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The NOURISH:ECE project explored the role of maternal and child health nurses (MCHNs) in early childhood education and care (ECEC) through the design and pilot of professional learning (PL) regarding responsive feeding practices. Eight focus groups were conducted in Queensland (MCHNs, n = 20; educators, n = 29) to explore attitudes regarding partnerships, PL, and feeding practices. Subsequently, a PL module was developed - incorporating videos, group discussion and reflection -- and delivered to 64 educators by a MCHN. Educator practices were compared pre- and post-PL. The proportion of meals at which an educator was observed to use responsive feeding practices increased (praise for eating healthy foods, 11.3%-29.2%), but educators were observed pressuring children to eat more often (19.9%-40.1%). NOURISH:ECE provided promising preliminary results regarding PL. However, adequate resourcing and workforce issues in both sectors are barriers to developing effective partnerships across education and health.

Early Childhood Education and Care (ECEC) services are vital in the establishment of optimal infant and young child feeding (IYCF) practices and long-term health. This qualitative study, informed by Social Cognitive Theory, aimed to describe ECEC infant feeding environments. Nineteen formal long day care and family day care ECEC services and 124 educators in metropolitan and regional Queensland, Australia participated in interviews and professional conversations. Inductive and deductive analysis identified three key themes: 'agency', 'IYCF environment', and 'monitoring/surveillance'. This research has identified the key environmental, behavioural and cognitive factors that contribute to optimal IYCF practices in Australian ECEC. Tensions and negotiation between educators, parents, infants and the regulatory framework operate to develop collective agency. Key recommendations are: (1) increasing the visibility of infants in ECEC policy frameworks; and (2) building educator and parent self-efficacy in supporting infant agency in order to meet shared goals related to optimal infant health and well-being.

Information about the Vietnamese physical education (PE) programme is limited due to a lack of relevant studies. Using the Health Optimising Physical Education as a conceptual framework, this study examined students' physical activity (PA) levels in the fifth-grade PE programme in Vietnam and barriers to programme implementation. Eight schools (28 PE classes) were randomly selected for assessing students' PA levels, lesson context, and PA promotion during PE lessons using the System for Observing Fitness Instruction Time. In-depth interviews were also conducted with school administrators, PE instructors, and classroom teachers using semi-structured guides to examine barriers influencing the implementation of the current PE programme. Results showed students spent 33% of PE time in moderate-vigorous physical activity (MVPA), which is less than the international recommendation of 50%. The amount of MVPA varied by school type, instructor gender and qualification. Programme implementation was negatively affected by the current structure that limits autonomy, a proclivity for a "one size fits all" approach to teaching PE, and limited motivation for PE instructors to improve their teaching. The low perceived value of PE, lack of support and professional development for existing PE instructors, and an over-emphasis on sports training due to available financial incentives were also identified as important barriers that affected programme implementation. Addressing these barriers could help improve the quality of the Vietnamese PE programme.

Household food insecurity has significant negative implications across the lifespan. While routine screening is recommended, particularly in healthcare, guidelines are lacking on selection of screening tools and best-practice implementation across different contexts in non-stigmatizing ways. The objective of this scoping review was to synthesize evidence on household food insecurity screening tools, including psychometrics, implementation in a range of settings, and experiences of carrying out screening or being screened. Four electronic databases were searched for studies in English published from 1990 until June 2023. A total of 58 papers were included, 21 of which focused on tool development and validation, and 37 papers described implementation and perceptions of screening. Most papers were from the USA and described screening in healthcare settings. There was a lack of evidence regarding screening in settings utilized by Indigenous people. The two-item Hunger Vital Sign emerged as the most used and most valid tool across settings. While there is minimal discomfort associated with screening, screening rates in practice are still low. Barriers and facilitators of screening were identified at the setting, system, provider, and recipient level and were mapped onto the COM-B model of behavior change. This review identifies practical strategies to optimize screening and disclosure. [ABSTRACT FROM AUTHOR]

Background: Design thinking is an iterative process that innovates solutions through a person‐centric approach and is increasingly used across health contexts. The person‐centric approach lends itself to working with groups with complex needs. One such group is families experiencing economic hardship, who are vulnerable to food insecurity and face challenges with child feeding. Objective: This study describes the application of a design thinking framework, utilizing mixed methods, including co‐design, to develop a responsive child‐feeding intervention for Australian families—'Eat, Learn, Grow'. Methods: Guided by the five stages of design thinking, which comprises empathizing, defining, ideating, prototyping, and testing. We engaged with parents/caregivers of a child aged 6 months to 3 years through co‐design workshops (n = 13), direct observation of mealtimes (n = 10), a cross‐sectional survey (n = 213) and semistructured interviews (n = 29). Findings across these methods were synthesized using affinity mapping to clarify the intervention parameters. Parent user testing (n = 12) was conducted online with intervention prototypes to determine acceptability and accessibility. A co‐design workshop with child health experts (n = 9) was then undertaken to review and co‐design content for the final intervention. Results: Through the design thinking process, an innovative digital child‐feeding intervention was created. This intervention utilized a mobile‐first design and consisted of a series of short and interactive modules that used a learning technology tool. The design is based on the concept of microlearning and responds to participants' preferences for visual, brief and plain language information accessed via a mobile phone. User testing sessions with parents and the expert co‐design workshop indicated that the intervention was highly acceptable. Conclusions: Design thinking encourages researchers to approach problems creatively and to design health interventions that align with participant needs. Applying mixed methods—including co‐design— within this framework allows for a better understanding of user contexts, preferences and priorities, ensuring solutions are more acceptable and likely to be engaged. [ABSTRACT FROM AUTHOR]

Background/objectives Vietnam is undergoing a nutrition transition, which is leading to marked shifts in body size at the population level, but up-to-date data are lacking. We therefore quantified the prevalence of undernutrition (stunting and thinness) and overnutrition (overweight, obesity, and abdominal obesity) in school-aged children in Ho Chi Minh City (HCMc), Vietnam, and compared this with previous estimates. Subjects/methods A cross-sectional survey of 10,949 children (6-18 years old) from 30 schools in HCMc, Vietnam in 2014-2015 was used to ascertain the nutritional status of children and adolescents. Different international classification systems (WHO, IOTF, IOTF for Asian children) were used to assess the prevalence of under and overnutrition. Comparisons were made with previous surveys in HCMc. Results Regardless of definitions used, the prevalence of overnutrition was high, particularly in primary school children (20-30% were overweight, 20-30% were obese, and 50% had abdominal obesity), in boys, and urban children. Undernutrition was more prevalent in high-school children (8% were stunted, and 6-18% were thin, versus 2 and 2-9% in primary children, respectively), and in rural areas. Comparisons with previous surveys indicated substantial increases in overnutrition and decreased in undernutrition since 2009 in all age groups. Conclusions Overnutrition is increasingly common in school-aged children and adolescents in HCMc, while over and undernutrition continue to coexist. These findings highlight an urgent need for greater efforts to control malnutrition in children in HCMc., Author(s): Thi My Thien Mai [sup.1] [sup.2], Ngoc Oanh Pham [sup.1], Thi Minh Hanh Tran [sup.3], Peter Baker [sup.4], Danielle Gallegos [sup.2], Thi Ngoc Diep Do [sup.2], Jolieke C. van [...]

There has been a recent surge of interest in cooking skills in a diverse range of fields, such as health, education and public policy. There appears to be an assumption that cooking skills are in decline and that this is having an adverse impact on individual health and well-being, and family wholesomeness. The problematisation of cooking skills is not new, and can be seen in a number of historical developments that have specified particular pedagogies about food and eating. The purpose of this paper is to examine pedagogies on cooking skills and the importance accorded them. The paper draws on Foucault's work on governmentality. By using examples from the USA, UK and Australia, the paper demonstrates the ways that authoritative discourses on the know how and the know what about food and cooking--called here "savoir fare"--are developed and promulgated. These discourses, and the moral panics in which they are embedded, require individuals to make choices about what to cook and how to cook, and in doing so establish moral pedagogies concerning good and bad cooking. The development of food literacy programmes, which see cooking skills as life skills, further extends the obligations to "cook properly" to wider populations. The emphasis on cooking knowledge and skills has ushered in new forms of government, firstly, through a relationship between expertise and politics which is readily visible through the authority that underpins the need to develop skills in food provisioning and preparation; secondly, through a new pluralisation of "social" technologies which invites a range of private-public interest through, for example, television cooking programmes featuring cooking skills, albeit it set in a particular milieu of entertainment; and lastly, through a new specification of the subject can be seen in the formation of a choosing subject, one which has to problematise food choice in relation to expert advice and guidance. A governmentality focus shows that as discourses develop about what is the correct level of "savoir fare", new discursive subject positions are opened up. Armed with the understanding of what is considered expert-endorsed acceptable food knowledge, subjects judge themselves through self-surveillance. The result is a powerful food and family morality that is both disciplined and disciplinary.

Early infant feeding practices are a critical part of education and care programs within Early Childhood Education and Care (ECEC) settings. With an increasing number of children attending ECEC services from a young age, adherence to best practice infant feeding will improve long-term health outcomes. This paper uses inductive and deductive thematic analysis informed by Social Cognitive Theory and inductive content analysis, to describe Australian infant feeding nutrition ECEC policy environments. Key Australian ECEC policy documents were analysed, revealing the invisibility of infants generally, and infant feeding specifically, in current quality standards. This was followed by analysis of 28 nutrition or infant feeding policies from 19 centre- and home-based ECEC services impacting over 1500 children in Queensland Australia. Five key themes characterising the content of service policies impacting infant feeding emerged: documentation, values, curriculum and pedagogy, supportive environments, and working in partnerships with parents. Service policies are required by legislation and set the foundation for a safe, supportive environment for infant feeding. The lack of infant feeding practice examples and invisibility of infants in legislation increase ambiguity, and health and safety risks. Opportunities exist to adopt separate infant feeding policies which will assist the provision of quality practice for the short-term and long-term optimal health of infants in ECEC settings.