Cargando…

Participatory prioritisation of interventions to improve primary school food environments in Gauteng, South Africa

BACKGROUND: In South Africa, overweight and obesity affect 17% of children aged 15–18. School food environments play a vital role in children’s health, influencing dietary behaviours and resulting in high obesity rates. Interventions targeting schools can contribute to obesity prevention if evidence...

Descripción completa

Detalles Bibliográficos
Autores principales: Erzse, Agnes, Karim, Safura Abdool, Rwafa-Ponela, Teurai, Kruger, Petronell, Hofman, Karen, Foley, Louise, Oni, Tolu, Goldstein, Susan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10308686/
https://www.ncbi.nlm.nih.gov/pubmed/37386466
http://dx.doi.org/10.1186/s12889-023-16101-z
_version_ 1785066298132135936
author Erzse, Agnes
Karim, Safura Abdool
Rwafa-Ponela, Teurai
Kruger, Petronell
Hofman, Karen
Foley, Louise
Oni, Tolu
Goldstein, Susan
author_facet Erzse, Agnes
Karim, Safura Abdool
Rwafa-Ponela, Teurai
Kruger, Petronell
Hofman, Karen
Foley, Louise
Oni, Tolu
Goldstein, Susan
author_sort Erzse, Agnes
collection PubMed
description BACKGROUND: In South Africa, overweight and obesity affect 17% of children aged 15–18. School food environments play a vital role in children’s health, influencing dietary behaviours and resulting in high obesity rates. Interventions targeting schools can contribute to obesity prevention if evidence-based and context-specific. Evidence suggests that current government strategies are inadequate to ensure healthy school food environments. The aim of this study was to identify priority interventions to improve school food environments in urban South Africa using the Behaviour Change Wheel model. METHODS: A three-phased iterative study design was implemented. First, we identified contextual drivers of unhealthy school food environments through a secondary framework analysis of 26 interviews with primary school staff. Transcripts were deductively coded in MAXQDA software using the Behaviour Change Wheel and the Theoretical Domains Framework. Second, to identify evidence-based interventions, we utilised the NOURISHING framework and matched interventions to identified drivers. Third, interventions were prioritised using a Delphi survey administered to stakeholders (n = 38). Consensus for priority interventions was defined as an intervention identified as being 'somewhat' or ‘very' important and feasible with a high level of agreement (quartile deviation ≤ 0.5). RESULTS: We identified 31 unique contextual drivers that school staff perceived to limit or facilitate a healthy school food environment. Intervention mapping yielded 21 interventions to improve school food environments; seven were considered important and feasible. Of these, the top priority interventions were to: 1) “regulate what kinds of foods can be sold at schools”, 2) “train school staff through workshops and discussions to improve school food environment”, and affix 3) “compulsory, child-friendly warning labels on unhealthy foods”. CONCLUSION: Prioritising evidence-based, feasible and important interventions underpinned by behaviour change theories is an important step towards enhanced policy making and resource allocation to tackle South Africa’s childhood obesity epidemic effectively. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-023-16101-z.
format Online
Article
Text
id pubmed-10308686
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-103086862023-06-30 Participatory prioritisation of interventions to improve primary school food environments in Gauteng, South Africa Erzse, Agnes Karim, Safura Abdool Rwafa-Ponela, Teurai Kruger, Petronell Hofman, Karen Foley, Louise Oni, Tolu Goldstein, Susan BMC Public Health Research BACKGROUND: In South Africa, overweight and obesity affect 17% of children aged 15–18. School food environments play a vital role in children’s health, influencing dietary behaviours and resulting in high obesity rates. Interventions targeting schools can contribute to obesity prevention if evidence-based and context-specific. Evidence suggests that current government strategies are inadequate to ensure healthy school food environments. The aim of this study was to identify priority interventions to improve school food environments in urban South Africa using the Behaviour Change Wheel model. METHODS: A three-phased iterative study design was implemented. First, we identified contextual drivers of unhealthy school food environments through a secondary framework analysis of 26 interviews with primary school staff. Transcripts were deductively coded in MAXQDA software using the Behaviour Change Wheel and the Theoretical Domains Framework. Second, to identify evidence-based interventions, we utilised the NOURISHING framework and matched interventions to identified drivers. Third, interventions were prioritised using a Delphi survey administered to stakeholders (n = 38). Consensus for priority interventions was defined as an intervention identified as being 'somewhat' or ‘very' important and feasible with a high level of agreement (quartile deviation ≤ 0.5). RESULTS: We identified 31 unique contextual drivers that school staff perceived to limit or facilitate a healthy school food environment. Intervention mapping yielded 21 interventions to improve school food environments; seven were considered important and feasible. Of these, the top priority interventions were to: 1) “regulate what kinds of foods can be sold at schools”, 2) “train school staff through workshops and discussions to improve school food environment”, and affix 3) “compulsory, child-friendly warning labels on unhealthy foods”. CONCLUSION: Prioritising evidence-based, feasible and important interventions underpinned by behaviour change theories is an important step towards enhanced policy making and resource allocation to tackle South Africa’s childhood obesity epidemic effectively. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-023-16101-z. BioMed Central 2023-06-29 /pmc/articles/PMC10308686/ /pubmed/37386466 http://dx.doi.org/10.1186/s12889-023-16101-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Erzse, Agnes
Karim, Safura Abdool
Rwafa-Ponela, Teurai
Kruger, Petronell
Hofman, Karen
Foley, Louise
Oni, Tolu
Goldstein, Susan
Participatory prioritisation of interventions to improve primary school food environments in Gauteng, South Africa
title Participatory prioritisation of interventions to improve primary school food environments in Gauteng, South Africa
title_full Participatory prioritisation of interventions to improve primary school food environments in Gauteng, South Africa
title_fullStr Participatory prioritisation of interventions to improve primary school food environments in Gauteng, South Africa
title_full_unstemmed Participatory prioritisation of interventions to improve primary school food environments in Gauteng, South Africa
title_short Participatory prioritisation of interventions to improve primary school food environments in Gauteng, South Africa
title_sort participatory prioritisation of interventions to improve primary school food environments in gauteng, south africa
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10308686/
https://www.ncbi.nlm.nih.gov/pubmed/37386466
http://dx.doi.org/10.1186/s12889-023-16101-z
work_keys_str_mv AT erzseagnes participatoryprioritisationofinterventionstoimproveprimaryschoolfoodenvironmentsingautengsouthafrica
AT karimsafuraabdool participatoryprioritisationofinterventionstoimproveprimaryschoolfoodenvironmentsingautengsouthafrica
AT rwafaponelateurai participatoryprioritisationofinterventionstoimproveprimaryschoolfoodenvironmentsingautengsouthafrica
AT krugerpetronell participatoryprioritisationofinterventionstoimproveprimaryschoolfoodenvironmentsingautengsouthafrica
AT hofmankaren participatoryprioritisationofinterventionstoimproveprimaryschoolfoodenvironmentsingautengsouthafrica
AT foleylouise participatoryprioritisationofinterventionstoimproveprimaryschoolfoodenvironmentsingautengsouthafrica
AT onitolu participatoryprioritisationofinterventionstoimproveprimaryschoolfoodenvironmentsingautengsouthafrica
AT goldsteinsusan participatoryprioritisationofinterventionstoimproveprimaryschoolfoodenvironmentsingautengsouthafrica