Results from New Zealand's 2014 report card on physical activity for children and youth

BACKGROUND: This brief report provides grades for the 2014 New Zealand Report Card on Physical Activity for Children and Youth. The Report Card presents a review of current evidence across 9 key indicators, including physical activity (PA), organized sport and free play, sedentary behavior, and community and government initiatives across New Zealand. METHODS: Nationally representative survey data were collated by researchers at the University of Auckland, New Zealand, between June and December 2013. The grade for each indicator is based on the percentage of children and youth meeting a defined benchmark: A is 81%-100%; B is 61%-80%; C is 41%-60%, D is 21%-40%; F is 0%-20%; INC is incomplete data. RESULTS: Overall PA received a score of B, as did Organized Sport Participation and Active Play. PA participation in School Environment scored slightly less with a score of B-. Sedentary Behaviors, Family and Peers, and Community and Built Environment scored a grade of C. Active transportation received a score of C-. An inconclusive grade was given for the Government indicator due to a lack of established international criteria for assessment. CONCLUSIONS: PA participation in New Zealand is satisfactory, but could improve. However, sedentary behavior is high. Of particular concern is the age-related decline in PA participation, particularly among adolescent females, and the increase in sedentary behavior.

Physical activity of children: a global matrix of grades comparing 15 countries

The Active Healthy Kids Canada (AHKC) Report Card on Physical Activity for Children and Youth has been effective in poweringthe movement to get kids moving by influencing priorities, policies, and practice in Canada. The AHKC Report Card process wasreplicated in 14 additional countries from 5 continents using 9 common indicators (Overall Physical Activity, Organized SportParticipation, Active Play, Active Transportation, Sedentary Behavior, Family and Peers, School, Community and Built Environment,and Government Strategies and Investments), a harmonized process and a standardized grading framework. The 15 ReportCards were presented at the Global Summit on the Physical Activity of Children in Toronto on May 20, 2014. The consolidatedfindings are summarized here in the form of a global matrix of grades. There is a large spread in grades across countries for mostindicators. Countries that lead in certain indicators lag in others. Overall, the grades for indicators of physical activity (PA) aroundthe world are low/poor. Many countries have insufficient information to assign a grade, particularly for the Active Play and Familyand Peers indicators. Grades for Sedentary Behaviors are, in general, better in low income countries. The Community and BuiltEnvironment indicator received high grades in high income countries and notably lower grades in low income countries. There wasa pattern of higher PA and lower sedentary behavior in countries reporting poorer infrastructure, and lower PA and higher sedentarybehavior in countries reporting better infrastructure, which presents an interesting paradox. Many surveillance and researchgaps and weaknesses were apparent. International cooperation and cross-fertilization is encouraged to tackle existing challenges,understand underlying mechanisms, derive innovative solutions, and overcome the expanding childhood inactivity crisis.

Health literacy and the determinants of obesity: a population-based survey of sixth grade school children in Taiwan

BACKGROUND: Health literacy has become an important health policy and health promotion agenda item in recent years. It had been seen as a means to reduce health disparities and a critical empowerment strategy to increase people's control over their health. So far, most of health literacy studies mainly focus on adults with few studies investigating associations between child health literacy and health status. This study aimed to investigate the association between health literacy and body weight in Taiwan's sixth grade school children.

METHODS: Using a population-based survey, 162,209 sixth grade (11-12 years old) school children were assessed. The response rate at school level was 83%, with 70% of all students completing the survey. The Taiwan child health literacy assessment tool was applied and information on sex, ethnicity, self-reported health, and health behaviors were also collected. BMI was used to classify the children as underweight, normal, overweight, or obese. A multinomial logit model with robust estimation was used to explore associations between health literacy and the body weight with an adjustment for covariates.

RESULTS: The sample consisted of 48.9% girls, 3.8% were indigenous and the mean BMI was 19.55 (SD = 3.93). About 6% of children self-reported bad or very bad health. The mean child health literacy score was 24.03 (SD = 6.12, scale range from 0 to 32). The overall proportion of obese children was 15.2%. Children in the highest health literacy quartile were less likely to be obese (12.4%) compared with the lowest quartile (17.4%). After controlling for gender, ethnicity, self-rated health, and health behaviors, children with higher health literacy were less likely to be obese (Relative Risk Ratio (RRR) = 0.94, p < 0.001) and underweight (RRR = 0.83, p < 0.001). Those who did not have regular physical activity, or had sugar-sweetened beverage intake (RRR > 1.10, p < 0.0001) were more likely to report being overweight or obese.

CONCLUSIONS: This study demonstrates strong links between health literacy and obesity, even after adjusting for key potential confounders, and provides new insights into potential intervention points in school education for obesity prevention. Systematic approaches to integrating a health literacy curriculum into schools may mitigate the growing burden of disease due to obesity.

‘Out of the loop’: early childhood educators gaining confidence with unfamiliar policy discourse

It has been seven years since the Early Years Learning Framework (EYLF) was introduced in Australia and four years since the National Quality Standard (NQS) was implemented. To gain insight into how educators are understanding practice in the Australian early childhood and care context, the study draws on a praxeological frame where educators have the opportunity to inquire and critically reflect on practice in a supported research environment. Data were analysed using critical discourse analysis, enabling a close examination of participant reflections and understandings about practice. Findings reveal that educators are confident when describing their teaching using familiar educational discourse, whereas educators were apprehensive when confronted with new and unfamiliar concepts. The third finding illustrates the ways educators gain confidence with unfamiliar policy discourse. The study’s findings add to limited empirical evidence about how early childhood educators understand key concepts introduced by the EYLF and NQS.

The perspectives of secondary school students with special needs in Spain during the crisis

This paper presents an overview of a situational analysis of inclusive schooling in Spain from the perspective of students with special educational needs. The purpose of this work was to learn how young people collectively considered their experiences of school inclusion. The participants—aged 12–19 years who attended six different settings—highlighted the school community, resources, teacher pedagogy, support and social cohesion as germane aspects of their inclusion. Through a presentation of these characteristics, this analysis demonstrates how schools can effectively fulfil the core requirement of teaching and supporting diversity and, in so doing, how they can incite included subjectivities of differently abled students. This analysis is positioned within the climate of economic instability in Spain, which threatens to derail the headway made towards inclusive schooling via the introduction of severe austerity measures.

Between education and psychology: school staff perspectives

When discussing contributions from psychology in/to educational practices like school-based mental health promotion, it is peculiar that psychologists (of an educational or clinical kind) or education-oriented sociologists, both not often based in schools or classrooms, dominate the topic. It has been acknowledged that school staff have been over looked and underutilised in contributing to the discussion, particularly as this pertains to sharing perspectives on how they experience their role in relationship to education policy and practice. The study presented here looked to address this situation by seeking the perspectives of school staff on a range of concerns situated at the nexus between education and psychology. Contrary to the type of displaced assessment intimated above, this group of school staff generally accepts they perform a crucial task in supporting students, their main concern being to incisively question how they might negotiate existing role-related pressures to better current school-based practice.

Teachers’ perspectives and practices on social and emotional learning: multiple case study approach

 This thesis has explored how Preparatory teachers in two Victorian primary schools understand and implement social and emotional learning in their classrooms. The findings of this research indicated that the participating teachers paid more attention to children's social skills rather than to their emotional skills. Another important finding was that social and emotional learning has a very limited place within the policies and the curricula of the participating schools.

Psychosocial paediatric training in Iraq: perspectives of trainers and students

There is an absence of education regarding psychosocial issues in Iraqi paediatric training programmes. The aim of this study is to examine current knowledge and perspectives around these topics and to explore potential development in these programmes. 56 paediatric trainers and students at the Child Central Teaching Hospital, a hospital affiliated to the Al-Mustansyria medical college in Baghdad, responded to a questionnaire to evaluate knowledge and perspectives regarding psychosocial approaches to child and adolescent health as delivered presently via academic training and used in professional practice. The majority of the respondents reported having no training in psychosocial interventions. Using a scale from 0 ('not relevant') to 10 ('very important'), psychosocial issues were rated 7.1 in their relevance to everyday paediatric practice. On a scale of 0 ('very poor') to 10 ('totally adequate'), respondents rated formal current psychosocial training at 2.5. It is concluded that incorporating psychosocial approaches in paediatric training will lead to a broader base of knowledge in children's health and contribute to the promotion of multidisciplinary practice in Iraq.

Professionals’ perspectives about the challenges of using interpreters in child sexual abuse interviews

Interpreters play a crucial role in many investigative interviews with child complainants of sexual abuse; however, little has been written about the interpreting process from the perspective of the interviewers. This study elicited interviewers’ perspectives about the challenges of using interpreters, with the aim of understanding how investigative interviews could be improved. The participants consisted of 21 investigative interviewers and prosecutors of child abuse cases (from a range of jurisdictions) who use interpreters on a regular basis. Thematic analysis of semi-structured interviews with the professionals about the interpreting process revealed two main challenges particular to child abuse interviews, namely the interpreters’ lack of preparedness to deal with the traumatic and sensitive nature of children's abuse histories, and an insufficient understanding of ‘best-practice’ child interview process. The recommendations focus on the need for more specialised training for, and screening of, interpreters, and more extensive use of pre-conferencing to familiarise children with the interpreter-mediated interview process.

Kitchens and pantries—helping or hindering? The perspectives of emergency food users in Victoria, Australia

In high-income countries, people affected by food insecurity may seek out free/subsidized food from charities. Their perceptions of the food programs provided and preferences for alternative strategies are underresearched. The aim of this study was to develop an understanding of the users’ experiences of food insecurity and gain evidence for effective responses in the future. Twelve semistructured interviews with a sample of users, who were also charity volunteers, were conducted in Victoria, Australia. A thematic analysis of the interview transcripts was undertaken. The results show that users have complex needs. Charities have both the capacity to hinder and help people maintain dignity, social inclusion, and health. Alternative community and policy food security strategies were proposed by interviewees. In the future, perspectives of affected community members must inform strategies that seek to improve people’s access to safe, nutritious, and affordable food. A human right to food framework is discussed as a mechanism to help realize food security in Australia.

Progress achieved in restricting the marketing of high-fat, sugary and salty food and beverage products to children

In May 2010, 192 Member States endorsed Resolution WHA63.14 to restrict the marketing of food and non-alcoholic beverage products high in saturated fats, trans fatty acids, free sugars and/or salt to children and adolescents globally. We examined the actions taken between 2010 and early 2016 - by civil society groups, the World Health Organization (WHO) and its regional offices, other United Nations (UN) organizations, philanthropic institutions and transnational industries - to help decrease the prevalence of obesity and diet-related noncommunicable diseases among young people. By providing relevant technical and policy guidance and tools to Member States, WHO and other UN organizations have helped protect young people from the marketing of branded food and beverage products that are high in fat, sugar and/or salt. The progress achieved by the other actors we investigated appears variable and generally less robust. We suggest that the progress being made towards the full implementation of Resolution WHA63.14 would be accelerated by further restrictions on the marketing of unhealthy food and beverage products and by investing in the promotion of nutrient-dense products. This should help young people meet government-recommended dietary targets. Any effective strategies and actions should align with the goal of WHO to reduce premature mortality from noncommunicable diseases by 25% by 2025 and the aim of the UN to ensure healthy lives for all by 2030.

Nordic policy lessons for Australia

This report considers public debate on Scandinavian and Finnish policy ideas of possible relevance to Australia since the publication in November 2014 by an Australian university press of Andrew Scott’s book Northern Lights: The Positive Policy Example of Sweden, Finland, Denmark and Norway. Two years on from the book’s publication, the report considers the varying reception in Australia of propositions advanced in Northern Lights for: expansion of public early childhood education and care and extension of paid parental leave, as well as properly enshrining children’s rights and other actions to reduce child poverty and improve children’s wellbeing (learning from Sweden); more equitable schools funding, better valuing of a quality teaching profession and more effective provision of vocational education in schools (learning from Finland); enhancement of support and skills retraining for mature-age workers displaced by job losses (learning from Denmark); and increasing revenue including through greater taxation and regulation of natural resource wealth (learning from Norway). The report then considers the main priority areas of Nordic achievement nominated by policy actors for additional consideration for Australia to now learn from. These are: better, healthier and more natural urban design, together with more balanced regional development; better workplace design – specifically the importance of taking into account aesthetics, ergonomics and nature in people’s workplace environments; and greater emphasis on both the prevention of crime and the rehabilitation of persons convicted of crimes. Sweden and Norway’s continuing leadership in the provision of quality foreign aid and other foreign policy initiatives such as Sweden's current “feminist foreign policy” are also discussed. Objections raised to the book’s premises, including to the possibility of policy transfer to Australia from nations presumed to be less multicultural, are evaluated.

Legitimising children’s evidence: Inclusive participatory research with children with disability

Achieving human rights is at the core of development outcomes, and the achievement of positive development outcomes increasingly relies on evidence-based policy and practice. However, people with disability have been routinely excluded from research evidence and knowledge production, both due to a lack of interest in their issues (Yeo and Moore, 2003) and through an over-reliance on research design that does not address barriers to their participation as research respondents (Wilson et al. 2013). Children with disability are even more marginalised from participation in knowledge production processes and have been passively subjected to research being conducted on or about them, rather than with them (Gray and Winter 2011a). This exclusion is even more evident in developing countries of the global south though with some rare exceptions (Kembhavi and Wirz, 2009; Singal, 2010; Wickenden and Kembhavi- Tam, 2014; Don et al, 2015; Nguyen et al, 2015). This paper reports on the ‘Voices of Pacific Children with Disability’ project (hereafter referred to as the Voices project) which, drawing on the broader field of child participatory research, developed a method for children with disability to competently provide evidence about their needs, aspirations and human rights priorities. Eighty-nine children with disability living in rural and urban areas of Vanuatu and Papua New Guinea (PNG) participated, using a suite of data collection ‘tools’ designed to support children to express their life priorities and human rights’ needs. In this paper we examine a sub-set of this data related to children’s future priorities, the primary one being employment, and explore the utility of such evidence for governments, NGOs and other stakeholders, in shaping policy and service delivery in line with the rights of children with disability. Such data is important when working in an evidence informed way as often these organisations have limited data on the needs and values of the groups they serve.

Family and carer smoking control programmes for reducing children's exposure to environmental tobacco smoke

BackgroundChildren's exposure to other people's cigarette smoke (environmental tobacco smoke, or ETS) is associated with a range of adverse health outcomes for children. Parental smoking is a common source of children's exposure to ETS. Older children are also at risk of exposure to ETS in child care or educational settings. Preventing exposure to cigarette smoke in infancy and childhood has significant potential to improve children's health worldwide.ObjectivesTo determine the effectiveness of interventions aiming to reduce exposure of children to ETS.Search methodsWe searched the Cochrane Tobacco Addiction Group Specialized Register and conducted additional searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PsycINFO, EMBASE, CINAHL, ERIC, and The Social Science Citation Index & Science Citation Index (Web of Knowledge). Date of the most recent search: September 2013.Selection criteriaControlled trials with or without random allocation. Interventions must have addressed participants (parents and other family members, child care workers and teachers) involved with the care and education of infants and young children (aged 0 to 12 years). All mechanisms for reduction of children's ETS exposure, and smoking prevention, cessation, and control programmes were included. These include health promotion, social-behavioural therapies, technology, education, and clinical interventions.Data collection and analysisTwo authors independently assessed studies and extracted data. Due to heterogeneity of methodologies and outcome measures, no summary measures were possible and results were synthesised narratively.Main resultsFifty-seven studies met the inclusion criteria. Seven studies were judged to be at low risk of bias, 27 studies were judged to have unclear overall risk of bias and 23 studies were judged to have high risk of bias. Seven interventions were targeted at populations or community settings, 23 studies were conducted in the 'well child' healthcare setting and 24 in the 'ill child' healthcare setting. Two further studies conducted in paediatric clinics did not make clear whether the visits were to well or ill children, and another included both well and ill child visits. Thirty-six studies were from North America, 14 were in other high income countries and seven studies were from low- or middle-income countries. In only 14 of the 57 studies was there a statistically significant intervention effect for child ETS exposure reduction. Of these 14 studies, six used objective measures of children's ETS exposure. Eight of the studies had a high risk of bias, four had unclear risk of bias and two had a low risk of bias. The studies showing a significant effect used a range of interventions: seven used intensive counselling or motivational interviewing; a further study used telephone counselling; one used a school-based strategy; one used picture books; two used educational home visits; one used brief intervention and one study did not describe the intervention. Of the 42 studies that did not show a significant reduction in child ETS exposure, 14 used more intensive counselling or motivational interviewing, nine used brief advice or counselling, six used feedback of a biological measure of children's ETS exposure, one used feedback of maternal cotinine, two used telephone smoking cessation advice or support, eight used educational home visits, one used group sessions, one used an information kit and letter, one used a booklet and no smoking sign, and one used a school-based policy and health promotion. In 32 of the 57 studies, there was reduction of ETS exposure for children in the study irrespective of assignment to intervention and comparison groups. One study did not aim to reduce children's tobacco smoke exposure, but rather aimed to reduce symptoms of asthma, and found a significant reduction in symptoms in the group exposed to motivational interviewing. We found little evidence of difference in effectiveness of interventions between the well infant, child respiratory illness, and other child illness settings as contexts for parental smoking cessation interventions.Authors' conclusionsWhile brief counselling interventions have been identified as successful for adults when delivered by physicians, this cannot be extrapolated to adults as parents in child health settings. Although several interventions, including parental education and counselling programmes, have been used to try to reduce children's tobacco smoke exposure, their effectiveness has not been clearly demonstrated. The review was unable to determine if any one intervention reduced parental smoking and child exposure more effectively than others, although seven studies were identified that reported motivational interviewing or intensive counselling provided in clinical settings was effective.