Food, Connection and Care: Perspectives of Service Providers in Alternative Education and Training Settings

While the formal school system has been the focus for researchers, practitioners and policy-makers for food and nutrition-related research and interventions, there has been less attention to the Alternative Education and Training (AET) sector. A qualitative social ecological examination of food issues among marginalised young people in Irish alternative education and training settings was conducted through interviews with 15 service providers. We aimed to provide insight into the everyday food practices of young people in AETs, understand educational responses to food and eating in AETs, and determine how these educational responses might be optimised. Through a socio-ecological framework, we examined service providers’ accounts beyond individual (intrapersonal) factors that related to young people’s dietary practices, to include interpersonal, organisational, community and policy-related factors. Across the socio-ecological framework analysis was organised in terms of four broad themes: (i) food practices of young people in AET; (ii) food and connection; (iii) food, place and community; (iv) teaching and learning about food and health to marginalised you in marginalised education settings. Food provision was central to AETs’ activities and impacted on young people’s home life and employment prospects. AETs experienced challenges: food provision resources; expertise to address food issues; and the tension between AETs’ holistic educational response to food and their obligation to provide certification and employment pathways. There is an opportunity to harness the interest in food, education and empowerment in these settings to bridge the social and nutritional dimensions of food for/with young people

Limited evidence exists on the effectiveness of education and training interventions on trial recruitment; a systematic review

Objective: To examine the effectiveness of education and training interventions on recruitment to randomised and non-randomised trials. Study Design and Setting: A systematic review of the effectiveness of education and training interventions for recruiters to trials. The review included randomised and non-randomised controlled trials of any type of education and training intervention for recruiters to trials, within any healthcare field. The primary outcome was recruitment rates, and secondary outcomes were: quality of informed consent, recruiter self-confidence, understanding/knowledge of trial information, numbers of potential trial participants approached, satisfaction with training, retention rates. Results: Of the 19 records reviewed at full text level, six met the inclusion criteria for our review. Due to heterogeneity of outcomes and methods between the included studies, meta-analysis was not possible for the primary outcome. Of the three studies that reported recruitment rates, one favoured the education and training intervention for increased recruitment; the remaining two found no differences between the groups. Of the reported secondary outcomes, quality of informed consent was improved, but no differences between groups in understanding/knowledge of trial information were found. Conclusion: There is limited evidence of effectiveness on the impact of education and training interventions on trial recruitment. Further work on developing a substantial evidence base around the effectiveness of education and training interventions for recruiters to trials is required. Keywords: trial recruitment, educational intervention, training intervention, systematic revie

Time for complete transparency about conflicts of interest in public health nutrition research

We are a group of researchers and academics with decades of experience in the protection and promotion of public health. We are writing to raise our concerns about how conflicts of interest are reported in public health nutrition research. We highlight examples of why it is important to accurately declare such conflicts, as well as providing examples of situations in which conflicts of interest have been inadequately reported. We call on researchers, and others, to be transparent about conflicts of interest in research. Journal editors in particular have an important responsibility in fully understanding how conflicts of interest can impact on research findings. They need to agree and adopt clear guidelines on conflicts of interest and ensure that authors abide by these to facilitate trust in the scientific process and the credibility of published articles.MW holds grants from the UK Medical Research Council to develop guidance on managing interactions between researchers and commercial food and drink companies; and with the UK National Institute of Health Research (NIHR) to evaluate the UK’s Soft Drinks Industry Levy. MW is also funded as Director of NIHR’s Public Health Research Programme

Time for complete transparency about conflicts of interest in public health nutrition research

We are a group of researchers and academics with decades of experience in the protection and promotion of public health. We are writing to raise our concerns about how conflicts of interest are reported in public health nutrition research. We highlight examples of why it is important to accurately declare such conflicts, as well as providing examples of situations in which conflicts of interest have been inadequately reported. We call on researchers, and others, to be transparent about conflicts of interest in research. Journal editors in particular have an important responsibility in fully understanding how conflicts of interest can impact on research findings and interpretations. They need to agree and adopt clear guidelines on conflicts of interest and ensure that authors abide by these to facilitate trust in the scientific process and the credibility of published articles.</ns4:p

Food, connection and care: perspectives of service providers in alternative education and training settings

While the formal school system has been the focus for researchers, practitioners and policy-makers for food and nutrition-related research and interventions, there has been less attention to the Alternative Education and Training (AET) sector. A qualitative social ecological examination of food issues among marginalised young people in Irish alternative education and training settings was conducted through interviews with 15 service providers. We aimed to provide insight into the everyday food practices of young people in AETs, understand educational responses to food and eating in AETs, and determine how these educational responses might be optimised. Through a socio-ecological framework, we examined service providers accounts beyond individual (intrapersonal) factors that related to young people s dietary practices, to include interpersonal, organisational, community and policy-related factors. Across the socio-ecological framework analysis was organised in terms of four broad themes: (i) food practices of young people in AET; (ii) food and connection; (iii) food, place and community; (iv) teaching and learning about food and health to marginalised you in marginalised education settings. Food provision was central to AETs activities and impacted on young people s home life and employment prospects. AETs experienced challenges: food provision resources; expertise to address food issues; and the tension between AETs holistic educational response to food and their obligation to provide certification and employment pathways. There is an opportunity to harness the interest in food, education and empowerment in these settings to bridge the social and nutritional dimensions of food for/with young people.This paper is based upon work funded by Safefood. We are grateful to the young people and service providers who participated in this study and to the Study Advisory Group for their interest and support during the course of the study.peer-reviewe

Obesity prevention during early life: Developing the evidence base to maximise the effectiveness of interventions delivered by health professionals

Background: Childhood obesity is a global public health challenge. Research priorities have not been established for obesity prevention research across childhood, however. Coproduction of research priorities leads to research which may be more translatable to policy and practice. Childhood obesity prevention is advocated, particularly during the first 1,000 days – the period between conception and a child’s second birthday. This is a critical window of opportunity to promote healthy growth and associated behaviours. Health professionals can play an important role in part due to the large number of routine contacts they have with parents. While there is some evidence of the effectiveness of health professional delivered interventions in impacting on obesity-related outcomes, reviews have not examined the impact of provider type, and the active ingredients of interventions have not been explored. The extent to which interventions are generalisable to populations or settings beyond those in the original study is also unclear. Furthermore, there is an absence of research on parental views and experiences of early life health professional-delivered obesity prevention interventions. Aims: The aim of this research is to examine opportunities for, and the effectiveness of, interventions delivered by health professionals during the first 1,000 days which aim to prevent childhood obesity. This will provide a basis for the development, adaptation and/or scale-up of future interventions. Methods: A mixed methods approach was taken. In study 1, a nominal group technique was used to co-produce research priorities, and generate information on facilitators and barriers to knowledge translation, in childhood obesity prevention. In study 2a, a systematic review was conducted to examine the effectiveness of health professional-delivered early life obesity prevention interventions, and what behaviour change theories and/or techniques were associated with more effective intervention outcomes. In study 2b, included studies within the systematic review were further examined to determine the extent to which they reported on elements that can be used to inform generalizability across settings and populations. Finally, in study 3, qualitative interviews with parents were conducted to examine their views and experiences of early life interventions to promote healthy growth, particularly those delivered by health professionals. Data were analysed using reflexive thematic analysis. Findings: Key themes identified during the research prioritization exercise were the importance of funding and resources, coproduction of research, and a focus on both implementation research and social determinants within the field of childhood obesity prevention. The systematic review identified 39 trials involving 46 intervention arms. There was some evidence of intervention effectiveness: only four interventions were effective on a primary (adiposity/weight) and secondary (behavioural) outcome measure, while twenty‐two were effective on a behavioural outcome only. Several methodological limitations were noted, impacting on efforts to establish the active ingredients of interventions. Reporting of external validity dimensions varied; elements that were poorly described included: representativeness of individuals and settings, treatment receipt, intervention mechanisms and moderators, cost effectiveness, and intervention sustainability and acceptability. Two central themes were generated from the qualitative data: (1) navigating the uncertainty, stress, worries, and challenges of parenting whilst under scrutiny and (2) accessing support in the broader system. Becoming a parent brings challenges relating to lack of knowledge and/or confidence in this role, and feeling judged for parenting/feeding decisions. Parents require support and face barriers to accessing and engaging with supports and services. They are often in the receiving end of uninformed, conflicting, confusing, changing and/or unsolicited advice. Relationships and relatability are key, and tailored information and support is required. Conclusion: The findings of this research contribute important insights into early life obesity prevention interventions, with implications for the conduct and reporting of research, and knowledge translation efforts. The identified research priorities may help to shape the agendas of funders and researchers, and aid in the conduct of policy-relevant research and the translation of research into practice in childhood obesity prevention. Health professional-delivered early life obesity prevention interventions show some evidence of effectiveness and there is some evidence that more active engagement strategies—such as problem solving, review behavioural goal(s), feedback on behaviour, feedback on outcome(s) of behaviour, and social support (unspecified) — should be incorporated into practice. More emphasis is needed on research designs that consider generalisability, and the reporting of external validity elements. Parents are receptive to, and would welcome, support during this critical time period, particularly around feeding. Such support, however, needs to be practical, realistic, evidence-based, timely, accessible, non-judgemental, and from trusted sources, including both health professionals and peers. Various levels of support and intervention are required, at individual, inter-personal, organisational, community, and policy levels. Interventions to promote healthy growth and related behaviours need to be developed/adapted and implemented in a way that supports parents, their views and circumstances