Fat talk: Influences on body image in childcare.

ISSUE ADDRESSED: This research explored the use of "fat talk" by early childhood educators and their awareness of their potential influence on the developing body image of young children. METHODS: Mixed methods comprising focus groups, telephone interviews and demographic surveys with 44 early childhood educators Australia-wide. RESULTS: Findings showed many educators in this research recognised that they had a role to play in the development of children's body image, though some were unsure when body image began to develop. Educators engaged widely in "fat talk," in the vicinity of children or other educators, and accepted such talk as normal. DISCUSSION: "Fat talk" features in the workplace and is commonly used by early childhood educators. Its influence on the development of body image on young children did not appear to be well understood by early years' educators or of a concern to them. CONCLUSIONS: Since body image develops in children from around three years of age, the role of early childhood educators in its development should not be overlooked. SO WHAT? RELEVANCE TO HEALTH PROMOTION: Body image is a misunderstood public health concern, with long-term impacts on weight, mental health and physical health. Promotion of positive body image and the early recognition of body image disturbance are crucial, as children who exhibit body dissatisfaction in their formative years have a greater risk of severe body image disturbance as they progress through childhood and adolescence. Since early childhood educators spend significant time with children, encouraging them to avoid engaging in "fat talk" and instead to promote positive body image is warranted.

Designing programmes of assessment: A participatory approach.

Programmatic approaches to assessment provide purposeful and meaningful assessment yet few examples of their development exist. The aim of this study was to describe the development of a programme of assessment using a participatory action research (PAR) approach. Nine work-based assessors together with three academics met on six occasions to explore the current approach to competency-based assessment in the placement component of a dietetics university course, the findings of which were used to design a programme of assessment. Findings revealed disconnect between current assessment approaches and best practice. The PAR methodology fostered a shared vision for the design of a programmatic approach to assessment and strong leadership was essential. Participants experienced a philosophical shift in their views towards assessment, supporting the implementation of a new assessment programme. This paper is the first to describe a PAR approach as a feasible and effective way forward in the design of programmatic assessment. The approach engaged stakeholders to strengthen their abilities as work-based assessors and produced champions for best practice assessment.

Maternity-care: measuring women's perceptions.

PURPOSE: Achieving maternity-care outcomes that align with women's needs, preferences and expectations is important but theoretically driven measures of women's satisfaction with their entire maternity-care experience do not appear to exist. The purpose of this paper is to outline the development of an instrument to assess women's perception of their entire maternity-care experience. DESIGN/METHODOLOGY/APPROACH: A questionnaire was developed on the basis of previous research and informed by a framework of standard service quality categories covering the spectrum of typical consumer concerns. A pilot survey with a sample of 195 women who had recent experience of birth was undertaken to establish valid and reliable scales pertaining to different stages of maternity care. Exploratory factor analysis was used to interpret scales and convergent validity was assessed using a modified version of the Client Satisfaction Questionnaire. FINDINGS: Nine theoretically informed, reliable and valid stand-alone scales measuring the achievement of different dimensions of women's expectancies of public maternity care were developed. The study scales are intended for use in identifying some potential areas of focus for quality improvement in the delivery of maternity care. RESEARCH LIMITATIONS/IMPLICATIONS: Reliable and valid tools for monitoring the extent to which services respond to women's expectations of their entire maternity care form part of the broader toolkit required to adequately manage health-care quality. This study offers guidance on the make-up of such tools. ORIGINALITY/VALUE: The scales produced from this research offer a means to assess maternity care across the full continuum of care and are brief and easy to use.

The impact of a parent-directed intervention on parent-child communication about tobacco and alcohol.

INTRODUCTION AND AIM: Given the likelihood of engaging in the hazardous use of tobacco and alcohol increases during teenage years, pre-adolescence is a critical time to implement prevention programmes. While social factors other than those associated with parenting play a role in determining a child's risk for initiation of tobacco and alcohol use, parents can have a significant influence on their children's decisions about these issues. The aim of this study was to assess the impact of an in-home parent-directed drug education intervention on parent-child communication about tobacco and alcohol. DESIGN AND METHODS: A group randomised intervention trial was conducted in Perth, Western Australia. Schools were selected using stratified random sampling and randomised to three study conditions. A total of 1201 parents of 10- 11-year-old children were recruited from 20 schools. The impact of a self-help intervention, comprised of five communication sheets containing information and activities designed to encourage parents to talk with their 10- 11-year-old child about issues related to smoking cigarettes and drinking alcohol, was assessed. RESULTS: Intervention-group parents were more likely to have spoken with their children, to have spoken more recently, to have engaged the child during the discussion and to have addressed the topics identified as being protective of children's involvement in tobacco and alcohol. In addition, the duration of talks about alcohol was longer than for parents in the comparison group. DISCUSSION AND CONCLUSIONS: Parents of 10- 11-year-old children appear to be receptive to participating in a home-based drug-related educational intervention and the parent-directed intervention seems to have enhanced parent-child tobacco- and alcohol-related communication.