Increasing community capacity to prevent childhood obesity: challenges, lessons learned and results from the Romp & Chomp intervention.

BACKGROUND: Obesity is a major public health issue; however, only limited evidence is available about effective ways to prevent obesity, particularly in early childhood. Romp & Chomp was a community-wide obesity prevention intervention conducted in Geelong Australia with a target group of 12,000 children aged 0-5 years. The intervention had an environmental and capacity building focus and we have recently demonstrated that the prevalence of overweight/obesity was lower in intervention children, post-intervention. Capacity building is defined as the development of knowledge, skills, commitment, structures, systems and leadership to enable effective health promotion and the aim of this study was to determine if the capacity of the Geelong community, represented by key stakeholder organisations, to support healthy eating and physical activity for young children was increased after Romp & Chomp. METHODS: A mixed methods evaluation with three data sources was utilised. 1) Document analysis comprised assessment of the documented formative and intervention activities against a capacity building framework (five domains: Partnerships, Leadership, Resource Allocation, Workforce Development, and Organisational Development); 2) Thematic analysis of key informant interviews (n = 16); and 3) the quantitative Community Capacity Index Survey. RESULTS: Document analysis showed that the majority of the capacity building activities addressed the Partnerships, Resource Allocation and Organisational Development domains of capacity building, with a lack of activity in the Leadership and Workforce Development domains. The thematic analysis revealed the establishment of sustainable partnerships, use of specialist advice, and integration of activities into ongoing formal training for early childhood workers. Complex issues also emerged from the key informant interviews regarding the challenges of limited funding, high staff turnover, changing governance structures, lack of high level leadership and unclear communication strategies. The Community Capacity Index provided further evidence that the project implementation network achieved a moderate level of capacity. CONCLUSIONS: Romp & Chomp increased the capacity of organisations, settings and services in the Geelong community to support healthy eating and physical activity for young children. Despite this success there are important learnings from this mixed methods evaluation that should inform current and future community-based public health and health promotion initiatives. TRIAL REGISTRATION NUMBER: ANZCTRN12607000374460.

Correlates and motives of pre-drinking with intoxication and harm around licensed venues in two cities.

INTRODUCTION AND AIMS: The study investigates the prevalence of pre-drinking culture in the night-time economy (NTE) and its impact upon intoxication and alcohol-related harm and violence experienced by patrons. DESIGN AND METHODS: Cross-sectional surveys were conducted in and around licensed venues in Newcastle (NSW) and Geelong (Victoria) during peak trading hours (typically 9pm-1am). Participants completed a five minute structured interview which targeted: demographics, past and planned movements on the survey night, safety/experience of harm, and patron intoxication. 3949 people agreed to be interviewed, a response rate of 90.7%. Around half (54.9%) of interviewees were male and mean age was 24.4 years (SD = 5.8). RESULTS: 66.8% of participants reported pre-drinking prior to attending licensed venues. On a 1-10 scale measuring self-rated intoxication, pre-drinkers scored significantly higher compared to non pre-drinkers (P < 0.001). Compared to non-pre-drinkers, patrons who had consumed 6-10 standard pre-drinks were 1.5 times more likely to be involved in a violent incident in the past 12 months (OR = 1.50, 95%CI 1.03-2.19, P = 0.037) increasing to 1.8 times more likely for patrons who had 11-15 drinks (OR = 1.80, 95%CI 1.04-3.11 P = .036). Pre-drinking was also associated with both self-rated and observer-rated intoxication, as well as increased probability of illicit drug use. Amongst pre-drinkers, price was the most commonly reported motive for pre-drinking (51.8%). DISCUSSION AND CONCLUSIONS: 'Pre-drinking' was normal behaviour in the current sample and contributes significantly to the burden of harm and intoxication in the NTE. Price disparity between packaged vs. venue liquor is a key motivator for pre-drinking.

The association between sports participation, alcohol use and aggression and violence: a systematic review.

OBJECTIVES: To review the current research on alcohol-related violence and sports participation. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to identify relevant studies for inclusion. A search of six databases (EBSCOhost) was conducted. RESULTS: A total of 6890 studies was were identified in the initial search. Of these, 11 studies met the inclusion criteria. The majority of the studies were from the US (n=10) and focused on collegiate athletes (n=7), adolescents (n=3), professional/former professional athletes (n=1). CONCLUSION: The reviewed research indicates higher rates of alcohol use and violence in athlete populations when compared against non-athlete populations. Masculinity, violent social identity and antisocial norms connected to certain sports stand out as potential factors that may impact the association between sport and violence in athlete populations.

Vested interests in addiction research and policy. Alcohol industry use of social aspect public relations organizations against preventative health measures.

AIM: It has been proposed that alcohol industry 'social aspects/public relations' organizations (SAPROs) serve the agenda of lending credibility to industry claims of corporate responsibility while promoting ineffective industry-friendly interventions (such as school-based education or TV advertising campaigns) and creating doubt about interventions which have a strong evidence base (such as higher taxes on alcoholic beverages). This paper investigated whether submissions to Australia's National Preventative Health Taskforce (NPHT) from alcohol industry bodies regarding the Australian SAPRO, Drinkwise, have used this organization to demonstrate corporate responsibility while promoting industry-friendly interventions. METHOD: Submissions to the Australian National Preventative Health Taskforce (NPHT) discussion paper Australia, the healthiest country by 2020 (n = 375) were examined to identify those with primary alcohol content. A thematic analysis of the resulting 33 submissions was conducted to determine which organization, institution or individual discussed Drinkwise. SETTING: Australia. FINDINGS: Nine of the 33 submissions discussed Drinkwise; all were submitted by the alcohol industry or its affiliates. Every industry submission referred to Drinkwise either as providing evidence of social responsibility or by suggesting the industry-friendly actions of Drinkwise as alternatives to those recommended by the NPHT report. CONCLUSIONS: Drinkwise has been used by the alcohol industry to create an impression of social responsibility while promoting interventions that maintain profits and campaigning against effective interventions such as higher taxes on alcohol.

Dealing with Alcohol-related problems in the Night-Time Economy: A Study Protocol for Mapping trends in harm and stakeholder views surrounding local community level interventions.

BACKGROUND: This project will provide a comprehensive investigation into the prevalence of alcohol-related harms and community attitudes in the context of community-based interventions being implemented to reduce harm in two regional centres of Australia. While considerable experimentation and innovation to address these harms has occurred in both Geelong and Newcastle, only limited ad-hoc documentation and analysis has been conducted on changes in the prevalence of harm as a consequence, leaving a considerable gap in terms of a systematic, evidence-based analysis of changes in harm over time and the need for further intervention. Similarly, little evidence has been reported regarding the views of key stakeholder groups, industry, government agencies, patrons or community regarding the need for, and the acceptability of, interventions to reduce harms. This project will aim to provide evidence regarding the impact and acceptability of local initiatives aimed at reducing alcohol-related harms. METHODS/DESIGN: This study will gather existing police data (assault, property damage and drink driving offences), Emergency Department presentations and Ambulance attendance data. Further, the research team will conduct interviews with licensed venue patrons and collect observational data of licensed venues. Key informant interviews will assess expert knowledge from key industry and government stakeholders, and a community survey will assess community experiences and attitudes towards alcohol-related harm and harm-reduction strategies. Overall, the project will assess: the extent of alcohol-related harm in the context of harm-reduction interventions, and the need for and acceptability of further intervention. DISCUSSION: These findings will be used to improve evidence-based practice both nationally and internationally. ETHICAL APPROVAL: This project has been approved by Deakin University HREC.

Reducing obesity in early childhood: results from Romp & Chomp, an Australian community-wide intervention program.

BACKGROUND: There is growing evidence that community-based interventions can reduce childhood obesity in older children. OBJECTIVE: We aimed to determine the effectiveness of the Romp & Chomp intervention in reducing obesity and promoting healthy eating and active play in children aged 0-5 y. DESIGN: Romp & Chomp was a community-wide, multisetting, multistrategy intervention conducted in Australia from 2004 to 2008. The intervention occurred in a large regional city (Geelong) with a target group of 12,000 children and focused on community capacity building and environmental (political, sociocultural, and physical) changes to increase healthy eating and active play in early-childhood care and educational settings. The evaluation was repeat cross-sectional with a quasiexperimental design and comparison sample. Main outcome measures were body mass index (BMI), standardized BMI (zBMI; according to the Centers for Disease Control and Prevention 2000 reference charts), and prevalence of overweight/obesity and obesity-related behaviors in children aged 2 and 3.5 y. RESULTS: After the intervention there was a significantly lower mean weight, BMI, and zBMI in the 3.5-y-old subsample and a significantly lower prevalence of overweight/obesity in both the 2- and 3.5-y-old subsamples (by 2.5 and 3.4 percentage points, respectively) than in the comparison sample (a difference of 0.7 percentage points; P < 0.05) compared with baseline values. Intervention child-behavioral data showed a significantly lower intake of packaged snacks (by 0.23 serving), fruit juice (0.52 serving), and cordial (0.43 serving) than that in the comparison sample (all P < 0.05). CONCLUSION: A community-wide multisetting, multistrategy intervention in early-childhood settings can reduce childhood obesity and improve young children's diets. This trial was registered with the Australian Clinical Trials Registry at anzctr.org.au as ACTRN12607000374460.