A Food Relief Charter for South Australia-Towards a Shared Vision for Pathways Out of Food Insecurity.

Chronic food insecurity persists in high-income countries, leading to an entrenched need for food relief. In Australia, food relief services primarily focus on providing food to meet immediate need. To date, there has been few examples of a vision in the sector towards client outcomes and pathways out of food insecurity. In 2016, the South Australian Government commissioned research and community sector engagement to identify potential policy actions to address food insecurity. This article describes the process of developing a co-designed South Australian Food Relief Charter, through policy-research-practice collaboration, and reflects on the role of the Charter as both a policy tool and a declaration of a shared vision. Methods used to develop the Charter, and resulting guiding principles, are discussed. This article reflects on the intentions of the Charter and suggests how its guiding principles may be used to guide collective actions for system improvement. Whilst a Charter alone may be insufficient to create an integrated food relief system that goes beyond the provision of food, it is a useful first step in enabling a culture where the sector can have a unified voice to advocate for the prevention of food insecurity.

Voluntary food fortification policy in Australia: did 'formal' stakeholder consultation influence the outcome?

This research aimed to understand how the policy was represented as a 'problem' in food regulatory decision-making in Australia, and the implications for public health nutrition engagement with policy development processes. Bacchi's 'what's the problem represented to be?' discourse analysis method was applied to a case study of voluntary food fortification policy (VFP) developed by the then Australia and New Zealand Food Regulation Ministerial Council (ANZFRMC) between 2002 and 2012. As a consultative process is a legislated aspect of food regulatory policy development in Australia, written stakeholder submissions contributed most of the key documents ascertained as relevant to the case. Four major categories of stakeholder were identified in the data; citizen, public health, government and industry. Predictably, citizen, government and public health stakeholders primarily represented voluntary food fortification (VF) as a problem of public health, while industry stakeholders represented it as a problem of commercial benefit. This reflected expected differences regarding decision-making control and power over regulatory activity. However, at both the outset and conclusion of the policy process, the ANZFRMC represented the problem of VF as commercial benefit, suggesting that in this case, a period of 'formal' stakeholder consultation did not alter the outcome. This research indicates that in VFP, the policy debate was fought and won at the initial framing of the problem in the earliest stages of the policy process. Consequently, if public health nutritionists leave their participation in the process until formal consultation stages, the opportunity to influence policy may already be lost.

A critical food system program in South Australia and the effects on consumer knowledge and attitudes.

ISSUE ADDRESSED: This study investigated the effects of food system literacy on knowledge and attitudes of food consumers. METHODS: A 2-week online course critically discussed the food system through three lenses of environmental sustainability, equity and health. Participants were randomly allocated into one Control and two Intervention groups (A & B). Data collection was by online questionnaire pre- and postintervention, addressing self-perceived food system knowledge, attitudes towards food purchasing behaviours, demographic characteristics and course evaluation. Differences in knowledge and attitude scores between Control and Intervention groups were assessed. Subjects were staff and students of Flinders University in South Australia. RESULTS: Forty-seven participants completed the course. The completion rate was 71.2%. Knowledge about the food system improved significantly for both Intervention groups when compared to the Control group (P ≤ 0.001). Although attitudes towards food purchasing behaviours also improved significantly for both Intervention groups (P < 0.001 and P = 0.005 for Interventions A and B respectively), the improvements were not significant when compared to the Control group (P = 0.065 and P = 0.43 for Interventions A and B respectively). The online methodology received positive feedback from participants. CONCLUSION: This 2-week online food system course showed that the pedagogy was appropriate and successful in improving self-perceived knowledge and attitudes towards food consumption. SO WHAT?: It provides encouraging indications of the potential of food system literacy to empower citizens to make healthier as well as, more environmentally and socially sustainable food choices.

Factors influencing food service provision decisions in centre-based early childhood education and care services: Cooks' perspective.

ISSUE ADDRESSED: Considerable public effort has been directed at centre-based childcare as an early childhood education and care (ECEC) setting to promote healthy food-related behaviours in young children. However, in the real-world setting, best practice, evidence-based guidelines are not always well-translated into usual, day-to-day routines. This study aims to understand what factors influence the centre-based childcare cooks' food and nutrition decisions for children aged 2-5 years. METHODS: Semi-structured qualitative interviews were conducted with cooks in centre-based childcare using purposeful maximum variation sampling and data analysed thematically. RESULTS: Fourteen cooks were interviewed from 14 services across South Australia. Central to providing a healthy food environment was expert-led knowledge and training gained through the workplace over several years and the embodiment of the service's healthy food and nutrition policy, evidenced through menu planning to maintain a focus on healthy eating. Threatening these positive, routine practices and decisions were pressures to modify menus in response to increasing food allergies and changing cultural and family preferences, in the absence of ongoing relevant training and expertise at the system-level. CONCLUSIONS: Children in ECEC benefit from cooks' commitment to providing nutritious foods; however, the requirements to extend their role to respond to increasing demands without relevant system-level support and training puts the children at risk of not being exposed to health-promoting menus and possible errors in providing dietary modifications. ECEC cooks urgently need access to system-level support and training. SO WHAT?: Understanding and addressing the barriers experienced by cooks and the complexity of factors that inform their food-related decision-making will sustain the implementation of effective, healthy eating guidelines and nutrition practices in ECEC.

Nothing beats taste or convenience: a national survey of where and why people buy sugary drinks in Australia.

OBJECTIVE: There is limited knowledge of what influences sugary drink purchasing decisions in the Australian population. This study aimed to identify the most common locations and reasons across different demographic groups for purchasing sugary drinks in Australia. METHODS: A total of 891 respondents (who purchased sugary drinks for personal consumption at least occasionally) from a broader national population telephone survey of Australian adults conducted in 2017 (n=3,430) were included in the analysis. RESULTS: 'Taste' was a ubiquitous reason for purchase (94%) and the majority also agreed with 'easily available' (76%). Males, younger people and people of lower socioeconomic status (SES) were significantly more likely to agree that sugary drinks were 'cheap' and 'better value than water'. Furthermore, males and younger people were more likely to report buying sugary drinks because they were 'part of a meal deal'. The most common purchase locations were supermarkets (56%), followed by convenience stores (19%) and food or entertainment venues (17%). CONCLUSION: Taste is paramount in decisions to purchase sugary drinks, and widespread availability and value for money support consumption. Implications for public health: Policies and interventions targeting point-of-sale sugary drink purchasing decisions among the most 'at risk' consumers are warranted.

Resetting the Narrative in Australian Aboriginal and Torres Strait Islander Nutrition Research.

As the oldest continuous living civilizations in the world, Aboriginal and Torres Strait Islander peoples have strength, tenacity, and resilience. Initial colonization of the landscape included violent dispossession and removal of people from Country to expand European land tenure and production systems, loss of knowledge holders through frontier violence, and formal government policies of segregation and assimilation designed to destroy ontological relationships with Country and kin. The ongoing manifestations of colonialism continue to affect food systems and food knowledges of Aboriginal peoples, and have led to severe health inequities and disproportionate rates of nutrition-related health conditions. There is an urgent need to collaborate with Aboriginal and Torres Strait Islander peoples to address nutrition and its underlying determinants in a way that integrates Aboriginal and Torres Strait Islander peoples' understandings of food and food systems, health, healing, and well-being. We use the existing literature to discuss current ways that Australian Aboriginal and Torres Strait Islander peoples are portrayed in the literature in relation to nutrition, identify knowledge gaps that require further research, and propose a new way forward.

Feeding the Australian family: challenges for mothers, nutrition and equity.

Australian women shoulder the bulk of household duties including family food provisioning, despite increasing participation in the workforce. This research aimed to understand employed mothers' daily-lived experience of family food provisioning, in particular, the intersection between family food provisioning, gender inequality and nutritional guidelines as they impact women's time and health. Semi-structured interviews were conducted with 22 employed mothers in South Australia. Participants had at least one child aged less than 13 years. Qualitative data was analysed using a thematic content approach. Time-scarcity was common and associated with stress in relation to family food provisioning; this relationship was particularly apparent among employed mothers who were also studying. Most mothers valued nutrition and strove to provide nutritious meals, although they tended to work from their own nutritional understandings, not the national nutrition guidelines; they saw the nutrition guidelines as unhelpful because of the time demands that were implied. The study invites policy makers, practitioners and researchers to consider time for family food provisioning as a social determinant of family as well as women's health, and structural strategies to address this health inequity for women.

Are Australians ready for warning labels, marketing bans and sugary drink taxes? Two cross-sectional surveys measuring support for policy responses to sugar-sweetened beverages.

OBJECTIVE: To assess public support for 10 potential policy initiatives to reduce sugar-sweetened beverage (SSB) consumption. DESIGN: A 2014 historical data set, which employed a face-to-face survey in one Australian state (study 1), provided the basis for comparison with our 2017 nationally representative, cross-sectional, computer-assisted telephone interviewing population survey (study 2). PARTICIPANTS: Study 1: South Australians, 15+ years (n=2732); study 2: Australians, 18+ years (n=3430). PRIMARY OUTCOME MEASURES: levels of support for SSB-specific policy initiatives. For the 2017 national study (study 2), demographic characteristics, body mass index, knowledge of potential harms caused by consuming SSBs and SSB consumption were included in multivariable regression analyses. RESULTS: In 2017, all 10 potential policy initiatives received majority support (60%-88% either 'somewhat' or 'strongly' in favour). Initiatives with educative elements or focused on children received high support (>70%), with highest support observed for text warning labels on drink containers (88%) and government campaigns warning of adverse health effects (87%). Higher support was observed for SSB tax paired with using funds for obesity prevention (77%) than a stand-alone tax (60%). Support for policy initiatives was generally greater among those who believed SSB daily consumption could cause health problems in adults (4%-18% absolute difference) and/or in children (8%-26% absolute difference) and lower among SSB high consumers (7+ drinks per week; 9%-29% absolute difference). State-specific data comparison indicated increased support from 2014 to 2017 for taxation (42%vs55%; χ2=15.7, p<0.001) and graphic health warnings (52%vs68%; χ2=23.4. p<0.001). CONCLUSIONS: There is strong public support for government action, particularly regulatory and educational interventions, to reduce SSB consumption, which appears to have increased since 2014. The findings suggest that framing policies as protecting children, presenting taxation of SSBs in conjunction with other obesity prevention initiatives and education focused on the harms associated with SSB consumption will increase support.

'Sustainable' Rather Than 'Subsistence' Food Assistance Solutions to Food Insecurity: South Australian Recipients' Perspectives on Traditional and Social Enterprise Models.

South Australian (SA) food charity recipients' perspectives were sought on existing services and ideas for improvement of food assistance models to address food insecurity. Seven focus groups were conducted between October and November 2017 with 54 adults. Thematically analysed data revealed five themes: (1) Emotional cost and consequences of seeking food relief; (2) Dissatisfaction with inaccessible services and inappropriate food; (3) Returning the favour-a desire for reciprocity; (4) Desiring help beyond food; and, (5) "It's a social thing", the desire for social interaction and connection. Findings revealed that some aspects of the SA food assistance services were disempowering for recipients. Recipients desired more empowering forms of food assistance that humanise their experience and shift the locus of control and place power back into their hands. Some traditional models, such as provision of supermarket vouchers, empower individuals by fostering autonomy and enabling food choice in socially acceptable ways. Improvement in the quality of existing food assistance models, should focus on recipient informed models which re-dress existing power relations. Services which are more strongly aligned with typical features of social enterprise models were generally favoured over traditional models. Services which are recipient-centred, strive to empower recipients and provide opportunities for active involvement, social connection and broader support were preferred.

Exploring family home food environments: Household resources needed to utilise weekly deliveries of free fruits and vegetables.

AIM: An adapted ethnographic approach was used to explore household factors that influence family fruit and vegetable consumption when access and cost barriers are removed. 'Structural' barriers, such as food affordability and accessibility, are likely to influence fruit and vegetable consumption in disadvantaged households, but households may require additional resources (human and social) to increase consumption. METHODS: Five low-income and five high-income households with children (N = 39 individuals) were observed in their home environment for three months. Including both advantaged and disadvantaged families allowed exploration of socioeconomic factors influencing these households. Each household received a free box of fresh fruit and vegetables each week for 10-12 weeks, delivered to their home, and were home-visited twice a week by a researcher (40+ hours per household). An inductive analysis of rich observational and discussion data revealed themes describing factors influencing household fruit and vegetable consumption. RESULTS: Household food cultures were dynamic and influenced by available resources. Even when free produce was delivered to homes, these households required human resource (personal drivers influenced by early life exposure and household dynamics) and external social networks to make use of them. When household finances and/or labour were limited, there was greater dependence on external organisations for tangible support. CONCLUSIONS: Even when structural barriers were removed, disadvantaged families needed a range of resources across the life course to improve eating behaviours, including sufficient, motivated and skilled labour and harmonious family relationships. Strategies targeting these households must consider structural, social, cultural and intra-familial influences on food choice.

Protocol for a randomized controlled trial testing the impact of feedback on familial risk of chronic diseases on family-level intentions to participate in preventive lifestyle behaviors.

BACKGROUND: Common disease risk clusters in families due to shared genetics, exposure to environmental risk factors, and because many health behaviours are established and maintained in family environments. This randomised controlled trial will test whether the provision of a family health history (FHH) risk assessment tool increases intentions and engagement in health behaviors. Message distribution and collective behavior change within family networks will be mapped using social network analysis. The relative intervention impact will be compared between families from different ethnic backgrounds. METHODS: One hundred and fifty mothers (50 Anglo-Australian, 50 Italian-Australian, 50 Vietnamese-Australian) will be recruited, with four or more other family members across three generations, including a child (aged 10-18 years). Each family is randomly assigned to intervention or control. At baseline and 6-month follow-up, all participants complete surveys to assess dietary and physical activity intentions and behaviors, attitudes towards food, and perceived disease risk. Intervention families receive a visual pedigree detailing their FHH of diabetes, heart disease, breast and bowel cancer, a health education workbook to ascertain members' disease risk (i.e. average or above average risk), and screening and primary prevention recommendations. After completion of follow-up assessments, controls will receive their pedigree and workbook. The primary hypothesis is that attitudes and lifestyle behaviors will improve more within families exposed to FHH feedback, although the extent of this improvement may vary between families from different ethnic backgrounds. Additionally, the extent of improvement in the treatment group will be moderated by the level of family disease risk, with above-average risk leading to greater improvement. A secondary aim will explore different family members' roles in message distribution and collective responses to risk using social network approaches and to compare network functioning between families with different ethnic backgrounds. DISCUSSION: Results will guide future health promotion programs aimed at improving lifestyle factors. This research will assess whether FHH can motivate families to adopt family-level strategies to support health promoting behaviors. Secondary analyses aim to identify change agents within the family who are particularly effective in shifting normative behaviors. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12613001033730 . Retrospectively registered: 17 September, 2013.

Consumer trust in the Australian food system - The everyday erosive impact of food labelling.

Consumer trust in food system actors is foundational for ensuring consumer confidence in food safety. As food labelling is a direct communication between consumers and food system actors, it may influence consumer perceptions of actor trustworthiness. This study explores the judgements formed about the trustworthiness of the food system and its actors through labelling, and the expectations these judgements are based on. In-depth, semi-structured interviews with 24 Australian consumers were conducted. Theoretical sampling focussed on shopping location, dietary requirements, rurality, gender, age and educational background. The methodological approach used (adaptive theory) enabled emerging data to be examined through the lens of a set of guiding theoretical concepts, and theory reconsidered in light of emerging data. Food labelling acted as a surrogate for personal interaction with industry and government for participants. Judgements about the trustworthiness of these actors and the broader food system were formed through interaction with food labelling and were based on expectations of both competence and goodwill. Interaction with labelling primarily reduced trust in actors within the food system, undermining trust in the system as a whole. Labelling has a role as an access point to the food system. Access points are points of vulnerability for systems, where trust can be developed, reinforced or broken down. For the participants in this study, in general labelling demonstrates food system actors lack goodwill and violate their fiduciary responsibility. This paper provides crucial insights for industry and policy actors to use this access point to build, rather than undermine, trust in food systems.

Six-months follow-up of a cluster randomized trial of school-based smoking prevention education programs in Aceh, Indonesia.

BACKGROUND: Smoking prevention programs have been taught in schools to reduce the high smoking prevalence and its related problems among adolescent populations. Although short-term benefits have been observed, the long-term effectiveness of such programs appear to be inconsistent. This study aims at investigating the long-term impact of both health and Islamic focused interventions amongst students in Indonesia. METHODS: At 6 months after completion of the interventions, 427 of the original 447 participants (control group = 128, intervention groups = 299) from a school-based cluster randomized control trial were re-assessed for their smoking knowledge, attitudes, intentions and behaviours using a self-report questionnaire. Data was analyzed according to the study's 2 × 2 factorial design with adjustment for baseline scores, school and classroom clustering effects and multiple comparisons. RESULTS: Compared to the control group, significant long term effects were found for the health-based intervention program in improved health (ß = 4.3 ± 0.4, p < 0.001), Islamic (ß = 1.1 ± 0.4, p = 0.01) knowledge and a reduction of smoking attitudes (ß = -11.5 ± 1.8, p < 0.001). For the Islamic-based intervention programs there was an improvement of health (ß = 3.7 ± 0.4, p < 0.001) and Islamic (ß = 2.2 ± 0.5, p < 0.001) knowledge and a reduction towards smoking attitude (ß = -6.0 ± 1.9, p < 0.01) and smoking behaviors in the past month (OR = 0.1, 95 % CI = 0.0-0.8, p = 0.03). The effects were greater but less than additive in the combined group for health (ß = -3.2 ± 0.9, p < 0.001 for interaction) and Islamic knowledge (ß = -2.3 ± 0.9, p = 0.01 for interaction) but were additive for smoking attitudes (ß = 6.1 ± 3.2, p = 0.07 for interaction). No significant effects on smoking intentions were observed at 6 months follow-up in the health or Islamic-based intervention programs. CONCLUSION: School-based programs can provide long term benefits on Indonesian adolescents' smoking knowledge and attitudes. Tailoring program intervention components with participants' religious background might maximise program effectiveness. A larger and more encompassing study is now required to confirm the effectiveness of this new Indonesia culturally-based program. Adolescents in similar areas might also benefit from this type of school-based smoking cessation program. TRIAL REGISTRATION: Australian New Zealand Clinical Trial Registry, ACTRN12612001070820.

A map of community-based obesity prevention initiatives in Australia following obesity funding 2009-2013.

OBJECTIVE: Obesity is the single biggest public health threat to developed and developing economies. In concert with healthy public policy, multi-strategy, multi-level community-based initiatives appear promising in preventing obesity, with several countries trialling this approach. In Australia, multiple levels of government have funded and facilitated a range of community-based obesity prevention initiatives (CBI), heterogeneous in their funding, timing, target audience and structure. This paper aims to present a central repository of CBI operating in Australia during 2013, to facilitate knowledge exchange and shared opportunities for learning, and to guide professional development towards best practice for CBI practitioners. METHODS: A comprehensive search of government, non-government and community websites was undertaken to identify CBI in Australia in 2013. This was supplemented with data drawn from available reports, personal communication and key informant interviews. The data was translated into an interactive map for use by preventive health practitioners and other parties. RESULTS: We identified 259 CBI; with the majority (84%) having a dual focus on physical activity and healthy eating. Few initiatives, (n=37) adopted a four-pronged multi-strategy approach implementing policy, built environment, social marketing and/or partnership building. CONCLUSION: This comprehensive overview of Australian CBI has the potential to facilitate engagement and collaboration through knowledge exchange and information sharing amongst CBI practitioners, funders, communities and researchers. IMPLICATIONS: An enhanced understanding of current practice highlights areas of strengths and opportunities for improvement to maximise the impact of obesity prevention initiatives.

Estimating informal household food waste in developed countries: the case of Australia.

Food waste is a global problem. In Australia alone, it is estimated that households throw away AU$5.2 billion worth of food (AU$616 per household) each year. Developed countries have formal waste management systems that provide measures of food waste. However, much remains unknown about informal food waste disposal routes and volumes outside of the formal system. This article provides indicative metrics of informal food waste by identifying, in detail, five of the dominant informal food waste disposal routes used by Australian households: home composting, feeding scraps to pets, sewer disposal, giving to charity, and dumping or incineration. Informal waste generation rates are then calculated from three primary data sources, in addition to data from previous Australian and UK surveys, using a weighted average method in conjunction with a Monte-Carlo simulation. We find that the average Australian household disposes of 2.6 kgs of food waste per week through informal routes (1.7 kgs via household composting, 0.2 kgs via animals, and 0.6 kgs via sewage). This represents 20% of Australian household food waste flows. Our results highlight that informal food waste is a sizable food waste flow from Australian homes, deserving of greater research and government attention. Our examination of the full extent of food waste by disposal mode provides waste managers and policy makers with clear disposal routes to target for behaviour change and positive environmental outcomes.

From targets to ripples: tracing the process of developing a community capacity building appraisal tool with remote Australian Indigenous communities to tackle food security.

BACKGROUND: The issue of food security is complex and requires capacity for often-unrelated groups to work together. We sought to assess the relevance and meaning of a commonly used set of community capacity development constructs in the context of remote Indigenous Australia and through this propose a model to support capacity. METHODS: The assessment was conducted with four communities and took place over five steps that involved: (i) test of clarity of construct meaning; (ii) inductive derivation of community capacity constructs; (iii) application of these constructs to the capacity of community multi-sector food-interest groups; (iv) a cross-check of these constructs and their meanings to literature-derived constructs, and; (v) achieving consensus on tool constructs. Data were collected over a three-year period (2010-2012) that involved two on-site visits to one community, and two urban-based workshops. These data were augmented by food-interest group meeting minutes and reports. RESULTS: Eleven community capacity development constructs were included in the proposed model: community ownership, building on strengths, strong leadership and voice, making decisions together, strong partnerships, opportunities for learning and skill development, way of working, getting together the things you need, good strong communication, sharing the true story, and continuing the process and passing on to the next generation. The constructs derived from the literature and commonly used to appraise community capacity development were well accepted and could be used to identify areas needing strengthening. The specifics of each construct however differed from those derived from the literature yet were similar across the four communities and had particular meaning for those involved. The involvement of elders and communication with the wider community seemed paramount to forming a solid foundation on which capacity could be further developed. CONCLUSION: This study explored an approach for ascribing context specific meanings to a set of capacity development constructs and an effective visual appraisal tool. An approach to tackling food security in the remote Indigenous context where community capacity goals are considered in parallel with outcome goals, or at least as incremental goals along the way, may well help to lay a more solid foundation for improved service practice and program sustainability.

The impact of funding deadlines on personal workloads, stress and family relationships: a qualitative study of Australian researchers.

OBJECTIVE: To examine the impact of applying for funding on personal workloads, stress and family relationships. DESIGN: Qualitative study of researchers preparing grant proposals. SETTING: Web-based survey on applying for the annual National Health and Medical Research Council (NHMRC) Project Grant scheme. PARTICIPANTS: Australian researchers (n=215). RESULTS: Almost all agreed that preparing their proposals always took top priority over other work (97%) and personal (87%) commitments. Almost all researchers agreed that they became stressed by the workload (93%) and restricted their holidays during the grant writing season (88%). Most researchers agreed that they submitted proposals because chance is involved in being successful (75%), due to performance requirements at their institution (60%) and pressure from their colleagues to submit proposals (53%). Almost all researchers supported changes to the current processes to submit proposals (95%) and peer review (90%). Most researchers (59%) provided extensive comments on the impact of writing proposals on their work life and home life. Six major work life themes were: (1) top priority; (2) career development; (3) stress at work; (4) benefits at work; (5) time spent at work and (6) pressure from colleagues. Six major home life themes were: (1) restricting family holidays; (2) time spent on work at home; (3) impact on children; (4) stress at home; (5) impact on family and friends and (6) impact on partner. Additional impacts on the mental health and well-being of researchers were identified. CONCLUSIONS: The process of preparing grant proposals for a single annual deadline is stressful, time consuming and conflicts with family responsibilities. The timing of the funding cycle could be shifted to minimise applicant burden, give Australian researchers more time to work on actual research and to be with their families.

Evaluating the use of citizens' juries in food policy: a case study of food regulation.

BACKGROUND: Deliberative engagement techniques and citizens' juries are touted as means of incorporating the public into policy decision-making, managing community expectations and increasing commitment to public health policy. This paper reports a study to examine the feasibility of citizens' juries as a means of collecting data to inform public health policy related to food regulation through evaluation of the conduct of a citizens' jury. METHODS: A citizens' jury was conducted with a representative sample of 17 South Australians to explore their willingness to consider the proposition that food and drink advertising and/or sponsorship should be banned at children's sporting events. RESULTS: The results showed that, in relation to the central proposition and evaluation data from the jury, opinion on the proposition remained comparatively stable. Most jurors indicated that they thought that food and drink sponsorship and/or advertising at children's sporting events would have little or no effect on altering children's diet and eating habits, with the proportion increasing during the jury process. Jurors were given evaluation sheets about the content of the jury and the process of the citizens' jury to complete at the end of the session. The evaluation of the citizens' jury process revealed positive perceptions. The majority of jurors agreed that their knowledge of the issues of food and drink sponsorship in children's sport had increased as a result of participation in the citizens' jury. The majority also viewed the decision-making process as fair and felt that their views were listened to. One important response in the evaluation was that all jurors indicated that, if given the opportunity, they would participate in another citizens' jury. CONCLUSIONS: The findings suggest that the citizens' jury increased participant knowledge of the issue and facilitated reflective discussion of the proposition. Citizens' juries are an effective means of gaining insight into public views of policy and the circumstances under which the public will consider food regulation; however a number of issues need to be considered to ensure the successful conduct of a citizens' jury.

Demographic indicators of trust in federal, state and local government: implications for Australian health policy makers.

OBJECTIVE: To provide baseline findings regarding Australians' trust in federal, state and local government. METHODS: A computer-assisted telephone interviewing (CATI) survey was administrated during October to December 2009 to a random sample (n=1109) across Australia (response rate 41.2%). Binary logistic regression analyses were carried out by means of SPSS. RESULTS: Age, household size, household income, IRSD and ARIA were found to be significant indicators for trust in federal, state and local government. Trust in state government is lower for older respondents and respondents living in inner and outer regional areas. Trust in local council is lower in respondents living in inner regional areas, respondents living in disadvantaged areas, and respondents in the income bracket of $60001 to $100000. Trust in federal government is lower for older respondents and respondents living in disadvantaged areas. Of note is diminished trust in government among older, regional and lower income ($30001-$60000) respondents. CONCLUSIONS: Trust in all levels of government was found to be the lowest in population groups that are identified by empirical research and media to have the poorest access to government services. As a consequence, improved access to services for these populations may increase trust in health policy. Increased trust in health governance may in turn, ensure effective dissemination and implementation of health policies and that existing inequities are not perpetuated through distrust of health information and policy initiatives.

Fruit and vegetable consumption - the influence of aspects associated with trust in food and safety and quality of food.

OBJECTIVE: To profile adults who eat less than the recommended servings of fruit and vegetables per day. DESIGN: Australia-wide population telephone survey on a random sample of the Australian population, with results analysed by univariate and multivariate models. SETTING: Australia. SUBJECTS: One thousand one hundred and eight interviews, respondents' (49·3 % males) mean age was 45·12 (sd 17·63) years. RESULTS: Overall 54·8 % and 10·7 % were eating the recommended number of servings of fruit and vegetables. Variables included in the multivariate model indicating low fruit consumption included gender, age, employment, education and those who were less likely to consider the safety and quality of food as important. In regard to low vegetable consumption, people who were more likely to do the food shopping only 'some of the time' and have a high level of trust in groups of people such as immediate family, neighbours, doctors and different levels of government were included in the final model. They were also less likely to neither consider the safety and quality of food as important nor trust organisations/institutions such as the press, television and politicians. In the final model depicting both low fruit and low vegetable servings, sex, age and a low level of importance with regard to safety and quality of food were included. CONCLUSION: To increase fruit and vegetable consumption, research into a broad range of determinants associated with behaviours should be coupled with a deeper understanding of the process associated with changing behaviours. While levels of trust are related to behaviour change, knowledge and attitudes about aspects associated with safety and quality of food are also of importance.