Fresh kids: the efficacy of a health promoting schools approach to increasing consumption of fruit and water in Australia

The Fresh Kids programme utilized the Health Promoting Schools (HPSs) framework to design a whole-of-school, multifaceted intervention targeting specific behaviours to promote healthy eating and reduce the risk factors associated with childhood obesity. The aim of the programme was to evaluate the effectiveness of the HPS framework to increase fruit and water consumption among primary school-aged children over a 2-year period. The study design was an interrupted time series. Four primary schools in the inner west of Melbourne, Australia, participated in the programme intervention. Baseline data were collected using a lunch box audit to assess the frequency of children with fresh fruit, water and sweet drinks, either brought from home or selected from canteen lunch orders. The lunch box audit was repeated periodically for up to 2 years following programme implementation to assess the sustainability of dietary changes. Across all participating schools, significant increases between 25 and 50% were observed in the proportion of children bringing fresh fruit. Similarly, all schools recorded increases between 15 and 60% in the proportion of students bringing filled water bottles to school and reductions between 8 and 38% in the proportion of children bringing sweet drinks. These significant changes in dietary patterns were sustained for up to 2 years following programme implementation. Targeting key nutrition behaviours and using the HPS framework is an effective and simple approach which could be readily implemented in similar childhood settings. Effective strategies include facilitating organizational change within the school; integrating curriculum activities; formalizing school policy and establishing project partnerships with local community nutrition and dietetic services.

Risk and protection factors for different intensities of adolescent substance use: when does the prevention paradox apply?

The 'Prevention Paradox' applies when low-risk individuals in a population contribute the most cases of a condition or problem behaviour by virtue of their being in the majority, thereby recommending a universal or whole of population approach to prevention. The applicability of a universal as opposed to a targeted high-risk approach to the prevention of youth substance use was examined in two studies of children and adolescents conducted in Victoria, Australia. These studies were reanalysed by recombining developmental, social and individual measures to form cumulative risk indices for substance use. In Study 1, a cross-sectional survey of students, most regular tobacco, alcohol and cannabis use by 15/16-year-olds occurred in the moderate and low-risk groups, recommending a universal prevention strategy . However, the majority of illicit drug use occurred in the highest-risk group (top 15%). Furthermore, in younger age groups both legal and illegal drug use was concentrated mainly in the highest risk group. Study 2 used data from a major longitudinal study where risk factors at around age 11/12 years were used to predict substance use at age 17/18 years. Most students who admitted involvement in frequent smoking, heavy drinking and, although to a lesser degree, cannabis were classified as low or average risk. It is concluded that universal prevention strategies are needed for late adolescent alcohol, tobacco and cannabis use and more targeted strategies for addressing harm related to early age drug use, frequent cannabis use and illegal drug use. [Stockwell T, Toumbouru JW, Letcher P, Sanson A, Bond L. Risk and protection factors for different intensities of adolescent substance use: when does the prevention paradox apply?

Current trends in the rehabilitation of juvenile offenders

The Australian Institute of Criminology's recent work on adult male offenders has found that the most serious and persistent adult offenders had been detained as a juvenile. In terms of crime reduction, interventions that focus on reducing the likelihood of juveniles escalating to adult offenders will have significant benefits for the whole of the Australian community. Research conducted in juvenile justice settings around the world consistently shows that young people who come to the attention of criminal justice agencies have multiple problems and experience high levels of need across all areas of functioning. In meeting these needs, correctional agencies have been increasingly influenced by the model of rehabilitation known as the 'what works' approach. This paper outlines a case management framework for rehabilitating juvenile offenders that includes three of the most important 'what works' principles, namely the risk principle, the needs principle and the responsivity principle. In the longer term, the implementation of the framework will need to be evaluated to determine what works and what doesn't with rehabilitating juveniles.

A systematic grounded approach to the development of complex interventions : The Australian WorkHealth Program – Arthritis as a case study

Despite demands for evidence-based research and practice, little attention has been given to systematic approaches to the development of complex interventions to tackle workplace health problems. This paper outlines an approach to the initial stages of a workplace program development which integrates health promotion and disease management. The approach commences with systematic and genuine processes of obtaining information from key stakeholders with broad experience of these interventions. This information is constructed into a program framework in which practice-based and research-informed elements are both valued. We used this approach to develop a workplace education program to reduce the onset and impact of a common chronic disease – osteoarthritis.

To gain information systematically at a national level, a structured concept mapping workshop with 47 participants from across Australia was undertaken. Participants were selected to maximise the whole-of-workplace perspective and included health education providers, academics, clinicians and policymakers. Participants generated statements in response to a seeding statement: Thinking as broadly as possible, what changes in education and support should occur in the workplace to help in the prevention and management of arthritis? Participants grouped the resulting statements into conceptually coherent groups and a computer program was used to generate a ‘cluster map’ along with a list of statements sorted according to cluster membership.

In combination with research-based evidence, the concept map informed the development of a program logic model incorporating the program's guiding principles, possible service providers, services, training modes, program elements and the causal processes by which participants might benefit. The program logic model components were further validated through research findings from diverse fields, including health education, coaching, organisational learning, workplace interventions, workforce development and osteoarthritis disability prevention.

In summary, wide and genuine consultation, concept mapping, and evidence-based program logic development were integrated to develop a whole-of-system complex intervention in which potential effectiveness and assimilation into the workplace for which optimised.

Cross-sector transfer of consolidated financial reporting - conceptual concerns

This article addresses a major concern about the use of particular accounting concepts, notably those of control and assets, for whole-of-government consolidated financial reporting. While whole-of-government consolidated financial reports may resemble the formats required by accounting standards and so provide a benchmark for comparative purposes, inherent weakness in the specification of underpinning concepts means that proper and full application of the consolidation methodology cannot be assumed. A study of the whole-of-government consolidated financial reports of the Commonwealth, state and territory governments of Australia revealed that significant assets, obligations and controlled entities have not been included.

An integrated observation network for the Gippsland Lakes, Victoria, Australia : balancing the needs of science and management

The Gippsland Lakes region in eastern Victoria is a partially flushed coastal lake system within a diverse catchment of rural and urban communities. Pressure from lakeside developments, re-occurring blue-green algal blooms, declining fisheries, sedimentation and infilling of the ocean entrance, has borne several decades of focussed studies and routine monitoring programs, along with a variety of engineering and management solutions. A recent review recommended that these disparate studies should be enhanced to formulate a coordinated monitoring network that could improve both spatial and temporal coverage, develop a capacity to trigger responsive investigations and was able to serve the needs of system management. Through a series of partnerships an integrated network was developed that comprises event and baseline monitoring of catchment loads, local meteorological forcing and an array of water quality sampling sites within the lakes system. A majority of these sites are incorporated with real-time telemetry that provides up to the minute information to stakeholders via a web-based information management system and vital operational status to technical system management.

Scaling up community-based obesity prevention in Australia : background and evaluation design of the health promoting communities : being active eating well initiative

Background : There is only limited evidence available on how best to prevent childhood obesity and community-based interventions hold promise, as several successful interventions have now been published. The Victorian Government has recently funded six disadvantaged communities across Victoria, Australia for three years to promote healthy eating and physical activity for children, families, and adults in a community-based participatory manner. Five of these intervention communities are situated in Primary Care Partnerships and are the subject of this paper. The interventions will comprise a mixture of capacity-building, environmental, and whole-of-community approaches with targeted and population-level interventions. The specific intervention activities will be determined locally within each community through stakeholder and community consultation. Implementation of the interventions will occur through funded positions in primary care and local government. This paper describes the design of the evaluation of the five primary care partnership-based initiatives in the 'Go for your life' Health Promoting Communities: Being Active Eating Well (HPC:BAEW) initiative.

Methods/Design : A mixed method and multi-level evaluation of the HPC:BAEW initiative will capture process, impact and outcome data and involve both local and state-wide evaluators. There will be a combined analysis across the five community intervention projects with outcomes compared to a comparison group using a cross-sectional, quasi-experimental design. The evaluation will capture process, weight status, socio-demographic, obesity-related behavioral and environmental data in intervention and comparison areas. This will be achieved using document analysis, paper-based questionnaires, interviews and direct measures of weight, height and waist circumference from participants (children, adolescents and adults).

Discussion : This study will add significant evidence on how to prevent obesity at a population level in disadvantaged and ethnically diverse communities. The outcomes will have direct influence on policy and practice and guide the development and implementation of future obesity prevention efforts in Australia and internationally.

The process evaluation of it's your move!, an Australian adolescent community-based obesity prevention project

Background
Evidence on interventions for preventing unhealthy weight gain in adolescents is urgently needed. The aim of this paper is to describe the process evaluation for a three-year (2005-2008) project conducted in five secondary schools in the East Geelong/Bellarine region of Victoria, Australia. The project, 'It's Your Move!' aimed to reduce unhealthy weight gain by promoting healthy eating patterns, regular physical activity, healthy body weight, and body size perception amongst youth; and improve the capacity of families, schools, and community organisations to sustain the promotion of healthy eating and physical activity in the region.

Methods
The project was supported by Deakin University (training and evaluation), a Reference Committee (strategic direction, budgetary approval and monitoring) and a Project Management Committee (project delivery). A workshop of students, teachers and other stakeholders formulated a 10-point action plan, which was then translated into strategies and initiatives specific to each school by the School Project Officers (staff members released from teaching duties one day per week) and trained Student Ambassadors. Baseline surveys informed intervention development. Process data were collected on all intervention activities and these were collated and enumerated, where possible, into a set of mutually exclusive tables to demonstrate the types of strategies and the dose, frequency and reach of intervention activities.

Results
The action plan included three guiding objectives, four on nutrition, two on physical activity and one on body image. The process evaluation data showed that a mix of intervention strategies were implemented, including social marketing, one-off events, lunch time and curriculum programs, improvements in infrastructure, and healthy school food policies. The majority of the interventions were implemented in schools and focused on capacity building and healthy eating strategies as physical activity practices were seen by the teachers as already meeting students' needs.

Conclusions
While substantial health-promoting activities were conducted (especially related to healthy eating), there remain further opportunities for secondary schools to use a whole-of-school approach through the school curriculum, environment, policies and ethos to improve healthy eating, physical activity and healthy body perceptions in youth. To achieve this, significant, sustained leadership will be required within the education sector generally and within schools specifically.

Theory and accountability : the case of government consolidated financial reporting

The objective in this study is to examine the existing literature regarding the antecedents to public sector accountability performance by including a new variable: preparer-commanders’ beliefs about the usefulness of whole-of-government consolidated financial reporting. Goldberg’s (1965) Commander Theory was used as a relevant theoretical framework. Survey results provided insights into the beliefs of preparer-commanders as to the usefulness of whole-of-government consolidated financial reports for the discharge of accountability. While there appears to be a view that such reports may be useful for decision-making purposes, there is relatively less evidence to suggest that this type of information is suitable for the purposes of government resource allocation decisions.

The impact of client attitudes on the selection of contractors

This research is concerned with identifying prequalification criteria that both clients and contractors believe are good indicators of future construction performance. Criteria used in the past have been developed by clients in a largely idiosyncratic manner with little or no consultation with the contractors affected. The methodology chosen for the research was a survey which probed stakeholder attitudes to commonly used prequalification criteria. This was carried out via a postal questionnaire involving contactors and clients across Australia. The data was analysed using Discriminant Analysis, which is a multivariate statistical approach that determines the differences between groups. The research is structured around 39 criteria that were developed as part of a whole-of–government task force into best practice in procurement. The findings identified the most important criteria from both a client’s perspective, and a contractor’s perspective. The purpose was to discover if those differences reduce the effectiveness of the procurement process. This paper contributes to a more clarified understanding of the impact or contrasting views between the stakeholders involved in the prequalification process. This work is innovative because it is one of a few pieces of research that showed that clients and contractors do actually have divergent opinions on the importance of some criteria currently relied upon in the decision making process. The most important prequalification criteria are identified and possible reasons for these differences are discussed.

How can the impact of cultural development work in local government be measured? Towards more effective planning and evaluation strategies

The field of cultural development in local government is relatively new, with most councils only having dedicated staff or teams within the last ten to fifteen years. Challenges are associated with that newness in the areas of planning, goal setting and formal evaluation of achievements in relation to goals. How can the best decisions be made about what is needed? How can the outcomes of that work be evaluated? What should be measured and how? This paper explores these challenges and presents some solutions. Program Logic is introduced as a methodology for effective planning and evaluation of cultural development work in local government. The need for both performance and outcome evaluation of cultural development work is discussed, as are the levels of evaluation required; considering the contribution of individual workers, departments, whole of council and the overall community outcomes. Factors beyond the influence of local government, which impact the outcomes of arts initiatives, are also considered in arguing that more sophisticated evaluation processes are required.

How to make the rhetoric of joined-up government really work

"Joined-up' government and 'whole-of-government' approaches have evolved over the past two decades from the simple 'one-stop-shop' concept to much more formal organisational structures mandated at the highest levels. In many cases, the participants in these developments were learning on the job, as they responded to community and political demands for better service delivery and more accountability. This paper looks back at some of those developments and proposes a schema to assess and place policies, strategies and programs.

Environmental and cultural change on the Mt Eccles lava-flow landscapes of southwest Victoria, Australia

The Gunditjmara people developed a socio-economic system based on the modification of wetland ecosystems associated with the Mt Eccles lava flow primarily for sustainable production and management of the highly nutritious shortfin eel (Anguilla australis). This paper examines the environmental history of these landscapes since their inception about 30 000 years ago, through palaeoecological analysis of sediment cores from associated lakes and swamps, in order to contribute to an understanding of the causes and timing of cultural transformation. Two records cover the whole of the 30 000 year history of the landscape while two others provide evidence of change within the Holocene. A great deal of variation within the landscape is revealed, both temporally and spatially, with opportunities for human exploitation through the whole recorded period. Although most features of the records can be explained by natural landscape development and climate change, some human modification can be suggested from around the Pleistocene—Holocene transition while more obvious indications of management relating to eel aquaculture are evident from about 4000 cal. yr BP that appear to include adaptations to the onset of a drier and more variable climate. The study has implications for the explanation of intensification of settlement in Australia more generally within the mid to late Holocene.

Riparian vegetation has disproportionate benefits for landscape-scale conservation of woodland birds in highly modified environments

1. Identifying landscape patterns that allow native fauna to coexist with human land use is a global challenge. Riparian vegetation often persists in anthropogenic environments as strips of natural or semi-natural vegetation that provide habitat for many terrestrial species. Its relative contribution to landscape-scale conservation is likely to change as environments become increasingly modified. We used a ‘whole of landscape’ approach to test the hypothesis that riparian vegetation offers disproportionate benefits, relative to non-riparian vegetation, for the conservation of woodland birds in highly modified agricultural landscapes. 2. We selected 24 landscapes, each 100 km2, along a gradient of landscape change represented by decreasing cover of native vegetation (from 60% to <2%), in an agricultural region in SE Australia. Bird species were systematically surveyed at three riparian and seven non-riparian sites in wooded vegetation in each landscape. 3. Riparian sites supported a greater richness of woodland-dependent species, a group of conservation concern, than did non-riparian sites. The composition of assemblages also differed between site types. 4. At the landscape scale, the pooled richness of bird assemblages at riparian and non-riparian sites, respectively, decreased with overall loss of tree cover despite constant sampling effort. Within landscapes, the β-diversity of woodland species among non-riparian sites increased (composition became less similar) as landscape tree cover declined. In contrast, riparian assemblages were relatively stable with no change in β-diversity. Importantly, as landscape tree cover declined, the proportion of woodland species uniquely present at riparian sites increased and made a greater contribution to overall landscape diversity. 5. Synthesis and applications. Landscape-scale richness of woodland species declines as landscape tree cover is lost. In highly depleted landscapes, riparian vegetation retains a relatively rich, stable assemblage compared with that in heterogeneous remnants of non-riparian vegetation and consequently contributes disproportionately to landscape-scale diversity. These observations, together with the diverse benefits of riparian vegetation for aquatic ecosystems, mean that protection and restoration of riparian vegetation is a high priority in anthropogenic environments. Importantly, such actions are directly amenable to individual land managers, and the benefits will accumulate to enhance the persistence and conservation of species at landscape and regional scales.