Many children globally do not meet government guidelines for daily fruit and vegetable intake, and in New Zealand, adherence to the vegetable intake recommendation is declining. This study aimed to identify systemic barriers to children meeting fruit and vegetable (FV) guidelines and generate sustainable actions within a local community to improve children’s FV intake. A qualitative system dynamics method of community group model building was used. The research team partnered with Healthy Families Waitākere, a Ministry of Health funded prevention initiative, to recruit 17 participants (including students, parents, teachers, community leaders, local retailers and health promoters) from a low-income, ethnically-diverse community in West Auckland, New Zealand. Three group model building workshops were held during which a systems map was created and used to identify actions by considering causal pathways and reinforcing loops in the system. Barriers to children’s FV intake identified by participants were the saturation of fast-food outlets in the community and ubiquitous marketing of these products, the high cost of fresh produce compared to fast food, and parents having little time for food preparation plus declining cooking skills and knowledge. Several actions to improve children’s FV intake by improving the local food environment were identified, which will be co-designed further and tested by a collaborative group involving community leaders. This project highlights the effectiveness of group model building for engaging a local community in systems change to improve child nutrition, and supplies a blueprint for future qualitative system dynamics research.
Objectives A nationwide spatial analysis of community retail food environments in relation to area socioeconomic deprivation was conducted in New Zealand.Methods Addresses from about 20,000 registered food outlets were retrieved from all 66 Councils. Outlets were classified, geocoded and (spatially) validated. The analysis included 4087 convenience, 4316 fast food/takeaway and 1271 supermarket and fruit/vegetable outlets and excluded outlets not considered 'healthy' or 'unhealthy'. The population-weighted density of different outlet types in Census areas and the proximity to different outlet types from Meshblock centres were calculated and associations with area socioeconomic deprivation assessed. Spatial scan statistics was used to identify food swamp areas with a significantly higher relative density of unhealthy outlets than other areas. Results A significantly positive association was observed between area deprivation and density of all retailers. A significantly negative association was observed between area deprivation and proximity to all retailers. Nationwide, 722 Census areas were identified as food swamps. Conclusions Access to food retailers is significantly higher in more deprived areas than in less deprived areas. Restricting unhealthy outlets in areas with a high relative density of those outlets is recommended.
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