127 research outputs found
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Food projects in London: Lessons for policy and practice - A hidden sector and the need for 'more unhealthy puddings ... sometimes'
Background and Objective: Successive governments have promoted local action to address food components of public health. This article presents findings from research commissioned by the (then) London NHS Office, scoping the range of food projects in the London area, and the potential challenges to public health practice.
Methods: Research followed four overlapping phases with a London focus: (1) a systemized review of the literature, (2) analysis of health authority Health Improvement Plans (HImPs) and Coronary Heart Disease (CHD) local implementation plans and Health Action Zone reports, (3) a scoping exercise of`food projects' and community-based participatory projects with a food focus using food databases and directories, and (4) 29 in-depth interviews with individuals responsible for commissioning and running projects.
Results: There were, in 2001/2, a variety of food projects in the London area, ranging from small-scale social enterprises to those whose turnover marked them out as small businesses. There was a significant human resource cost in maintaining and setting up such projects both from NHS staff and in terms of volunteer and paid labour. The lack of an overall or area-based approach to food policy development in London was apparent, and little thought seemed to have been given to creating a supportive policy environment. Food projects often existed as isolated entities in a borough or health authority area, with short-term funding and little systemic long-term support. The majority employed what might best be called health education approaches. This is now partially addressed by the draft London Food Strategy.
Conclusions: Food projects run by local professionals and/or volunteers operated within an isolated policy and suffered from a lack of support both from financial and human resources perspectives. The potential for long-term delivery of improved health was unrealized, as was their potential contribution to a London-wide food economy and to London food policy
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Access to healthy foods: Part I. Barriers to accessing healthy foods: Differentials by gender, social class, income and mode of transport
This paper examines the issues of access to food and the influences people face when shopping for a healthy food basket. It uses data from the Health Edu cation Authority's 1993 Health and Lifestyles Survey to examine the barriers people face in accessing a healthy diet. The main findings are that access to food is primarily determined by income, and this is in turn closely related to physical resources available to access healthy food. There is an associated class bias over access to sources of healthy food. The poor have less access to a car, find it harder to get to out-of-town shopping centres and thus are less able to carry and transport food in bulk. The majority of people shop in supermarkets as they report that local shops do not provide the services people demand and that food choice and quality are limited. In tackling food poverty and pro moting healthy eating, health promotion practice needs to address these struc tural issues as opposed to relying on psycho-social models of education based on the provision of information and choice
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Access to shops: The views of low-income shoppers
Concern is mounting as the retail stranglehold upon access to food grows. Research on the implications of restructuring retailing and health inequality has failed to involve low-income consumers in this debate. This paper reports on an exercise conducted for the UK Government's, Social Exclusion Unit's Policy Action Team on Access to Shops. The survey provides a useful baseline of the views of low-income groups in England. The choices that people on low income can make were found to be dominated by certain factors such as income and, most importantly, transport. Consumers reported varying levels of satisfaction with retail provision. The findings suggest gaps between what people have, what they want and what the planning process does and does not offer them. Better policy and processes are needed to include and represent the interests of low-income groups
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A tale of two cities: A study of access to food, lessons for public health practice
Objectives: To map food access in the city of Preston in the north-west of England in order to determine access, availability and affordability of healthy food options.
Design and methodology: The research design employed a number of distinct methods including: surveys of shops; interviews with local people and shopkeepers; a cost and availability survey of shops in two deprived areas of Preston —Deepdale and Ingol — the former with a majority South Asian population; and the use of geographical information systems to map access and availability.
Results:
• Preston had more fast food outlets (186) [not including restaurants who operate takeaways] than general groceries outlets (165).
• There were more local shops selling affordable food in the area with the high South Asian population than in Ingol with its white working class population. There were clear gaps in provision and access in the white working class area (Ingol), with shops being more than 500 metres away from where people lived. Shops in this area stocked more familiar ‘British foods’ and less specialist or fresh produce.
• Analysis of the availability of some healthy options such as brown bread, wholemeal pasta and brown rice showed that they were not widely available within shops in the two areas.
• The price of the ‘White British’ basket in Ingol was £70.61 (cheapest price). For comparable goods in Deepdale, using the most expensive shopping basket, the price for the same basket was £42.47.
• A South Asian family shopping at a major national supermarket outlet in Deepdale would pay £47.05. Using local shops they could pay between £38.59 and £44.28 by seeking out the best bargains in five shops (including some top-up items from a national supermarket).
• At the time of the research a mother with two children, entitled to income support and child allowance, would have to spend 28—32 per cent of her income in local shops and 34 per cent in a supermarket to buy a basket of healthy goods.
Conclusions: There is a need to engage proactively with the location of shops in urban areas, to ensure they offer a healthy range of options and are sited near to where people live. The number of fast food outlets needs to be controlled and the food they offer improved.This latter issue of the number of outlets and quality of fast food contributes to an overall obesogenic environment. Access to food is heavily dependent on having access to a car; local shopping and the quality of food on offer are important for key groups such as those on benefits, the elderly, single parents and others with limited access to a car. Proactive policy solutions may lie with the engagement of health agencies with the planning processes in local authorities to ensure that the food retail environment reflects a healthy choice. Local area agreements between health agencies and local authorities offer a way forward, in that they can take into account the expressed needs of local residents
Increasing intention to cook from basic ingredients: A randomised controlled study
The promotion of home cooking is a strategy used to improve diet quality and health. However, modern home cooking typically includes the use of processed food which can lead to negative outcomes including weight gain. In addition, interventions to improve cooking skills do not always explain how theory informed their design and implementation. The Behaviour Change Technique (BCT) taxonomy successfully employed in other areas has identified essential elements for interventions. This study investigated the effectiveness of different instructional modes for learning to cook a meal, designed using an accumulating number of BCTs, on participant's perceived difficulty, enjoyment, confidence and intention to cook from basic ingredients.
141 mothers aged between 20 and 39 years from the island of Ireland were randomised to one of four conditions based on BCTs (1) recipe card only [control condition]; (2) recipe card plus video modelling; (3) recipe card plus video prompting; (4) recipe card plus video elements. Participants rated their enjoyment, perceived difficulty, confidence and intention to cook again pre, mid and post experiment. Repeated one-way factorial ANOVAs, correlations and a hierarchical regression model were conducted.
Despite no significant differences between the different conditions, there was a significant increase in enjoyment (PÂ <Â 0.001), confidence (PÂ <Â 0.001) and intention to cook from basics again (PÂ <Â 0.001) and a decrease in perceived difficulty (PÂ =Â 0.001) after the experiment in all conditions. Intention to cook from basics pre-experiment, and confidence and enjoyment (both pre and post experiment) significantly contributed to the final regression model explaining 42% of the variance in intention to cook from basics again.
Cooking interventions should focus on practical cooking and increasing participants' enjoyment and confidence during cooking to increase intention to cook from basic ingredients at home
Barriers and facilitators to cooking from 'scratch' using basic or raw ingredients: A qualitative interview study
BACKGROUND: Previous research has highlighted an ambiguity in understanding cooking related terminology and a number of barriers and facilitators to home meal preparation. However, meals prepared in the home still include convenience products (typically high in sugars, fats and sodium) which can have negative effects on health. Therefore, this study aimed to qualitatively explore: (1) how individuals define cooking from 'scratch', and (2) their barriers and facilitators to cooking with basic ingredients.
METHODS: 27 semi-structured interviews were conducted with participants (aged 18-58 years) living on the island of Ireland, eliciting definitions of 'cooking from scratch' and exploring the reasons participants cook in a particular way. The interviews were professionally transcribed verbatim and Nvivo 10 was used for an inductive thematic analysis.
RESULTS: Our results highlighted that although cooking from 'scratch' lacks a single definition, participants viewed it as optimal cooking. Barriers to cooking with raw ingredients included: 1) time pressures; (2) desire to save money; (3) desire for effortless meals; (4) family food preferences; and (5) effect of kitchen disasters. Facilitators included: 1) desire to eat for health and well-being; (2) creative inspiration; (3) ability to plan and prepare meals ahead of time; and (4) greater self-efficacy in one's cooking ability.
CONCLUSIONS: Our findings contribute to understanding how individuals define cooking from 'scratch', and barriers and facilitators to cooking with raw ingredients. Interventions should focus on practical sessions to increase cooking self-efficacy; highlight the importance of planning ahead and teach methods such as batch cooking and freezing to facilitate cooking from scratch
All in it Together? Community Food Aid in a Multi-Ethnic Context
This paper derives from a study of community food aid in a multi-ethnic, multi-faith city in the North of England. The paper begins to make sense of the diversity of types of food insecurity assistance, examines the potential exclusion of certain groups from receipt of food aid, and explores the relationship between food aid providers and the state. Faith-based food aid is common in the case study area, particularly among food bank provision to the most 'destitute' clients. While food aid is adopting service responsibilities previously borne by the state, this does not imply an extension of the 'shadow state'. Rather, it appears reflective of a pre-welfare state system of food distribution, supported by religious institutions and individual/business philanthropy, but adapted to be consistent with elements of the 'Big Society' narrative. Most faith-based providers are Christian. There is little Muslim provision of (or utilisation of) food aid, despite the local demographic context. This raises concerns as to the unintentional exclusion of ethnic and religious groups, which we discuss in the concluding sections
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