Combining Outreach and Cross-sectional Research to Gather Children's Soil Values in Aotearoa New Zealand: Protocol for the Mixed Methods Soilsafe Kids Program.

BACKGROUND: Soil underpins most terrestrial systems; hence, its degradation should concern everyone. In 2021, Soilsafe Aotearoa surveyed the adult population of New Zealand about how they value soil, particularly values related to how they care about and are concerned about soil. Pursuant to this study, Soilsafe Kids (the outreach branch of Soilsafe Aotearoa) developed a combined research and outreach program to collect a supplemental data set of children's soil values, so both adults' and children's voices can be considered when understanding the implications of different practices and how to care for presently "uncared for" or neglected soils in the future. OBJECTIVE: The program not only asks primary school students about their soil values but also aims to teach them about soil from many disciplinary perspectives to enhance their understanding and awareness of soil, and, more broadly, for knowledge production. METHODS: Here we describe the research protocol used in this Soilsafe Kids program. This program uses surveys (in the form of worksheets), focus groups (introduced as group discussions), and art projects to learn what children think about soil in Tamaki Makaurau Auckland. We have received ethics approval from the University of Auckland's Human Participants Ethics Committee (reference number 23556) on March 25, 2022, for 3 years. RESULTS: We have begun recruiting participants and delivering the Soilsafe Kids program in schools across Tamaki Makaurau Auckland. Our data collection is ongoing with final student engagement in the first quarter of 2023. We expect to analyze data at the start of 2023 and to disseminate results later this year. CONCLUSIONS: Once this study is complete, we will disseminate the final results to the research community, stakeholders, and the local community through conference presentations, journal articles, hui (meetings), on our website, and in art exhibits. We note that although Tamaki Makaurau Auckland is home to the majority of people living in Aotearoa New Zealand, the Auckland region only represents a small portion of Aotearoa New Zealand's land, and findings are not generalizable to Aotearoa New Zealand as a whole. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/43390.

More-Than-Human: A Cross-Sectional Study Exploring Children's Perceptions of Health and Health-Promoting Neighbourhoods in Aotearoa New Zealand.

A disconnect between children's ideas and their incorporation into environmental design, in the context of rapid urbanisation and climate crises, compelled us to reflect on children's meaningful participation in positive environmental change. Our research aimed to bring new knowledge to the fore using a participatory, child-centred approach to understanding children's perceptions of health and health-promoting neighbourhoods in Aotearoa New Zealand. The cross-sectional Neighbourhoods and Health study was conducted with 93 primary school-aged children (approximate ages 8 to 10 years) from two schools in Otepoti Dunedin and two schools in Tamaki Makaurau Auckland from June 2020 to August 2021. We present a framework of twelve child-centred topics of importance for health (Healthcare and 'not getting sick', 'How you feel', and Taking care of yourself), health-promoting neighbourhoods (Proximity, safety and feel, Range of 'places to go', 'Friendly streets', and 'No smoking'), and those common to both (Connections with other humans, Healthy food and drink, Exercising and playing sport 'to keep fit', 'Nature' and 'helping the environment', and Recreational activities). The more-than-human theory was used to situate our study findings, and we explored three threads evident in children's thinking: (1) care for humans and non-humans, (2) vital interdependence of human-non-human relations, and (3) understanding complex urban environments through everyday activities. We conclude that the thriving of humans and non-humans in urban environments is important to children in Aotearoa New Zealand. We affirm that children have clear and salient ideas about health and health-promoting neighbourhoods.

Household Mealtimes During the 2020 COVID-19 Lockdown in Aotearoa New Zealand: The Influence of Household Type and Psychological Distress.

COVID-19 lockdown meant disruptions to daily routines for households in Aotearoa New Zealand. The research presented here investigates how mealtimes changed for people living in New Zealand during the first COVID-19 lockdown in mid-2020 and sought to determine if household composition type and psychological distress impacted the frequency of engaging in several mealtime behaviors. The COVID Kai Survey collected data using an anonymous, online survey and asked questions on sociodemographic characteristics including household composition, frequency of engaging in different mealtime behaviors before and during lockdown, and psychological distress, which was measured using the Kessler 6 screening tool. The findings of this study shows an increase in the perceived importance of mealtimes (n = 807, 26.9% before lockdown, n = 1,154, 38.5% during lockdown) and an increase in the proportion of the survey respondents who stated that they frequently ate meals at the dinner table (n = 1,343, 44.8% before lockdown, n = 1,481, 49.4% during lockdown). There was a decrease, across all household composition types, in the proportion of respondents who ate out frequently at a restaurant or café (n = 878, 29.3% before lockdown, n = 5, 0.2% during lockdown, P < 0.001). The use of meal kits, e-dining, and eating meals in front of screens is also presented and discussed. All results are discussed with reference to Aotearoa New Zealand's stringent lockdown restrictions. Respondents who experienced psychological distress during lockdown were 1.47 times more likely to consider mealtimes an important part of their day and respondents living in households with one adult and at least one child who also experienced psychological distress were 5.95 times more likely to eat dinner at the dinner table than those who did not report psychological distress. Findings of this study further the understanding of the wider societal impact of COVID-19 lockdown on everyday life.

"It's more personal if you can have that contact with a person": Qualitative study of health information preferences of parents and caregivers of children with obesity in New Zealand.

The objective of this study was to understand how participants referred to a childhood obesity intervention programme prefer to receive health information, and secondly, to determine acceptability of digital technologies such as a social media platform or IT application for programme engagement. This study includes a subset of interviews (n = 64) of a wider study of the barriers and facilitators of engagement in a multidisciplinary healthy lifestyle programme for childhood obesity, based in Taranaki, Aotearoa/New Zealand. The topics of health information and social media and/or app use were covered in 53 and 30 interviews, respectively. Participants were parents and caregivers of children and adolescents referred to the programme, and interviews were mostly conducted in family homes. Findings showed that participants consulted a range of people, places and resources for information about their health, notably the internet, health professionals, and family and friends. Participants reported using the internet to complement or supplement information from health professionals. A strong relationship with health professionals built on trust was important. Use of digital technologies such as an IT application or social media platform for engagement with the programme was generally acceptable, with the caveat that this did not replace face-to-face communication with their primary care provider. In conclusion, the high usage of digital sources of health information requires accurate and reliable information. Digital technologies such as IT applications or social media platforms may have a role in terms of supplementing the patient journey; however, the importance of in-person communication and an ongoing relationship with a health professional or practice remains paramount.

Who We Seek and What We Eat? Sources of Food Choice Inspirations and Their Associations with Adult Dietary Patterns before and during the COVID-19 Lockdown in New Zealand.

Research shows the shaping of food choices often occurs at home, with the family widely recognised as significant in food decisions. However, in this digital age, our eating habits and decision-making processes are also determined by smartphone apps, celebrity chefs, and social media. The 'COVID Kai Survey' online questionnaire assessed cooking and shopping behaviours among New Zealanders during the 2020 COVID-19 'lockdown' using a cross-sectional study design. This paper examines how sources of food choice inspirations (cooking-related advice and the reasons for recipe selection) are related to dietary patterns before and during the lockdown. Of the 2977 participants, those influenced by nutrition and health experts (50.9% before; 53.9% during the lockdown) scored higher for the healthy dietary pattern. Participants influenced by family and friends (35% before; 29% during the lockdown) had significantly higher scores for the healthy and the meat dietary patterns, whereas participants influenced by celebrity cooks (3.8% before; 5.2% during the lockdown) had significantly higher scores in the meat dietary pattern. There was no evidence that associations differed before and during the lockdown. The lockdown was related to modified food choice inspiration sources, notably an increase in 'comforting' recipes as a reason for recipe selection (75.8%), associated with higher scoring in the unhealthy dietary pattern during the lockdown. The lockdown in New Zealand saw an average decrease in nutritional quality of diets in the 'COVID Kai Survey', which could be partly explained by changes in food choice inspiration sources.

Understanding children's perceptions of, and priorities for, healthy neighbourhoods in Aotearoa New Zealand: study protocol for a cross-sectional study.

INTRODUCTION: Neighbourhood environments can have significant and enduring impacts on children's physical, psychological and social health. Environments can impact health through promoting or hindering physical activity, active travel, and healthy eating in addition to opportunities for social interaction, cognitive development, rest and relaxation. There is a paucity of research that has examined neighbourhood and health priorities, strengths and needs from the perspectives of the community, and even less that has focused on the perspectives of children within communities. The aim of this article is to describe the research protocol for a project to gather child-identified needs and strengths-based solutions for promoting child health and well-being in urban neighbourhood environments. METHODS AND ANALYSIS: This participatory research project is designed to partner with children in school settings in Tamaki Makaurau Auckland and Otepoti Dunedin, Aotearoa New Zealand. An abundant communities approach will be used with children to identify needs and strengths related to neighbourhoods and health. Specific methods including collaborative, creative, play-based methods such as concept-mapping activities and co-creation of final dissemination material on the key messages are described. Plans for researcher reflections, data analysis and dissemination are also detailed. ETHICS AND DISSEMINATION: This research has been approved by the University of Auckland Human Participants Ethics Committee. Results will be disseminated through child and researcher co-created output, a technical report and academic journal articles. By using evidence-based child-centred approaches to knowledge generation, we anticipate the research will generate new localised insights about children's preferences and needs for healthy neighbourhoods which will be shared with stakeholders in planning and practice. The detailed session protocol including critical researcher reflections is shared in this manuscript for application, development and refinement in future research.

Bus Stops Near Schools Advertising Junk Food and Sugary Drinks.

Children rarely understand the full extent of the persuasive purpose of advertising on their eating behaviours. Addressing the obesogenic environments in which children live, through a quantification of outdoor advertising, is essential in informing policy changes and enforcing stricter regulations. This research explores the proportion of bus stop advertisements promoting non-core food and beverages within walking distance (500 m) from schools in Auckland, New Zealand while using Google Street View. Information was collected on: school type, decile, address, Walk Score®, and Transit Score for all 573 schools in the Auckland region. Ground-truthing was conducted on 10% of schools and showed an alignment of 87.8%. The majority of advertisements on bus shelters were for non-food items or services (n = 541, 64.3%). Of the advertisements that were for food and/or beverages, the majority were for non-core foods (n = 108, 50.2%). There was no statistically significant difference between the variables core and non-core food and beverages and School decile (tertiles), Walk Score (quintiles), and Transit Score (quintiles). 12.8% of all bus stop advertisements in this study promoted non-core dietary options; highlighting an opportunity for implementing stricter regulations and policies preventing advertising unhealthy food and drink to children in New Zealand.

Deprivation matters: understanding associations between neighbourhood deprivation, unhealthy food outlets, unhealthy dietary behaviours and child body size using structural equation modelling.

BACKGROUND: Children residing in neighbourhoods of high deprivation are more likely to have poorer health, including excess body size. While the availability of unhealthy food outlets are increasingly considered important for excess child body size, less is known about how neighbourhood deprivation, unhealthy food outlets and unhealthy dietary behaviours are interlinked. METHODS: This study involves children aged 8-13 years (n=1029) and resided in Auckland, New Zealand. Unhealthy dietary behaviours (frequency of consumption of unhealthy snacks and drinks) and food purchasing behaviour on the route to and from school were self-reported. Height and waist circumference were measured to calculate waist-to-height ratio (WtHR). Geographic Information Systems mapped neighbourhood deprivation and unhealthy food outlets within individual, child-specific neighbourhood buffer boundaries (800 m around the home and school). Associations between neighbourhood deprivation (calculated using the New Zealand Index of Deprivation 2013), unhealthy food outlets, unhealthy dietary behaviours and WtHR were investigated using structural equation modelling in Mplus V.8.0. Age, sex and ethnicity were included as covariates, and clustering was accounted for at the school level. RESULTS: Structural equation models showed that unhealthy food outlets were unrelated to unhealthy dietary behaviours (estimate 0.029, p=0.416) and excess body size (estimate -0.038, p=0.400). However, greater neighbourhood deprivation and poorer dietary behaviours (estimate -0.134, p=0.001) were associated with greater WtHR (estimate 0.169, p<0.001). CONCLUSION: Excess child body size is associated with neighbourhood deprivation and unhealthy dietary behaviours but not unhealthy outlet density or location of these outlets near home and school.

Migrant caregiving for family members with mild cognitive impairment: an ethnographic study.

BACKGROUND: Migrant families caring for family members with mild cognitive impairment (MCI) face considerable socioeconomic burden and isolation. AIM: To examine the cultural needs, beliefs and health seeking behaviours of migrant Turkish family member caregivers. DESIGN: An ethnographic approach was used employing in depth interviews. METHODS: Turkish caregivers residing in Melbourne, Australia were purposively sampled. Ten participants undertook face-to-face interviews in Turkish and English, followed by coding, transcription and thematic analysis. RESULTS: Common themes were: (i) characteristics of MCI; (ii) care complicates our lives; (iii) beneficial coping strategies; (iv) adherence to cultural beliefs; (v) an uncertain future; (vi) interfacing with community health providers: need to understand Turkish culture (vii) need for long-term support. Migrant caregivers voiced undergoing considerable stress exacerbated by their cultural obligations. CONCLUSIONS: Establishing ethnically appropriate community support groups and advocating for a health workforce tier of representative migrant health care workers is recommended as a new role for community nurses.

Neighbourhoods for Active Kids: study protocol for a cross-sectional examination of neighbourhood features and children's physical activity, active travel, independent mobility and body size.

INTRODUCTION: New Zealand children's physical activity, including independent mobility and active travel, has declined markedly over recent decades. The Neighbourhoods for Active Kids (NfAK) study examines how neighbourhood built environments are associated with the independent mobility, active travel, physical activity and neighbourhood experiences of children aged 9-12 years in primary and intermediate schools across Auckland, New Zealand's largest city. METHODS AND ANALYSIS: Child-specific indices of walkability, destination accessibility and traffic exposure will be constructed to measure the built environment in 8 neighbourhoods in Auckland. Interactive online-mapping software will be used to measure children's independent mobility and transport mode to destinations and to derive measures of neighbourhood use and perceptions. Physical activity will be measured using 7-day accelerometry. Height, weight and waist circumference will be objectively measured. Parent telephone interviews will collect sociodemographic information and parent neighbourhood perceptions. Interviews with school representative will capture supports and barriers for healthy activity and nutrition behaviours at the school level. Multilevel modelling approaches will be used to understand how differing built environment variables are associated with activity, neighbourhood experiences and health outcomes. DISCUSSION: We anticipate that children who reside in neighbourhoods considered highly walkable will be more physically active, accumulate more independent mobility and active travel, and be more likely to have a healthy body size. This research is timely as cities throughout New Zealand develop and implement plans to improve the liveability of intensifying urban neighbourhoods. Results will be disseminated to participants, local government agencies and through conventional academic avenues.

The development of a model of community garden benefits to wellbeing.

Community gardens contribute to community wellbeing by influencing the nutritional and social environment. The aim of this research was to develop a model that communicates the many benefits of community garden participation as described in the academic literature, to a diverse audience of laypersons. This model is an example of effective knowledge translation because the information is able to be more than simply understood but also practically applied. From April to August 2015, a model depicting the many benefits of community garden participation was prepared based on a global, critical literature review. The wellbeing benefits from community garden participation have been grouped into factors influencing the nutritional health environment and factors influencing the social environment. The graphic chosen to form the basis of the model is a fractal tree of life. In October 2015, to test the models comprehension and to obtain stakeholder feedback this model was presented to a diverse group of community members, leaders and workers from the Tamaki region of Auckland, New Zealand. The model we present here effectively and clearly translates knowledge obtained from the academic literature on the benefits to wellbeing from community garden participation into a tool that can be used, adapted and developed by community groups, government agencies and health promoters.