677 (2017)
DOI 10.1002/14651858.CD011677.pub2
Co-authors Rebecca Hodder, Luke Wolfenden, John Wiggers, Tara Clinton-Mcharg, Christopher M Williams, Rebecca Wyse, Serene Yoong, Flora Tzelepis
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.', J Sci Med Sport, (2017)
DOI 10.1016/j.jsams.2017.04.016
Co-authors Luke Wolfenden, David Lubans
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]
DOI 10.1093/her/cyx038
Co-authors Luke Wolfenden, Christopher M Williams, John Wiggers, Rebecca Wyse, Serene Yoong
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]

© Australian Health Promotion Association 2017. Issue addressed: This study of primary school principals assessed the awareness, use, barriers to use and acceptability of online ... [more]

© Australian Health Promotion Association 2017. 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.

DOI 10.1071/HE15095
Citations Scopus - 1Web of Science - 2
Co-authors Rebecca Wyse, Serene Yoong, John Wiggers, Luke Wolfenden
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]

© 2017 World Obesity Federation Objective: The aims of this systematic review and meta-analysis are (i) to determine the impact of school-based interventions on objectively measu... [more]

© 2017 World Obesity Federation 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 m eta-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.

DOI 10.1111/obr.12517
Citations Scopus - 6Web of Science - 4
Co-authors David Lubans, Jordan Smith
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]

© 2017 The Author(s). Background: Schools play an important role in physical activity promotion for adolescents. The systematic review aimed to determine the proportion of second... [more]

© 2017 The Author(s). 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.

DOI 10.1186/s12966-017-0504-0
Citations Scopus - 1Web of Science - 1
Co-authors John Wiggers, Luke Wolfenden, Philip Morgan, David Lubans, Jenna Hollis
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]
DOI 10.1186/s13012-016-0537-9
Citations Scopus - 3Web of Science - 3
Co-authors Christopher Oldmeadow, John Wiggers, Serene Yoong, Christopher M Williams, Luke Wolfenden, Rebecca Wyse
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]
DOI 10.1186/s12966-016-0431-5
Citations Scopus - 3Web of Science - 3
Co-authors Li K Chai, Serene Yoong, Luke Wolfenden, John Wiggers
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]
DOI 10.1016/j.amepre.2016.02.020
Citations Scopus - 8Web of Science - 6
Co-authors Christopher Oldmeadow, Jenna Hollis, John Wiggers, David Lubans, Luke Wolfenden, Philip Morgan
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) [C1]

© 2015 Elsevier Inc. Objective: To examine elementary school students' moderate-to-vigorous physical activity (MVPA) levels during physical education (PE) lessons. Methods: ... [more]

© 2015 Elsevier Inc. 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.

DOI 10.1016/j.ypmed.2015.11.018
Citations Scopus - 19Web of Science - 13
Co-authors David Lubans, Jenna Hollis, John Wiggers, Luke Wolfenden, Philip Morgan
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]
DOI 10.1186/s12966-016-0453-z
Citations Scopus - 2Web of Science - 2
Co-authors John Wiggers, Christopher Oldmeadow, Rebecca Wyse, Christopher M Williams, Serene Yoong, Luke Wolfenden
2016 Nathan N, Wolfenden L, Williams CM, 'Educational interventions are effective in treating childhood obesity: (PEDro synthesis)', BRITISH JOURNAL OF SPORTS MEDICINE, 50 130-+ (2016)
DOI 10.1136/bjsports-2015-094667
Citations Scopus - 3Web of Science - 3
Co-authors Luke Wolfenden, Christopher M Williams
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]

© 2016 The Author(s). Background: Few school-based interventions have been successful in reducing physical activity decline and preventing overweight and obesity in adolescent po... [more]

© 2016 The Author(s). 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.

DOI 10.1186/s12966-016-0418-2
Co-authors Luke Wolfenden, David Lubans, Philip Morgan, John Wiggers
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]

© 2016 Society for Nutrition Education and Behavior. Because physical inactivity and unhealthy diets are highly prevalent, there is a need for cost-effective interventions that c... [more]

© 2016 Society for Nutrition Education and Behavior. 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.

DOI 10.1016/j.jneb.2015.12.006
Citations Scopus - 24Web of Science - 19
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]

© Australian Health Promotion Association 2016. Bridging the gap between research-based evidence and public health policy and practice is a considerable challenge to public healt... [more]

© Australian Health Promotion Association 2016. 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.

DOI 10.1071/HE16056
Citations Scopus - 3Web of Science - 4
Co-authors Christopher M Williams, Serene Yoong, John Wiggers, Luke Wolfenden
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]
DOI 10.1038/ijo.2016.107
Citations Scopus - 3Web of Science - 2
Co-authors Philip Morgan, Christopher Oldmeadow, John Wiggers, Jenna Hollis, David Lubans, Luke Wolfenden
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]

© 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians) Aim: Despite ongoing investments to improve the obesogenic environments of childcare s... [more]

© 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians) 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.

DOI 10.1111/jpc.13252
Citations Web of Science - 1
Co-authors John Wiggers, Serene Yoong, Luke Wolfenden
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]

© Australian Health Promotion Association 2016. Issue addressed In order to assess the impact of healthy school canteen policies on food availability for students, valid methods ... [more]

© Australian Health Promotion Association 2016. 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.

DOI 10.1071/HE16053
Citations Scopus - 5Web of Science - 4
Co-authors Rebecca Wyse, Serene Yoong, John Wiggers, Luke Wolfenden
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]

© 2014. Objectives: Physical education (PE) plays an important role in contributing to students' physical activity (PA); however, moderate-to-vigorous PA (MVPA) within PE is... [more]

© 2014. 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.

DOI 10.1016/j.jsams.2014.12.003
Citations Web of Science - 1
Co-authors Philip Morgan, John Wiggers, David Lubans
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.

DOI 10.1136/bjsports-2014-094523
Citations Scopus - 6Web of Science - 5
Co-authors Luke Wolfenden, Philip Morgan, Jenna Hollis, John Wiggers, David Lubans
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]

© 2015 Australian Health Promotion Association. Issue addressed Since 2005, a government-endorsed strategy guiding food sold in New South Wales school canteens has been in place.... [more]

© 2015 Australian Health Promotion Association. 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.

DOI 10.1071/HE14098
Citations Scopus - 9Web of Science - 9
Co-authors Luke Wolfenden
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)
DOI 10.2196/jmir.3639
Citations Web of Science - 2
Co-authors Luke Wolfenden, Rebecca Wyse, Christopher M Williams
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]

© 2015, Society of Behavioral Medicine. Many early childhood education and care (ECEC) services fail to implement recommended policies and practices supportive of healthy eating ... [more]

© 2015, Society of Behavioral Medicine. 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.

DOI 10.1007/s13142-015-0319-y
Citations Scopus - 5Web of Science - 6
Co-authors Rebecca Wyse, Luke Wolfenden, John Wiggers, Serene Yoong, Natasha Weaver
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]
DOI 10.1093/her/cyu068
Citations Scopus - 2Web of Science - 1
Co-authors Luke Wolfenden, Serene Yoong, John Wiggers, Rebecca Wyse, Christopher M Williams
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]

© 2015 American Journal of Preventive Medicine. Introduction Schools represent a valuable setting for interventions to improve children&apos;s diets, as they offer structured opp... [more]

© 2015 American Journal of Preventive Medicine. 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.

DOI 10.1016/j.amepre.2015.02.002
Citations Scopus - 6Web of Science - 5
Co-authors Rebecca Wyse, John Wiggers, Serene Yoong, Christopher M Williams, Luke Wolfenden
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]
DOI 10.1111/1753-6405.12321
Co-authors Luke Wolfenden, John Wiggers
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.

DOI 10.1136/bmjopen-2014-006969
Citations Scopus - 5Web of Science - 5
Co-authors Christopher M Williams, Luke Wolfenden, Rebecca Wyse, Serene Yoong, John Wiggers
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.

DOI 10.2196/jmir.3639
Citations Scopus - 1
Co-authors John Wiggers, Rebecca Wyse, Luke Wolfenden, Serene Yoong, Christopher M Williams
2015 Wolfenden L, Nathan N, Williams CM, 'Computer-tailored interventions to facilitate health behavioural change.', Br J Sports Med, 49 1478-1479 (2015) [C2]
DOI 10.1136/bjsports-2014-093508
Citations Scopus - 1Web of Science - 2
Co-authors Christopher M Williams, Luke Wolfenden
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.

DOI 10.1186/1471-2458-14-572
Citations Scopus - 9Web of Science - 9
Co-authors Rebecca Wyse, Luke Wolfenden, Serene Yoong, John Wiggers
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]
DOI 10.1186/s13012-014-0147-3
Citations Scopus - 9Web of Science - 9
Co-authors Serene Yoong, Luke Wolfenden, Christopher M Williams, John Wiggers, Rebecca Wyse
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]
DOI 10.1136/bjsports-2013-093187
Citations Scopus - 1Web of Science - 1
Co-authors Christopher M Williams, Luke Wolfenden
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]
DOI 10.1111/1753-6405.12056
Co-authors Luke Wolfenden, Philip Morgan
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]
DOI 10.1186/1471-2458-13-57
Citations Scopus - 11Web of Science - 10
Co-authors Luke Wolfenden, David Lubans, Philip Morgan, John Wiggers
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]
DOI 10.1186/1479-5868-10-75
Citations Scopus - 8Web of Science - 8
Co-authors Luke Wolfenden, John Wiggers, Philip Morgan, Daniel Barker
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]
DOI 10.1186/1471-2458-12-651
Citations Scopus - 20Web of Science - 19
Co-authors Rebecca Wyse, Philip Morgan, John Wiggers, Luke Wolfenden
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]
Citations Scopus - 60Web of Science - 54
Co-authors Luke Wolfenden, Rebecca Wyse
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]
DOI 10.1093/her/cyr033
Citations Scopus - 19Web of Science - 17
Co-authors John Wiggers, Rebecca Wyse, Luke Wolfenden
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]
Co-authors Luke Wolfenden
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]
Co-authors Luke Wolfenden
Show 42 more journal articles

Conference (9 outputs)

Year Citation Altmetrics Link
2017 Reilly K, Nathan N, Wiggers J, LinYoong S, Wolfenden L, 'Scale up of a Multistrategic Intervention to Increase Implementation of a Mandatory State-Based Healthy Canteen Policy', ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY (2017)
Co-authors Luke Wolfenden
2016 Wolfenden L, Chan C, Powell RMBJ, Presseau J, Milat A, Francis L, et al., 'Advancing the science of implementation research to improve health: Key challenges and potential solutions', INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE (2016)
Co-authors Luke Wolfenden
2016 Sutherland R, Hollis J, Campbell E, Lubans DR, Morgan PJ, Nathan N, et al., 'EFFECTS OF A SCHOOL-BASED PHYSICAL ACTIVITY INTERVENTION ON ADIPOSITY IN ADOLESCENTS FROM ECONOMICALLY DISADVANTAGED COMMUNITIES: 'PHYSICAL ACTIVITY 4 EVERYONE' RCT.', INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE (2016)
Co-authors John Wiggers, Christopher Oldmeadow, Philip Morgan, Luke Wolfenden, David Lubans
2016 Finch M, Nathan N, Yoong S, Sutherland R, Seward K, Reilly K, et al., 'SUPPORTING THE IMPLEMENTATION OF STATE NUTRITION GUIDELINES AND POLICIES IN SCHOOLS AND CHILDCARE: APPLICATION OF THE THEORETICAL DOMAINS FRAMEWORK', INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE (2016)
Co-authors John Wiggers, Luke Wolfenden, Serene Yoong
2016 Yoong S, Nathan N, Finch M, Sutherland R, Seward K, Reilly K, et al., 'IMPLEMENTING STATE NUTRITION GUIDELINES AND POLICIES IN SCHOOLS AND CENTRE BASED CHILDCARE: BARRIERS AND ENABLERS', INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE (2016)
Co-authors John Wiggers, Luke Wolfenden, Serene Yoong
2016 Wyse R, Yoong SL, Dodds P, Campbell L, Delaney T, Nathan N, et al., 'THE POTENTIAL OF ONLINE CANTEENS TO DELIVER PUBLIC HEALTH NUTRITION INTERVENTIONS TO SCHOOL COMMUNITIES', INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE (2016)
Co-authors John Wiggers, Rebecca Wyse, Serene Yoong, Luke Wolfenden
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)
Co-authors Luke Wolfenden, Serene Yoong, John Wiggers
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)
Co-authors Christopher M Williams, Luke Wolfenden, Rebecca Wyse, John Wiggers, Serene Yoong
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)
Co-authors Luke Wolfenden, John Wiggers, David Lubans, Philip Morgan
Show 6 more conferences
Edit

Grants and Funding

Summary

Number of grants 26
Total funding $4,244,763

Click on a grant title below to expand the full details for that specific grant.


20179 grants / $1,547,400

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$178,117

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Doctor 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 Doctor Nicole Nathan, Doctor Luke Wolfenden, Ms Rachel Sutherland, Doctor Serene Yoong, Professor John Wiggers
Scheme Project Grant
Role Lead
Funding Start 2017
Funding Finish 2017
GNo G1701511
Type Of Funding Grant - Aust Non Government
Category 3AFG
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
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Research Supervision

Number of supervisions

Completed1
Current1

Current Supervision

Commenced Level of Study Research Title Program Supervisor Type
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
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
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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 52
United Kingdom 14
Canada 2
United States 2
Germany 1
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Dr Nicole Nathan

Position

Postdoctoral Research Fellow
School of Medicine and Public Health
Faculty of Health and Medicine

Contact Details

Email nicole.nathan@newcastle.edu.au
Phone (02) 4924 6257
Fax (02) 4924 6022
Link Twitter

Office

Room Booth Building Wallsend Health Campus Room 1105
Building Booth Building Wallsend Health Campus
Location Wallsend

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