ResearchReliability and relative validity of a child nutrition questionnaire to simultaneously assess dietary patterns associated with positive energy balance and food behaviours, attitudes, knowledge and environments associated with healthy eating AbstractBackground: Food behaviours, attitudes, environments and knowledge are relevant to professionals in childhood obesity prevention, as are dietary patterns which promote positive energy balance. There is a lack of valid and reliable tools to measure these parameters. The aim of this study was to determine the reliability and relative validity of a child nutrition questionnaire assessing all of these parameters, used in the evaluation of a community-based childhood obesity prevention project.

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Objective: To describe the rationale, development and implementation of the quantitative component of evaluation of a multi-setting, multi-strategy, community-based childhood obesity prevention project (the eat well be active (ewba) Community Programs) and the challenges associated with this process and some potential solutions. Design: ewba has a quasi-experimental design with intervention and comparison communities. Baseline data were collected in 2006 and post-intervention measures will be taken from a non-matched cohort in 2009. Schoolchildren aged 10-12 years were chosen as one litmus group for evaluation purposes. Setting: Thirty-nine primary schools in two metropolitan and two rural communities in South Australia. Subjects: A total of 1732 10-12-year-old school students completed a nutrition and/ or a physical activity questionnaire and 1637 had anthropometric measures taken; 983 parents, 286 teachers, thirty-six principals, twenty-six canteen and thirteen outof-school-hours care (OSHC) workers completed Program-specific questionnaires developed for each of these target groups. Results: The overall child response rate for the study was 49 %. Sixty-five per cent, 43 %, 90 %, 90 % and 68 % of parent, teachers, principals, canteen and OSHC workers respectively, completed and returned questionnaires. A number of practical, logistical and methodological challenges were experienced when undertaking this data collection. Conclusions: Learnings from the process of quantitative baseline data collection for the ewba Community Programs can provide insights for other researchers planning similar studies with similar methods, particularly those evaluating multi-strategy programmes across multiple settings. Keywords Community-based obesity prevention Evaluation ChildhoodThe prevalence of overweight and obesity in school-aged children is estimated to be 10 % worldwide and increasing (1) . Obesity is recognised as a rapidly growing threat to the health of populations in an increasing number of countries around the world (2) , placing significant burden on health-care systems. Prevention is recognised as the most realistic and cost-effective strategy to deal with childhood obesity (3) . While positive energy balance leads to the accumulation of excess weight, the aetiology of obesity is complex and dependent on more than just biology. For example, increased energy intake and/or decreased energy expenditure is commonly entwined with environmental factors, across multiple settings (4) .There has been a call for community-based obesity interventions as a strategy for prevention of childhood obesity (2) . Community-based interventions recognise the depth of community understanding held by members and their knowledge of community resources and dynamics (5) . These provide the foundation when designing and delivering interventions, including choice of settings and strategies. Furthermore, individual behaviours are only sustained if they are carried out in an environment that supports healthy choices (5) . In the case of...

Rigorous evaluation of large-scale community-based obesity interventions can provide important guidance to policy and decision makers. The eat well be active (ewba) Community Programs, a five-year multilevel, multistrategy community-based obesity intervention targeting children in a range of settings, was delivered in two communities. A comprehensive mixed-methods evaluation using a quasiexperimental design with nonmatched comparison communities was undertaken. This paper describes the changes in primary school children's attitudes, behaviours, knowledge, and environments associated with healthy eating and physical activity, based on data from six questionnaires completed pre- and postintervention by students, parents, and school representatives. As self-reported by students in years from five to seven there were few significant improvements over time in healthy eating and physical activity behaviours, attitudes, knowledge, and perceived environments, and there were few changes in the home environment (parent report). Overall there were considerably more improvements in intervention compared with comparison schools affecting all environmental areas, namely, policy, physical, financial, and sociocultural, in addition to improvements in teacher skill and knowledge. These improvements in children's learning environments are important and likely to be sustainable as they reflect a change of school culture. More sensitive evaluation tools may detect behaviour changes.