IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v16y2019i8p1387-d223710.html
   My bibliography  Save this article

Systemic Barriers and Equitable Interventions to Improve Vegetable and Fruit Intake in Children: Interviews with National Food System Actors

Author

Listed:
  • Sarah Gerritsen

    (School of Population Health, University of Auckland, Auckland 1142, New Zealand)

  • Sophia Harré

    (School of Population Health, University of Auckland, Auckland 1142, New Zealand)

  • Boyd Swinburn

    (School of Population Health, University of Auckland, Auckland 1142, New Zealand)

  • David Rees

    (Synergia Consulting Ltd, Auckland 1011, New Zealand)

  • Ana Renker-Darby

    (School of Population Health, University of Auckland, Auckland 1142, New Zealand)

  • Ann E. Bartos

    (School of Environment, University of Auckland, Auckland 1142, New Zealand)

  • Wilma E. Waterlander

    (Department of Public Health, Amsterdam UMC, University of Amsterdam, 1105AZ Amsterdam, The Netherlands)

Abstract

Fruit and vegetable (FV) intake is declining in New Zealand, and over half of New Zealand’s children do not meet the recommendation of two serves of fruit and three serves of vegetables daily (with even lower adherence among children in high-deprivation neighbourhoods). The aim of this study was to map the potential causal pathways explaining this decline and possible actions to reverse it. Semi-structured interviews were held in April–May 2018 with 22 national actors from the produce industry, food distribution and retail sector, government, and NGO health organisations. The qualitative systems dynamics method of cognitive mapping was used to explore causal relationships within the food system that result in low FV intake among children. Barriers and solutions identified by participants were analysed using thematic analysis and according to a public health intervention framework. Participants were in agreement with the goal of improving FV intake for health and economic outcomes, and that health promotion strategies had been ineffectual to date due to multiple systemic barriers. Common barriers discussed were poverty, high food prices, low skills/knowledge, unhealthy food environments, climate change, and urbanization. Solutions with the strongest evidence of efficacy identified by the participants were subsidizing FVs and early childhood interventions to improve FV exposure.

Suggested Citation

  • Sarah Gerritsen & Sophia Harré & Boyd Swinburn & David Rees & Ana Renker-Darby & Ann E. Bartos & Wilma E. Waterlander, 2019. "Systemic Barriers and Equitable Interventions to Improve Vegetable and Fruit Intake in Children: Interviews with National Food System Actors," IJERPH, MDPI, vol. 16(8), pages 1-19, April.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:8:p:1387-:d:223710
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/16/8/1387/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/16/8/1387/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Sharon Friel & Melanie Pescud & Eleanor Malbon & Amanda Lee & Robert Carter & Joanne Greenfield & Megan Cobcroft & Jane Potter & Lucie Rychetnik & Beth Meertens, 2017. "Using systems science to understand the determinants of inequities in healthy eating," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-18, November.
    2. Zaynel Sushil & Stefanie Vandevijvere & Daniel J. Exeter & Boyd Swinburn, 2017. "Food swamps by area socioeconomic deprivation in New Zealand: a national study," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 62(8), pages 869-877, November.
    3. Helen Eyles & Cliona Ni Mhurchu & Nhung Nghiem & Tony Blakely, 2012. "Food Pricing Strategies, Population Diets, and Non-Communicable Disease: A Systematic Review of Simulation Studies," PLOS Medicine, Public Library of Science, vol. 9(12), pages 1-22, December.
    4. Backholer, K. & Beauchamp, A. & Ball, K. & Turrell, G. & Martin, J. & Woods, J. & Peeters, A., 2014. "A framework for evaluating the impact of obesity prevention strategies on socioeconomic inequalities in weight," American Journal of Public Health, American Public Health Association, vol. 104(10), pages 43-50.
    5. Jean Adams & Oliver Mytton & Martin White & Pablo Monsivais, 2016. "Why Are Some Population Interventions for Diet and Obesity More Equitable and Effective Than Others? The Role of Individual Agency," PLOS Medicine, Public Library of Science, vol. 13(4), pages 1-7, April.
    6. Ashkan Afshin & José L Peñalvo & Liana Del Gobbo & Jose Silva & Melody Michaelson & Martin O'Flaherty & Simon Capewell & Donna Spiegelman & Goodarz Danaei & Dariush Mozaffarian, 2017. "The prospective impact of food pricing on improving dietary consumption: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-18, March.
    7. Eden, Colin & Ackermann, Fran, 2018. "Theory into practice, practice to theory: Action research in method development," European Journal of Operational Research, Elsevier, vol. 271(3), pages 1145-1155.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Pippa McKelvie-Sebileau & David Rees & David Tipene-Leach & Erica D’Souza & Boyd Swinburn & Sarah Gerritsen, 2022. "Community Co-Design of Regional Actions for Children’s Nutritional Health Combining Indigenous Knowledge and Systems Thinking," IJERPH, MDPI, vol. 19(9), pages 1-14, April.
    2. Wilma E. Waterlander & Angie Luna Pinzon & Arnoud Verhoeff & Karen den Hertog & Teatske Altenburg & Coosje Dijkstra & Jutka Halberstadt & Roel Hermans & Carry Renders & Jacob Seidell & Amika Singh & M, 2020. "A System Dynamics and Participatory Action Research Approach to Promote Healthy Living and a Healthy Weight among 10–14-Year-Old Adolescents in Amsterdam: The LIKE Programme," IJERPH, MDPI, vol. 17(14), pages 1-18, July.
    3. Catherine Paquet, 2019. "Environmental Influences on Food Behaviour," IJERPH, MDPI, vol. 16(15), pages 1-4, August.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Gesa Czwikla & Filip Boen & Derek G. Cook & Johan de Jong & Tess Harris & Lisa K. Hilz & Steve Iliffe & Richard Morris & Saskia Muellmann & Denise A. Peels & Claudia R. Pischke & Benjamin Schüz & Mart, 2019. "Equity-Specific Effects of Interventions to Promote Physical Activity among Middle-Aged and Older Adults: Development of a Collaborative Equity-Specific Re-Analysis Strategy," IJERPH, MDPI, vol. 16(17), pages 1-17, September.
    2. Saha, Sanjib & Nordström, Jonas & Scarborough, Peter & Thunström, Linda & Gerdtham, Ulf-G., 2021. "In search of an appropriate mix of taxes and subsidies on nutrients and food: A modelling study of the effectiveness on health-related consumption and mortality," Social Science & Medicine, Elsevier, vol. 287(C).
    3. Chiara Milani & Chiara Lorini & Alberto Baldasseroni & Claudia Dellisanti & Guglielmo Bonaccorsi, 2019. "An Umbrella Review and Narrative Synthesis of the Effectiveness of Interventions Aimed at Decreasing Food Prices to Increase Food Quality," IJERPH, MDPI, vol. 16(13), pages 1-15, July.
    4. Liana Jacobi & Nhung Nghiem & Andrés Ramírez‐Hassan & Tony Blakely, 2021. "Food Price Elasticities for Policy Interventions: Estimates from a Virtual Supermarket Experiment in a Multistage Demand Analysis with (Expert) Prior Information," The Economic Record, The Economic Society of Australia, vol. 97(319), pages 457-490, December.
    5. Birgit Kopainsky & Anita Frehner & Adrian Müller, 2020. "Sustainable and healthy diets: Synergies and trade‐offs in Switzerland," Systems Research and Behavioral Science, Wiley Blackwell, vol. 37(6), pages 908-927, November.
    6. Beulah Pretorius & Jane Ambuko & Effie Papargyropoulou & Hettie C. Schönfeldt, 2021. "Guiding Nutritious Food Choices and Diets along Food Systems," Sustainability, MDPI, vol. 13(17), pages 1-19, August.
    7. Anne Magnus & Linda Cobiac & Julie Brimblecombe & Mark Chatfield & Anthony Gunther & Megan Ferguson & Marj Moodie, 2018. "The cost-effectiveness of a 20% price discount on fruit, vegetables, diet drinks and water, trialled in remote Australia to improve Indigenous health," PLOS ONE, Public Library of Science, vol. 13(9), pages 1-19, September.
    8. Leah Salm & Nicholas Nisbett & Katie Cuming & Tabitha Hrynick & Alexandra Lulache & Hayley MacGregor, 2023. "A whole system approach to childhood obesity: how a supportive environment was created in the city of Brighton and Hove, United Kingdom," Food Security: The Science, Sociology and Economics of Food Production and Access to Food, Springer;The International Society for Plant Pathology, vol. 15(4), pages 919-935, August.
    9. Härkänen, Tommi & Kotakorpi, Kaisa & Pietinen, Pirjo & Pirttilä, Jukka & Reinivuo, Heli & Suoniemi, Ilpo, 2014. "The welfare effects of health-based food tax policy," Food Policy, Elsevier, vol. 49(P1), pages 196-206.
    10. Bernardo García Bulle Bueno & Abigail L. Horn & Brooke M. Bell & Mohsen Bahrami & Burçin Bozkaya & Alex Pentland & Kayla Haye & Esteban Moro, 2024. "Effect of mobile food environments on fast food visits," Nature Communications, Nature, vol. 15(1), pages 1-11, December.
    11. Sanjib Saha & Jonas Nordstrom & Ulf-G Gerdtham & Irene Mattisson & Peter M Nilsson & Peter Scarborough, 2019. "Prevention of Cardiovascular Disease and Cancer Mortality by Achieving Healthy Dietary Goals for the Swedish Population: A Macro-Simulation Modelling Study," IJERPH, MDPI, vol. 16(5), pages 1-11, March.
    12. Irz, Xavier & Leroy, Pascal & Réquillart, Vincent & Soler, Louis-Georges, 2015. "Economic assessment of nutritional recommendations," Journal of Health Economics, Elsevier, vol. 39(C), pages 188-210.
    13. Vieira, Fabiana C. & Ferreira, Fernando A.F. & Govindan, Kannan & Ferreira, Neuza C.M.Q.F. & Banaitis, Audrius, 2022. "Measuring urban digitalization using cognitive mapping and the best worst method (BWM)," Technology in Society, Elsevier, vol. 71(C).
    14. Le, Ha N.D. & Gold, Lisa & Abbott, Gavin & Crawford, David & McNaughton, Sarah A. & Mhurchu, Cliona Ni & Pollard, Christina & Ball, Kylie, 2016. "Economic evaluation of price discounts and skill-building strategies on purchase and consumption of healthy food and beverages: The SHELf randomized controlled trial," Social Science & Medicine, Elsevier, vol. 159(C), pages 83-91.
    15. Christina Zorbas & Jennifer Browne & Alexandra Chung & Anna Peeters & Sue Booth & Christina Pollard & Steven Allender & Anna Isaacs & Corinna Hawkes & Kathryn Backholer, 2023. "Shifting the social determinants of food insecurity during the COVID-19 pandemic: the Australian experience," Food Security: The Science, Sociology and Economics of Food Production and Access to Food, Springer;The International Society for Plant Pathology, vol. 15(1), pages 151-170, February.
    16. Sharea Ijaz & James Nobles & Laura Johnson & Theresa Moore & Jelena Savović & Russell Jago, 2021. "Preventing Childhood Obesity in Primary Schools: A Realist Review from UK Perspective," IJERPH, MDPI, vol. 18(24), pages 1-25, December.
    17. Anja Mizdrak & Peter Scarborough & Wilma E Waterlander & Mike Rayner, 2015. "Differential Responses to Food Price Changes by Personal Characteristic: A Systematic Review of Experimental Studies," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-19, July.
    18. Knai, C. & Petticrew, M. & Durand, M.A. & Eastmure, E. & James, L. & Mehrotra, A. & Scott, C. & Mays, N., 2015. "Has a public–private partnership resulted in action on healthier diets in England? An analysis of the Public Health Responsibility Deal food pledges," Food Policy, Elsevier, vol. 54(C), pages 1-10.
    19. Meng Yang & Feng Qiu & Juan Tu, 2022. "Premiums for Residing in Unfavorable Food Environments: Are People Rational?," IJERPH, MDPI, vol. 19(12), pages 1-14, June.
    20. Wiki, Jesse & Kingham, Simon & Campbell, Malcolm, 2021. "A geospatial analysis of Type 2 Diabetes Mellitus and the food environment in urban New Zealand," Social Science & Medicine, Elsevier, vol. 288(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:16:y:2019:i:8:p:1387-:d:223710. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.