Nutrition and Dietetics - Collected Works

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    Parent Feeding Practices in the Australian Indigenous Population within the Context of non-Indigenous Australians and Indigenous Populations in Other High-Income Countries—A Scoping Review
    (Oxford University Press, 2019-01) Rohit, Athira ; Tonkin, Emma ; Maple-Brown, Louise J ; Golley, Rebecca Kirsty ; McCarthy, Mary ; Brimblecombe, Julie
    Although extensive literature on parent feeding practices among the general Australian population exists, Australian Indigenous populations are generally overlooked. A systematic scoping review was carried out to map any source of literature showing Indigenous parent feeding practices in Australia in the context of what is known about parent feeding practices among broader Australian populations and Indigenous populations in other high-income countries. A search of 8 electronic health databases was conducted. Inclusion criteria were children aged <12 y and reporting ≥1 child outcome related to childhood overweight and/or obesity, body mass index, dietary intake, or eating behavior in the context of parent feeding practices. Studies were grouped according to Indigenous status of the population for data extraction and synthesis. A total of 79 studies were identified; 80% (n = 65) were conducted among the general Australian population and <20% (n = 14) focused on Indigenous populations. Although a wide range of feeding practices were identified among the general Australian population, Indigenous practices most closely aligned with highly responsive and permissive parenting dimensions. The highly valued child autonomy in Indigenous parenting is sometimes criticized by researchers when viewed through a Western lens because the child has agency in deciding what and when to eat. Evidence-based understanding and knowledge of Indigenous parent feeding practices in Australia are limited. Indigenous worldviews are expressed distinctly differently than the general Western worldview in parent feeding practices. How worldviews are represented in parent-child relationships is important to consider for the way in which research with Indigenous populations is conducted and the evidence it generates to inform policy and practice.
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    Development of a short‐item diet quality questionnaire for Indigenous mothers and their young children: The Menzies remote short‐item dietary assessment tool
    (WIley, 2018-04-19) Rohit, Athira ; Brimblecombe, Julie ; O'Dea, Kerin ; Tonkin, Emma ; Maypilama, Lawurrpa ; Maple-Brown, Louise J
    The importance of a healthy diet in facilitating optimal childhood development and preventing chronic disease cannot be overstated. Despite this, unhealthy food patterns frequently occur as early as 9 months of age and continue through childhood. Australian Bureau of Statistics data indicate Indigenous Australian children to have particularly concerning dietary patterns, with children aged 2–3 years three times more likely to consume carbonated sugary drinks than their non‐Indigenous counterparts (18% versus 5.8%, respectively).1 Early intervention to prevent or improve obesity‐related behaviours can have a positive impact. The ability to improve dietary outcomes depends primarily on an accurate assessment of dietary intake. Data reliability and compliance issues common in dietary assessment are exacerbated when working with Indigenous Australians living remotely due to existing tools using inappropriate language, being resource‐intensive and not incorporating culturally diverse foods and serving methods. The aim of this research was to develop a short‐item questionnaire to assess the dietary quality of mothers and their young children (2–4 years) in the remote Indigenous community (RIC) setting for the Pregnancy and Adverse Neonatal Diabetes Outcomes in Remote Australia (PANDORA) longitudinal birth cohort study.2 PANDORA participants are Northern Territory women (both Indigenous and non‐Indigenous) with and without diabetes during pregnancy and their babies.
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    Characteristics of Smartphone Applications for Nutrition Improvement in Community Settings: A Scoping Review
    (Oxford University Press, 2017-03-10) Tonkin, Emma ; Brimblecombe, Julie ; Wycherley, Thomas Philip
    Smartphone applications are increasingly being used to support nutrition improvement in community settings. However, there is a scarcity of practical literature to support researchers and practitioners in choosing or developing health applications. This work maps the features, key content, theoretical approaches, and methods of consumer testing of applications intended for nutrition improvement in community settings. A systematic, scoping review methodology was used to map published, peer-reviewed literature reporting on applications with a specific nutrition-improvement focus intended for use in the community setting. After screening, articles were grouped into 4 categories: dietary self-monitoring trials, nutrition improvement trials, application description articles, and qualitative application development studies. For mapping, studies were also grouped into categories based on the target population and aim of the application or program. Of the 4818 titles identified from the database search, 64 articles were included. The broad categories of features found to be included in applications generally corresponded to different behavior change support strategies common to many classic behavioral change models. Key content of applications generally focused on food composition, with tailored feedback most commonly used to deliver educational content. Consumer testing before application deployment was reported in just over half of the studies. Collaboration between practitioners and application developers promotes an appropriate balance of evidence-based content and functionality. This work provides a unique resource for program development teams and practitioners seeking to use an application for nutrition improvement in community settings.
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    Consumer Trust
    (Sage, 2015) Coveney, John David ; Henderson, Julie Anne ; Meyer, Samantha B ; Mamerow, Loreen ; Taylor, Anne ; Ward, Paul Russell ; Wilson, Annabelle
    In the past two decades, food industries in developed countries have experienced increasing numbers of food scares that have resulted in increased consumer concerns about the safety of food. Concerns about the safety and quality of food have become one of the most prominent issues about food. Media coverage of incidents around food safety and the increased attention to food scares internationally (e.g., bovine spongiform encephalopathy, genetic modification, pesticides, Salmonella, Listeria) have raised public concerns around food safety. As a result of food scares and food safety issues, as well as resulting media stories, there has been a decline in trust in the food supply and production. This decline in trust has led to decreased demands in the foods in question and the purchase of foods from associated companies. For example, within Western Europe, there has been a growing public unease about the health and safety of modern food production. Food-related scares have dominated the news media and have led to the erosion of public trust as well as increasing consumer confusion about food safety and diet issues. In addition, the increase in information from the media regarding what to eat, and where to eat, differs according to the “expert” in question. The results have been a decline in the authority of experts generally. This entry examines the conceptualization and scope of trust in food. The entry begins with a look at reasons for the decline in consumers’ trust in the quality and safety of the food they eat.
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    The Relative Validity of the Menzies Remote Short-Item Dietary Assessment Tool (MRSDAT) in Aboriginal Australian Children Aged 6–36 Months
    (MDPI, 2018-05-10) Tonkin, Emma ; Kennedy, Dani ; Golley, Rebecca Kirsty ; Byrne, Rebecca ; Rohit, Athira ; Kearns, Therese ; Hanieh, Sarah ; Biggs, Beverley-Ann ; Brimblecombe, Julie
    The Menzies Remote Short-item Dietary Assessment Tool (MRSDAT) can be used to derive a dietary index score, which measures the degree of compliance with the Australian Dietary Guidelines. This study aimed to determine the relative validity of a dietary index score for children aged 6–24 months, living in a Remote Aboriginal Community (RAC), derived using MRSDAT. This validation study compared dietary index scores derived using MRSDAT with those derived from the average of three 24-h recalls. Participants were aged 6–36 months at the first dietary assessment and were living in a RAC. The level of agreement between the two methods was explored using Lin’s concordance correlation coefficient (CCC), Bland-Altman plots, weighted Cohen’s kappa, and Fischer’s exact and paired t-tests. Forty participants were recruited. The CCC was poor between methods (R = 0.35, 95% CI 0.06, 0.58), with MRSDAT estimating higher dietary intake scores for all food groups except fruit, and higher dietary quality scores by an average of 4.78 points/100. Community-based Aboriginal researchers were central to this validation study. MRSDAT was within the performance range of other short-item dietary assessment tools developed for young children, and shows promise for use with very young children in RACs. View Full-Text
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    A Smartphone App to Reduce Sugar-Sweetened Beverage Consumption Among Young Adults in Australian Remote Indigenous Communities: Design, Formative Evaluation and User-Testing
    (JMIR Publications, 2017-12-12) Tonkin, Emma ; Jeffs, Lauren ; Wycherley, Thomas Philip ; Maher, Carol ; Smith, Ross Travers ; Hart, Ross ; Cubillo, Beau ; Brimblecombe, Julie
    Background: The disproportionate burden of noncommunicable disease among Indigenous Australians living in remote Indigenous communities (RICs) is a complex and persistent problem. Smartphones are increasingly being used by young Indigenous adults and therefore represent a promising method to engage them in programs seeking to improve nutritional intake. Objective: This study aimed to consult RIC members to inform the content of a smartphone app that can be used to monitor and reduce sugar-sweetened beverage intake in RICs. Methods: The study was conducted in two phases. The formative phase involved a simulated grocery selection activity with think aloud (“think aloud shop”), a semistructured interview, a questionnaire outlining current smartphone and app use, and a paper prototyping activity. A preliminary end-user testing phase involved a think aloud prototype test and a semistructured interview regarding user satisfaction. Convenience sampling was used to recruit 20 18- to 35-year-old smartphone users for each phase from two RICs in the Northern Territory, Australia. Thematic analysis of transcribed audio recordings was used to identify determinants of food choice from the think aloud shop; themes related to the Theory of Planned Behavior (TPB) from the eating behaviors interview; and usability, comprehension, and satisfaction with the app from the preliminary end-user testing. Results: Smartphone use in RICs is currently different to that found in urban environments; in particular, extremely low use of Facebook, restricted variety of phone types, and limited Internet access. Findings regarding promoting app engagement indicate that utilizing an opt-in approach to social features such as leader boards and team challenges is essential. The inclusion of games was also shown to be important for satisfaction, as were the use of audio features, contextually embedded dissemination, and streamlined app design for comprehension in this target group. Conclusions: This research provides critical insights and concrete recommendations for the development of lifestyle improvement apps targeted toward disadvantaged young adults in nonurban settings, specifically RICs. It serves as a framework for future app development projects using a consultative user-centered design approach, supporting calls for the increased use of this strategy in app development.