Grandmothers' care practices in areas of high deprivation of Scotland: the potential for health promotion.

In many families grandparents play an essential role by providing secondary care for grandchildren. The family is a key setting for promoting children's health; however, studies describing health initiatives with grandparents are rare. Grandparents could play an important role in promoting health for their grandchildren within their families and communities. The aim of this study was to examine the care practices of grandparents in families living in areas of high deprivation, and to consider the extent to which grandparents could be at the centre of health-promoting initiatives for children. A family practices approach was used to examine care practices within the framework of family resource (assets/capitals) use. In-depth interviews were carried out with grandmothers (n = 15) and mothers (n = 15) living in areas of high deprivation in Scotland. The results are presented as three economies of family living-political, moral and emotional. Grandparent care was described as a form of social capital, central to the wellbeing of the families, and enabled parents to access education and employment. Grandparent care was supported through families' ability to access cultural amenities and green space (political). Grandparents' care practices were described as either being responsible or fun (moral). Love appeared to be at the centre of grandparents' care (emotional). The strengths and weaknesses of this framework were examined in relation to developing initiatives with grandparents. With further development work, grandparents could be the focus of health initiatives with their grandchildren with the support of appropriate policies and resources within their communities.

In many families, grandparents help by providing childcare. Children's health is linked to their family's overall wellbeing and there have been programmes to improve children's health within the family. These programmes do not usually include grandparents. In this study, we spoke with 15 grandmothers and 15 mothers living in Scotland about the care that grandparents provide to their grandchildren. They described the different ways in which this care was managed in relation to other aspects of family life, like work. Grandmother care was described in two main ways­as either being responsible or as fun. The main driver of grandparent care was emotional­the love grandmothers held for their grandchildren. We consider the ways in which grandparents, with appropriate support from government at different levels, might help promote health in their grandchildren.

Reducing the volume, exposure and negative impacts of advertising for foods high in fat, sugar and salt to children: A systematic review of the evidence from statutory and self-regulatory actions and educational measures.

PURPOSE: To identify and review evidence on 1) the effectiveness of statutory and self-regulatory actions to reduce the volume, exposure or wider impact of advertising for foods high in fat, sugar and salt (HFSS) to children, and 2) the role of educational measures. DESIGN/METHODOLOGY/APPROACH: A systematic review of three databases (Medline, CINAHL and PsycINFO) and grey literature was carried out. Relevant evidence included studies evaluating advertising bans and restrictions, advertising literacy programmes and parental communication styles. Relevant media included TV, internet, radio, magazines and newspaper advertising. No studies were excluded based on language or publication date. FINDINGS: Forty-seven publications were included: 19 provided evidence for the results of statutory regulation, 25 for self-regulation, and six for educational approaches. Outcome measures varied in approach, quality and results. Findings suggested statutory regulation could reduce the volume of and children's exposure to advertising for foods HFSS, and had potential to impact more widely. Self-regulatory approaches showed varied results in reducing children's exposure. There was some limited support for educational measures. DISCUSSION: Consistency in measures from evaluations over time would assist the development and interpretation of the evidence base on successful actions and measures to reduce the volume, exposure and impact of advertising for foods HFSS to children.

A systematic review of grandparents' influence on grandchildren's cancer risk factors.

Many lifestyle patterns are established when children are young. Research has focused on the potential role of parents as a risk factor for non communicable disease in children, but there is limited investigation of the role of other caregivers, such as grandparents. The aim of this review was to identify and synthesise evidence for any influence grandparents' care practices may have on their grandchildren's long term cancer risk factors. A systematic review was carried out with searches across four databases (MEDLINE, Embase, Web of Science, PsycINFO) as well as searches of reference lists and citing articles, and Google Scholar. Search terms were based on six areas of risk that family care could potentially influence-weight, diet, physical activity, tobacco, alcohol and sun exposure. All study designs were included, as were studies that provided an indication of the interaction of grandparents with their grandchildren. Studies were excluded if grandparents were primary caregivers and if children had serious health conditions. Study quality was assessed using National Institute for Health and Care Excellence checklists. Grandparent impact was categorised as beneficial, adverse, mixed or as having no impact. Due to study heterogeneity a meta-analysis was not possible. Qualitative studies underwent a thematic synthesis of their results. Results from all included studies indicated that there was a sufficient evidence base for weight, diet, physical activity and tobacco studies to draw conclusions about grandparents' influence. One study examined alcohol and no studies examined sun exposure. Evidence indicated that, overall, grandparents had an adverse impact on their grandchildren's cancer risk factors. The theoretical work in the included studies was limited. Theoretically underpinned interventions designed to reduce these risk factors must consider grandparents' role, as well as parents', and be evaluated robustly to inform the evidence base further.

What the UK public believes causes obesity, and what they want to do about it: a cross-sectional study.

Increases in the prevalence of obesity have led to calls for policy interventions in the United Kingdom. Little is known, however, about how the public explains overweight, or their support for interventions. Our research team recruited 500 adults (≥18 years of age) across the United Kingdom to complete a cross-sectional survey asking about beliefs concerning the causes of excess weight, and support for particular policy interventions. Respondents completed questionnaires in their homes with the assistance of an interviewer. Results suggested that support for policy interventions was greatest when responsibility was attributed to factors beyond individual control, with support for child-focused interventions particularly high. The relationship is more complex than previous studies suggest, as believing in the over-availability of unhealthy foods predicted higher support for policy interventions, whereas beliefs in structural explanations, such as cost, had little influence on support. Recognition of this complexity may help to design more effective future policies to tackle obesity.

An RCT study to evaluate a targeted, theory driven healthy eating leaflet.

A theory based healthy eating leaflet was evaluated against an existing publicly available standard leaflet. The intervention leaflet was designed to encourage healthy eating in 18-30 year olds and was developed by modifying an existing British Nutrition Foundation leaflet. The intervention leaflet targeted attitudes and self-efficacy. Participants (n = 104) were randomly assigned either to the intervention, Foundation or a local food leaflet control condition. Cognitions were measured pre-intervention, immediately after reading the corresponding leaflet, and once again at two weeks follow-up. Critically, intentions to eat healthily were significantly greater at follow-up in the Intervention group compared to the other two groups, with the former leaflet also being perceived as more persuasive. The Intervention group also showed evidence of healthier eating at two weeks compared to the other two groups. Collectively the results illustrate the utility of a targeted theory-based approach.