No abstract

Issue addressed Increasing the proportion of older adults meeting current recommendations for physical activity is important. This study aimed to determine the acceptability of outdoor gym use among older adults by assessing their outdoor gym use, intention to use, motivators, frequency and preference for use, and barriers and enablers to use. Methods Interviews were conducted with 438 consenting English speaking park users≥50 years after installation and promotion of an outdoor gym. Results Forty-two percent of older adults interviewed had used the outdoor gym. Outdoor gym users had a significantly higher proportion of local residents (χ=10.43; P<0.01), were more frequent park users (χ=8.75; P<0.01) and spoke a language other than English (χ=15.44; P<0.0001) compared with general park users. Shade and different equipment types were the most cited enablers. Conclusions Outdoor gyms may be an acceptable form of physical activity for older adult park users. Installations should offer a variety of equipment types and shade. So what? Outdoor gyms are a potential equitable approach to engaging older adults in a variety of physical activity types. Social and physical benefits of outdoor gym use in high risk groups for physical inactivity should be explored.

Issue addressed: Policy and environmental approaches can reduce the accessibility and purchasing of sugar-sweetened beverages (SSBs), potentially reducing overweight and obesity. This study examined the impact of a state-wide policy on removal of SSBs from sale in NSW public hospitals (launched July 2017), and explored consumer awareness and support.Methods: A convenience sample of 81 food outlets in 26 hospitals were audited for SSB availability before and after the target date for SSB removal (31 December 2017). An interviewer-administered intercept survey in 10 randomly selected hospitals (March-May 2018), assessed staff and visitors' awareness of and support for SSB removal. Descriptive and χ 2 analyses assessed differences in: SSB availability; staff and visitor awareness and support. Open-ended survey responses were thematically analysed.

Background: Policies that support healthier food environments, including healthy retail food availability and promotion, are an important strategy for obesity prevention. The aim of this systematic review was to examine the evidence for barriers and enablers to successful implementation of healthy food and drink policies, delivered at scale. Methods: MEDLINE, SCOPUS and INFORMIT were searched to May 2019 for peer-reviewed studies. Google and Google Scholar were searched for grey literature. Studies of any design relating to a healthy food and drink policy delivered at scale (≥10 sites) in non-commercial food settings, for specific retail outlets (e.g., vending machines, cafes, cafeterias, school canteens), and that reported on implementation barriers and/or enablers were included. Studies in commercial food retail environments (e.g., supermarkets) were excluded. Studies were appraised for quality and key information was extracted and summarised. Extracted information on barriers and enablers was further grouped into overarching themes relating to perceptions of the policy itself, organisational and contextual factors influencing policy implementation, stakeholder responses to the implemented policy and perceived policy impacts. Results: Of 19 studies, 16 related to policies implemented in schools, two in hospital/health facilities and one in a sport/recreation setting. Most studies were conducted in North America or Australia, and policy implementation occurred mainly at state/regional or federal levels. The most commonly cited barriers across overarching themes and intervention settings were: lack of stakeholder engagement or prioritisation of the policy (11 studies); resistance to change from school stakeholders or customers (8 studies); and concern over profitability, revenue and/or commercial viability (8 studies). Few studies reported on mitigation of barriers. Enablers most commonly raised were: stakeholder engagement, whole-school approach and/or prioritisation of the policy (9 studies); policy level or higher-level support in the form of information, guidance and/or training (5 studies); and leadership, school/policy champion, management commitment and/or organisational capacity (4 studies). Conclusions: Key considerations for policy implementation ranged from building stakeholder support, prioritising policy implementation within organisations, to implementing strategies that address financial concerns and implementation barriers.

Objective: To determine the impact of a healthy food and drink policy on hospital staff and visitors’ food purchasing behaviours, and their awareness and support for the changes introduced. Design: Two repeated cross-sectional surveys, consisting of intercept interviews and observations of food items purchased were conducted before (March-July 2018) and after (April-June 2019) the target date for implementation of 13 food and drink practices (31 December 2018). Food purchases were coded as ‘Everyday’ (healthy) or ‘Occasional’ (unhealthy). Setting: Ten randomly selected NSW public hospitals, collection sites including hospital entrances and 13 hospital cafés/cafeterias. Participants: 4,808 hospital staff and visitors completed the surveys (response rate 85%). The majority were female (63%), spoke English at home (85%), and just over half had completed tertiary education (55%). Results: Significant increases from before to after the implementation target date were found for policy awareness (23% to 42%; p<0.0001) and support (89% to 92%; p=0.01). The proportion of ‘Everyday’ food purchases increased, but not significantly (56% to 59%; p=0.22); with significant heterogeneity between outlets (p=0.0008). Overall, younger, non-tertiary-educated adults, visitors and those that spoke English at home were significantly less likely to purchase ‘Everyday’ food items. Support was also significantly lower in males. Conclusions: The findings provide evidence of strong policy support, an increasing awareness of related changes, and a trend towards increased ‘Everyday’ food purchasing. Given the relatively early phase of policy implementation, and the complexity of individual food purchasing decisions, longer-term follow-up of purchasing behaviour is recommended following ongoing implementation efforts.